63 Questions
What is the primary disorder in diabetes?
Carbohydrate metabolism
Which of the following symptoms results from a deficiency of insulin?
Polyuria
What can sustained hyperglycemia lead to in the long term?
Renal failure and blindness
What percentage of all diabetes cases does type 1 diabetes account for?
5%
Why are terms like juvenile-onset diabetes mellitus falling out of favor?
Due to increased awareness of type 2 diabetes
When does type 1 diabetes typically develop?
During childhood or adolescence
What is the primary defect in type 1 diabetes?
Destruction of pancreatic β cells
What is the main cause of symptoms in type 2 diabetes?
Insulin resistance
In type 2 diabetes, which tissues exhibit insulin resistance?
Liver, muscle, adipose tissue
What factor leads to reduced binding of insulin to its receptors in insulin resistance?
Reduced receptor numbers
What hormone promotes hyperglycemia during pregnancy and increases threefold?
Cortisol
How is gestational diabetes defined?
Diabetes that appears during pregnancy and subsides after delivery
What is the current practice regarding oral medications for type 2 diabetes during pregnancy?
Switch to insulin during pregnancy
Which statement best describes the management of gestational diabetes?
Monitor and control blood glucose with diet and insulin during pregnancy.
What effect does hyperinsulinism in the fetus have?
It can have multiple adverse effects on the fetus.
How should blood glucose levels be monitored during diabetic pregnancy according to some experts?
Six to seven times a day is advised.
What is one of the criteria for diagnosing diabetes based on fasting plasma glucose levels?
Exactly 126 mg/dL
When is OGTT often used in diagnosing diabetes?
When diabetes is suspected but not definitively diagnosed by fasting glucose levels
What level of 2-hour plasma glucose suggests diabetes during an OGTT?
200 mg/dL or greater
How is increased risk for diabetes (prediabetes) defined?
Impaired fasting plasma glucose (between 100 and 125 mg/dL)
How can the risk for cardiovascular disease in individuals with prediabetes be reduced?
Through dietary modifications and increased physical activity
What is the primary goal of treating both type 1 and type 2 diabetes?
To prevent long-term complications
What is the current blood pressure goal set by the American Diabetes Association (ADA)?
At or less than 140/90 mm Hg
Which drug can reduce the risk for diabetic nephropathy in individuals with poor glycemic control?
Angiotensin-converting enzyme (ACE) inhibitor
Which type of insulin is indicated for once-daily subQ dosing for both type 1 and type 2 diabetes?
U-300 insulin glargine (Toujeo)
Which insulin analog is used to provide basal glycemic control and not given before meals to control postprandial hyperglycemia?
Insulin detemir (Levemir)
At what doses do the effects of insulin detemir persist for about 12 hours and up to 20 to 24 hours, respectively?
Low doses (0.2 units/kg) and high doses (0.4 units/kg)
Which insulin product can be an option for individuals who do not realize a full 24 hours of effect with U-100 insulin glargine?
U-300 insulin glargine (Toujeo)
What is the primary difference between U-300 insulin glargine and U-100 insulin glargine in terms of concentration?
U-300 is three times more concentrated than U-100
For which patients may twice-daily administration of U-100 insulin glargine be necessary?
Patients requiring full 24 hours of basal coverage
What distinguishes insulin degludec (Tresiba) from other human insulin analogs?
It has a duration of up to 42 hours
What is the primary function of insulin degludec?
Offering basal glycemic control
What is the recommended total daily insulin dosage range for patients?
$1.0$-$2.0$ units/kg
What strategy involves the use of both long-acting and short-acting insulins?
Intensive basal/bolus strategy
What is NOT a disadvantage of using premixed insulin products in a twice-daily regimen?
Requirement for multiple daily injections
Why is tight glucose control challenging to achieve?
Several elements need careful attention
What occurs when insulin levels surpass the body's needs?
Hypoglycemia
What should patients be educated on regarding insulin administration?
Avoiding arbitrary changes between insulins
How does exercise impact insulin needs?
Decreases insulin needs
What is the primary therapeutic use of second-generation sulfonylureas?
Glycemic control in type 2 diabetes
In what way do second-generation sulfonylureas differ significantly from first-generation agents?
They have fewer drug interactions
What is the main mechanism of action of metformin in lowering blood glucose levels?
Reducing glucose production in the liver
Which drug class can intensify hypoglycemia induced by insulin?
Thiazide diuretics
What is a common side effect associated with metformin use?
Gastrointestinal disturbances
Which family of drugs promotes insulin release and is hence used only in type 2 diabetes?
Sulfonylureas
What is the primary complication that can arise from metformin use in patients with renal impairment?
Lactic acidosis
Which drug class leads to masking signs associated with sympathetic nervous system stimulation during hypoglycemia?
eta-Blockers
What is the primary difference between the indications for pramlintide and GLP-1 receptor agonists?
Pramlintide is indicated for type 1 and type 2 diabetes, while GLP-1 receptor agonists are indicated for type 2 diabetes only.
Which mechanism do both amylin and pramlintide utilize to reduce postprandial glucose levels?
Suppressing glucagon secretion
Why is hypoglycemia a principal concern with the use of pramlintide?
As it mimics the effects of amylin, which regulates insulin release
Which adverse effect is common to both exenatide (Byetta) and Exenatide Once Weekly (Bydureon)?
Nausea
What is the main goal of utilizing incretin mimetics like exenatide in the treatment of diabetes?
To suppress appetite and lower caloric intake
Why can hypoglycemia occur when exenatide is used in combination with a sulfonylurea?
Both drugs stimulate insulin release, potentially leading to low blood sugar
What is the mechanism of action of meglitinides, also known as glinides, in stimulating pancreatic insulin release?
Blocking ATP-sensitive potassium channels on pancreatic β cells
Which antidiabetic agent is contraindicated in patients with heart failure due to an associated risk?
Pioglitazone
What is the primary therapeutic indication for thiazolidinediones (TZDs)?
Type 2 diabetes
Which antidiabetic drug carries a low risk for hypoglycemia unless combined with insulin?
Sitagliptin
What is the main adverse effect associated with α-glucosidase inhibitors in the treatment of type 2 diabetes?
Abdominal distention and diarrhea
Which organ plays a significant role in glucose homeostasis by filtering and reabsorbing glucose in the renal tubules?
Kidney
What is the mechanism of action of SGLT-2 inhibitors in improving glycemic control in patients with type 2 diabetes?
Blocking reabsorption of filtered glucose
Which class of antidiabetic drugs is associated with an increased risk of genital fungal infections and UTIs as adverse effects?
extit{SGLT-2} inhibitors
[Difficult] Which antidiabetic agent can cause ovulation in anovulatory premenopausal women?
Pioglitazone
[Difficult] What is the main difference between glinides and sulfonylureas concerning their pharmacokinetic profile?
Glinides are shorter acting and taken with each meal, while sulfonylureas are longer acting and taken at bedtime.
Learn about drugs used in the treatment of type one and type two diabetes, focusing on carbohydrate metabolism and insulin deficiency. Understand the symptoms, causes, and effects of sustained hyperglycemia in diabetes.
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