Diabetes Mellitus Overview
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Questions and Answers

What is the mechanism of action for sulfonylureas?

  • Inhibit gluconeogenesis in the liver
  • Increase insulin sensitivity in muscle tissues
  • Slow down gastric emptying
  • Stimulate insulin release from the pancreas (correct)

    • What is the peak time for Humulin 70/30 insulin?

  • 4-12 hours
  • 20-24 hours
  • 30-90 minutes
  • 2-5 hours (correct)

    • Which of the following correctly describes the action of insulin on potassium levels?

  • Has no effect on potassium levels
  • Causes potassium retention in the body
  • Increases potassium excretion in urine
  • Decreases potassium levels by driving it into cells (correct)

    • What is the duration of action for glargine insulin?

    <p>18-24 hours</p> Signup and view all the answers

    Which insulin type is characterized as intermediate-acting and appears cloudy?

    <p>NPH</p> Signup and view all the answers

    What potential complication is associated with insulin use that includes muscle cramping?

    <p>Hypokalemia</p> Signup and view all the answers

    When should sulfonylureas be administered in relation to meals?

    <p>30 minutes before meals</p> Signup and view all the answers

    Which of the following medications can potentially raise blood glucose levels?

    <p>Glucocorticoids</p> Signup and view all the answers

    Which class of medications does Glyburide belong to?

    <p>Sulfonylureas</p> Signup and view all the answers

    What is the hemoglobin A1c level indicating diabetes?

    <p>6.5% or greater</p> Signup and view all the answers

    What type of insulin is typically administered with meals to control postprandial blood glucose levels?

    <p>Rapid-acting insulin</p> Signup and view all the answers

    Which of the following insulin types is classified as long-acting?

    <p>Glargine</p> Signup and view all the answers

    Which mechanism of action do Biguanides primarily utilize?

    <p>Decrease hepatic glucose production</p> Signup and view all the answers

    What fasting blood glucose level qualifies as diabetes?

    <p>126 mg/dL or greater</p> Signup and view all the answers

    What is the primary effect of glucagon when blood glucose levels are too low?

    <p>Stimulate glycogenolysis</p> Signup and view all the answers

    How does the duration of action compare between rapid-acting and long-acting insulin?

    <p>Long-acting lasts longer than rapid-acting</p> Signup and view all the answers

    What is the primary mechanism of action of metformin?

    <p>Suppresses gluconeogenesis in the liver</p> Signup and view all the answers

    What is a common side effect associated with the use of biguanides like metformin?

    <p>Vitamin B12 deficiency</p> Signup and view all the answers

    Which of the following hypoglycemic agents promotes the release of insulin and decreases glucagon secretion?

    <p>Sitagliptin</p> Signup and view all the answers

    What blood glucose level defines hypoglycemia?

    <p>Under 65 mg/dL</p> Signup and view all the answers

    What potential complication can arise from administering glucagon?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is the purpose of dextrose (D50W) in treating hypoglycemia?

    <p>Rapid elevation of blood glucose levels</p> Signup and view all the answers

    What should be monitored in patients taking meglitinides?

    <p>Hypoglycemia risk</p> Signup and view all the answers

    Which of the following is a key consideration when administering beta blockers in patients with diabetes?

    <p>They can mask signs of hypoglycemia</p> Signup and view all the answers

    What is the primary mechanism of action of sitagliptin?

    <p>Promotes insulin release and decreases glucagon secretion</p> Signup and view all the answers

    Which class of drugs includes repaglinide?

    <p>Meglitinides</p> Signup and view all the answers

    What is a potential side effect of taking metformin?

    <p>Nausea and vomiting</p> Signup and view all the answers

    At what blood glucose level is hypoglycemia defined?

    <p>65 mg/dL</p> Signup and view all the answers

    What condition can arise from the administration of glucagon?

    <p>Hyperglycemia</p> Signup and view all the answers

    What is the primary purpose of dextrose (D50W) in clinical practice?

    <p>Raise blood glucose levels</p> Signup and view all the answers

    What complication should be monitored for in patients using biguanides like metformin?

    <p>Vitamin B12 deficiency</p> Signup and view all the answers

    What is the therapeutic effect of glucagon?

    <p>Increases blood glucose</p> Signup and view all the answers

    What type of drug is classified as a Biguanide?

    <p>Metformin</p> Signup and view all the answers

    What is the hemoglobin A1c level that indicates a person has prediabetes?

    <p>6.4%</p> Signup and view all the answers

    Which insulin type is considered rapid-acting?

    <p>Lispro</p> Signup and view all the answers

    What is a primary side effect associated with insulin use due to potassium levels?

    <p>Hypokalemia</p> Signup and view all the answers

    What is the blood glucose level that qualifies as diabetes during a fasting blood glucose test?

    <p>126 mg/dL</p> Signup and view all the answers

    What is the primary effect of sulfonylureas on blood glucose levels?

    <p>Increase insulin production</p> Signup and view all the answers

    Which insulin type is characterized as long-acting?

    <p>Glargine</p> Signup and view all the answers

    Which insulin type is known to have a duration of action between 18-24 hours?

    <p>Humulin 70/30</p> Signup and view all the answers

    Which of the following antihyperglycemic agents is categorized as a rapid-acting insulin?

    <p>Humalog</p> Signup and view all the answers

    What fasting blood glucose range indicates prediabetes?

    <p>100-125 mg/dL</p> Signup and view all the answers

    What is the usual duration of action for rapid-acting insulin?

    <p>2-4 hours</p> Signup and view all the answers

    What is the onset time for glargine insulin?

    <p>Within 30 minutes</p> Signup and view all the answers

    Which class of medications is known for causing a reduction in blood glucose by blocking the sympathetic nervous system responses?

    <p>Beta blockers</p> Signup and view all the answers

    How should NPH insulin be prepared before administration?

    <p>Rolled gently</p> Signup and view all the answers

    Which of the following classes of medications is associated with increasing insulin release from the pancreas?

    <p>Sulfonylureas</p> Signup and view all the answers

    What is the duration of action for Humulin 70/30 insulin?

    <p>5-8 hours</p> Signup and view all the answers

    Which insulin type peaks at 30-90 minutes after administration?

    <p>Humulin 70/30</p> Signup and view all the answers

    Which side effect is commonly associated with insulin therapy due to its effect on potassium levels?

    <p>Hypokalemia</p> Signup and view all the answers

    What is the recommended administration timing for sulfonylureas relative to meals?

    <p>30 minutes before meals</p> Signup and view all the answers

    Which beta-blocker interaction with insulin can cause a decrease in blood glucose levels?

    <p>Blocking the sympathetic nervous system</p> Signup and view all the answers

    What is the mechanism of action of metformin?

    <p>Suppresses gluconeogenesis and increases glucose uptake</p> Signup and view all the answers

    Which of the following medications is classified as a meglitinide?

    <p>Repaglinide</p> Signup and view all the answers

    What is the primary complication to monitor when administering beta blockers in diabetic patients?

    <p>Hypoglycemia</p> Signup and view all the answers

    What is the primary therapeutic effect of glucagon?

    <p>Increases the breakdown of glycogen to glucose</p> Signup and view all the answers

    What potential complication should be monitored when using dextrose solutions for hypoglycemia?

    <p>Fluid overload</p> Signup and view all the answers

    What is the mechanism of action for sitagliptin?

    <p>Increases insulin secretion and decreases glucagon</p> Signup and view all the answers

    What is the primary mechanism of action of sulfonylureas?

    <p>They stimulate the pancreas to release more insulin.</p> Signup and view all the answers

    Which of the following blood glucose levels indicates that a person is in the prediabetes range?

    <p>100 - 125 mg/dL</p> Signup and view all the answers

    Which insulin type is characterized by a rapid onset of action and is typically administered with meals?

    <p>Lispro</p> Signup and view all the answers

    What is the usual time frame for correctional insulin dosing using a sliding scale?

    <p>At the same time every day</p> Signup and view all the answers

    What blood glucose level qualifies as diabetes when using a two-hour postprandial glucose test?

    <p>200 mg/dL or higher</p> Signup and view all the answers

    Which class of medications includes metformin?

    <p>Biguanides</p> Signup and view all the answers

    What is the duration of action for long-acting insulin, such as glargine?

    <p>18-24 hours</p> Signup and view all the answers

    Study Notes

    Glucose Functioning

    • Glucose comes from three sources: carbohydrates, glycogenolysis (breaking down glycogen from the liver), and gluconeogenesis (creating new glucose from fat and muscle tissue).
    • When glucose levels are too high, beta cells release insulin, which carries glucose into cells.
    • When glucose levels are too low, alpha cells release glucagon, which triggers glycogenolysis.

    Diabetes Mellitus Pathophysiology

    • Type 1 diabetes mellitus is characterized by insulin deficiency, meaning the pancreas does not produce enough insulin.
    • Type 2 diabetes mellitus involves insulin resistance, where the body's cells do not respond effectively to insulin, despite the pancreas producing it. Type 2 can progress to type 1.

    Diagnosis of Diabetes Mellitus

    • Hemoglobin A1c levels exceeding 6.5% indicate diabetes; 5.7%-6.4% indicates prediabetes.
    • Fasting blood glucose greater than or equal to 126 mg/dL indicates diabetes; 100-125 mg/dL indicates prediabetes.
    • Two-hour postprandial glucose test greater than or equal to 200 mg/dL indicates diabetes; 140-199 mg/dL indicates prediabetes.
    • A random glucose level greater than or equal to 200 mg/dL with hyperglycemia symptoms indicates diabetes.

    DM Pharmacology - Insulin

    • Insulin therapy aims to mimic normal blood glucose control and optimize glycemic management.
    • There are different types of insulin, each with varying onset and duration of action, including rapid-acting, short-acting, intermediate-acting, and long-acting.
    • Different types of insulin are administered to provide basal and prandial coverage, mimicking the body's natural insulin release throughout the day, including before and after meals.

    DM Pharmacology - Oral Antidiabetics

    • Sulfonylureas: (e.g., glipizide, glimepiride) MoA: stimulate insulin release from pancreas. Complications/Side Effects: Hypoglycemia, weight gain. Special Considerations: caution with beta blockers, renal/hepatic impairment.
    • Meglitinides: Mechanism of Action: Similar to sulfonylureas, but with a faster onset and shorter duration. Complications/Side Effects: Hypoglycemia. Special Considerations: caution with beta blockers, renal/hepatic impairment.
    • Biguanides: (e.g., metformin). Mechanism of Action: Reduce glucose production by the liver, increase glucose uptake by tissues, reduce glucose absorption in the intestines. Complications/Side Effects: GI upset (anorexia, nausea). Use cautiously in patients with kidney issues and those who drink heavily.
    • Gliptins: (e.g., sitagliptin). Mechanism of Action: Promote insulin release and reduce glucagon secretion. Complications/Side Effects: GI distress.

    Hyperglycemic Agents (e.g., Dextrose solutions)

    • Dextrose (glucose) solutions are used to raise blood glucose levels rapidly.
    • D50W is a 50% dextrose solution in water, used for severe hypoglycemia.
    • D10W is a 10% dextrose solution in water.

    Hypoglycemia

    • Hypoglycemia is characterized by blood glucose levels below 65 mg/dL.
    • Causes include high insulin doses, medications that stimulate insulin release, renal insufficiency, and decreased nutritional intake.
    • Symptoms include anxiety, hunger, palpitations, sweating, shaking, and difficulty thinking.

    Insulin Administration and Storage

    • Note that only NPH (intermediate-acting) insulin requires rolling before injection; other insulins do not.
    • Store unopened insulin in the refrigerator. Once open, most can be stored at room temperature.

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    Description

    This quiz covers the functioning of glucose, the pathophysiology of diabetes mellitus types 1 and 2, and the diagnostic criteria for diabetes. Test your knowledge on how glucose is regulated in the body and the implications of high and low levels. Learn about the differences between insulin deficiency and resistance.

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