Drugs for Diabetes
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Questions and Answers

What is the primary disorder in diabetes?

  • Lipid metabolism
  • Insulin production
  • Protein metabolism
  • Carbohydrate metabolism (correct)

Which of the following symptoms results from a deficiency of insulin?

  • Polyuria (correct)
  • Weight loss
  • Heart disease
  • Neuropathy

What can sustained hyperglycemia lead to in the long term?

  • Neuropathy and stroke
  • Polydipsia and ketonuria
  • Amputations and impotence
  • Renal failure and blindness (correct)

What percentage of all diabetes cases does type 1 diabetes account for?

<p>5% (C)</p> Signup and view all the answers

Why are terms like juvenile-onset diabetes mellitus falling out of favor?

<p>Due to increased awareness of type 2 diabetes (C)</p> Signup and view all the answers

When does type 1 diabetes typically develop?

<p>During childhood or adolescence (C)</p> Signup and view all the answers

What is the primary defect in type 1 diabetes?

<p>Destruction of pancreatic β cells (A)</p> Signup and view all the answers

What is the main cause of symptoms in type 2 diabetes?

<p>Insulin resistance (C)</p> Signup and view all the answers

In type 2 diabetes, which tissues exhibit insulin resistance?

<p>Liver, muscle, adipose tissue (A)</p> Signup and view all the answers

What factor leads to reduced binding of insulin to its receptors in insulin resistance?

<p>Reduced receptor numbers (A)</p> Signup and view all the answers

What hormone promotes hyperglycemia during pregnancy and increases threefold?

<p>Cortisol (C)</p> Signup and view all the answers

How is gestational diabetes defined?

<p>Diabetes that appears during pregnancy and subsides after delivery (D)</p> Signup and view all the answers

What is the current practice regarding oral medications for type 2 diabetes during pregnancy?

<p>Switch to insulin during pregnancy (B)</p> Signup and view all the answers

Which statement best describes the management of gestational diabetes?

<p>Monitor and control blood glucose with diet and insulin during pregnancy. (B)</p> Signup and view all the answers

What effect does hyperinsulinism in the fetus have?

<p>It can have multiple adverse effects on the fetus. (C)</p> Signup and view all the answers

How should blood glucose levels be monitored during diabetic pregnancy according to some experts?

<p>Six to seven times a day is advised. (C)</p> Signup and view all the answers

What is one of the criteria for diagnosing diabetes based on fasting plasma glucose levels?

<p>Exactly 126 mg/dL (C)</p> Signup and view all the answers

When is OGTT often used in diagnosing diabetes?

<p>When diabetes is suspected but not definitively diagnosed by fasting glucose levels (B)</p> Signup and view all the answers

What level of 2-hour plasma glucose suggests diabetes during an OGTT?

<p>200 mg/dL or greater (A)</p> Signup and view all the answers

How is increased risk for diabetes (prediabetes) defined?

<p>Impaired fasting plasma glucose (between 100 and 125 mg/dL) (D)</p> Signup and view all the answers

How can the risk for cardiovascular disease in individuals with prediabetes be reduced?

<p>Through dietary modifications and increased physical activity (C)</p> Signup and view all the answers

What is the primary goal of treating both type 1 and type 2 diabetes?

<p>To prevent long-term complications (D)</p> Signup and view all the answers

What is the current blood pressure goal set by the American Diabetes Association (ADA)?

<p>At or less than 140/90 mm Hg (C)</p> Signup and view all the answers

Which drug can reduce the risk for diabetic nephropathy in individuals with poor glycemic control?

<p>Angiotensin-converting enzyme (ACE) inhibitor (C)</p> Signup and view all the answers

Which type of insulin is indicated for once-daily subQ dosing for both type 1 and type 2 diabetes?

<p>U-300 insulin glargine (Toujeo) (A)</p> Signup and view all the answers

Which insulin analog is used to provide basal glycemic control and not given before meals to control postprandial hyperglycemia?

<p>Insulin detemir (Levemir) (D)</p> Signup and view all the answers

At what doses do the effects of insulin detemir persist for about 12 hours and up to 20 to 24 hours, respectively?

<p>Low doses (0.2 units/kg) and high doses (0.4 units/kg) (D)</p> Signup and view all the answers

Which insulin product can be an option for individuals who do not realize a full 24 hours of effect with U-100 insulin glargine?

<p>U-300 insulin glargine (Toujeo) (B)</p> Signup and view all the answers

What is the primary difference between U-300 insulin glargine and U-100 insulin glargine in terms of concentration?

<p>U-300 is three times more concentrated than U-100 (A)</p> Signup and view all the answers

For which patients may twice-daily administration of U-100 insulin glargine be necessary?

<p>Patients requiring full 24 hours of basal coverage (D)</p> Signup and view all the answers

What distinguishes insulin degludec (Tresiba) from other human insulin analogs?

<p>It has a duration of up to 42 hours (B)</p> Signup and view all the answers

What is the primary function of insulin degludec?

<p>Offering basal glycemic control (B)</p> Signup and view all the answers

What is the recommended total daily insulin dosage range for patients?

<p>$1.0$-$2.0$ units/kg (A)</p> Signup and view all the answers

What strategy involves the use of both long-acting and short-acting insulins?

<p>Intensive basal/bolus strategy (A)</p> Signup and view all the answers

What is NOT a disadvantage of using premixed insulin products in a twice-daily regimen?

<p>Requirement for multiple daily injections (B)</p> Signup and view all the answers

Why is tight glucose control challenging to achieve?

<p>Several elements need careful attention (C)</p> Signup and view all the answers

What occurs when insulin levels surpass the body's needs?

<p><em>Hypoglycemia</em> (C)</p> Signup and view all the answers

What should patients be educated on regarding insulin administration?

<p><em>Avoiding arbitrary changes between insulins</em> (B)</p> Signup and view all the answers

How does exercise impact insulin needs?

<p><em>Decreases insulin needs</em> (C)</p> Signup and view all the answers

What is the primary therapeutic use of second-generation sulfonylureas?

<p>Glycemic control in type 2 diabetes (A)</p> Signup and view all the answers

In what way do second-generation sulfonylureas differ significantly from first-generation agents?

<p>They have fewer drug interactions (C)</p> Signup and view all the answers

What is the main mechanism of action of metformin in lowering blood glucose levels?

<p>Reducing glucose production in the liver (A)</p> Signup and view all the answers

Which drug class can intensify hypoglycemia induced by insulin?

<p>Thiazide diuretics (A)</p> Signup and view all the answers

What is a common side effect associated with metformin use?

<p>Gastrointestinal disturbances (A)</p> Signup and view all the answers

Which family of drugs promotes insulin release and is hence used only in type 2 diabetes?

<p>Sulfonylureas (D)</p> Signup and view all the answers

What is the primary complication that can arise from metformin use in patients with renal impairment?

<p>Lactic acidosis (B)</p> Signup and view all the answers

Which drug class leads to masking signs associated with sympathetic nervous system stimulation during hypoglycemia?

<p>eta-Blockers (D)</p> Signup and view all the answers

What is the primary difference between the indications for pramlintide and GLP-1 receptor agonists?

<p>Pramlintide is indicated for type 1 and type 2 diabetes, while GLP-1 receptor agonists are indicated for type 2 diabetes only. (B)</p> Signup and view all the answers

Which mechanism do both amylin and pramlintide utilize to reduce postprandial glucose levels?

<p>Suppressing glucagon secretion (B)</p> Signup and view all the answers

Why is hypoglycemia a principal concern with the use of pramlintide?

<p>As it mimics the effects of amylin, which regulates insulin release (C)</p> Signup and view all the answers

Which adverse effect is common to both exenatide (Byetta) and Exenatide Once Weekly (Bydureon)?

<p>Nausea (C)</p> Signup and view all the answers

What is the main goal of utilizing incretin mimetics like exenatide in the treatment of diabetes?

<p>To suppress appetite and lower caloric intake (C)</p> Signup and view all the answers

Why can hypoglycemia occur when exenatide is used in combination with a sulfonylurea?

<p>Both drugs stimulate insulin release, potentially leading to low blood sugar (B)</p> Signup and view all the answers

What is the mechanism of action of meglitinides, also known as glinides, in stimulating pancreatic insulin release?

<p>Blocking ATP-sensitive potassium channels on pancreatic β cells (B)</p> Signup and view all the answers

Which antidiabetic agent is contraindicated in patients with heart failure due to an associated risk?

<p>Pioglitazone (B)</p> Signup and view all the answers

What is the primary therapeutic indication for thiazolidinediones (TZDs)?

<p>Type 2 diabetes (B)</p> Signup and view all the answers

Which antidiabetic drug carries a low risk for hypoglycemia unless combined with insulin?

<p>Sitagliptin (B)</p> Signup and view all the answers

What is the main adverse effect associated with α-glucosidase inhibitors in the treatment of type 2 diabetes?

<p>Abdominal distention and diarrhea (A)</p> Signup and view all the answers

Which organ plays a significant role in glucose homeostasis by filtering and reabsorbing glucose in the renal tubules?

<p>Kidney (B)</p> Signup and view all the answers

What is the mechanism of action of SGLT-2 inhibitors in improving glycemic control in patients with type 2 diabetes?

<p>Blocking reabsorption of filtered glucose (A)</p> Signup and view all the answers

Which class of antidiabetic drugs is associated with an increased risk of genital fungal infections and UTIs as adverse effects?

<pre><code>extit{SGLT-2} inhibitors (D) </code></pre> Signup and view all the answers

[Difficult] Which antidiabetic agent can cause ovulation in anovulatory premenopausal women?

<p>Pioglitazone (C)</p> Signup and view all the answers

[Difficult] What is the main difference between glinides and sulfonylureas concerning their pharmacokinetic profile?

<p>Glinides are shorter acting and taken with each meal, while sulfonylureas are longer acting and taken at bedtime. (C)</p> Signup and view all the answers

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