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

    When does type 1 diabetes typically develop?

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

    What is the primary defect in type 1 diabetes?

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

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

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

    In type 2 diabetes, which tissues exhibit insulin resistance?

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

    What hormone promotes hyperglycemia during pregnancy and increases threefold?

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

    How is gestational diabetes defined?

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

    What is the primary function of insulin degludec?

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

    Why is tight glucose control challenging to achieve?

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

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

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

    What should patients be educated on regarding insulin administration?

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

    How does exercise impact insulin needs?

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

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

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

    Which drug class can intensify hypoglycemia induced by insulin?

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

    What is a common side effect associated with metformin use?

    <p>Gastrointestinal disturbances</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</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</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</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.</p> Signup and view all the answers

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

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

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

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

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

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

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

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

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

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

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

    <p>Pioglitazone</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.</p> Signup and view all the answers

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