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FNP~DM
Diagnosis & Treatment
| Question | Answer |
|---|---|
| Onset of "Rapid Acting" Insulin | <15 minutes |
| Peak of "Rapid Acting" Insulin | 1-2 hours |
| Duration of "Rapid Acting" Insulin | 3-4 hours |
| Onset of "Regular" Insulin | 1/2-1 hour |
| Peak of "Regular" Insulin | 2-3 hours |
| Duration of "Regular" Insulin | 3-6 hours |
| Onset of "Intermediate Acting" Insulin | 2-4 hours |
| Peak of "Intermediate Acting" Insulin | 4-10 hours |
| Duration of "Intermediate Acting" Insulin | 10-16 hours |
| Onset of "Long Acting" (Lantus) Insulin | 2-4 hours |
| Peak of "Long Acting" (Lantus) Insulin | no peak |
| Duration of "Long Acting" (Lantus) Insulin | 20-24 hours |
| What is the diagnostic value of "serum fasting" blood sugar? | > or equal to 126 mg/dL on 2 separate days |
| What is the diagnostic "random" blood sugar and what sx's must accompany it? | > or equal to 200 mg/dL + 3 P's, wt loss, sores that don't heal, etc. |
| Normal FPG? | <99 mg/dL |
| Pre~Diabetes FPG (impaired fasting glucose)? | 100-125 mg/dL |
| OGTT normal? | <139 |
| OGTT pre~diabetes (impaired fasting glucose)? | 140-199 |
| OGTT diabetes? | 200 and > on 2 separate days |
| What is the rule of thumb when starting patients on insulin? | Regular 0.5 u/kg/day giving 2/3 in the AM and 1/3 in the PM |
| What conditions result in early morning hyperglycemia? | Somogyi effect & Dawn Phenomenon |
| Dawn Phenomenon? | tissues become desensitized to insulin nocturnally, blood sugar gets higher throughout the night |
| Somogyi Effect? | nocturnal hypoglycemia stimulates surge of counter regulatory hormones that raise blood sugar (rebound affect)...i.e. hypoglycemic @ 3 am and is elevated at 7 am |
| Signs associated with insulin resistance (4)? | Acanthosis Nigricans, HTN, Dyslipidemia, PCOD |
| What drug class is Metformin? | Biguanide |
| What type of patient should NOT receive Metformin? | hepatic/renal failure (increased cr.), alcoholics, those prone to hypoxia |
| Metabolic syndrome consists of at least 3 of the following? | Waist circumference > or equal to 40" in men & > or equal to 35" in women @ umbilicus~~BP > or equal to 130/85~~Triglycerides > or equal to 150~~FBG > or equal to 100~~ HDL: < 40 men & < 50 women |
| Name 1st generation Sulfonylureas? | Tobutamide (Orinase), Tolazamide (Tolinase), Chlorpropamide (Diabinese) |
| Name 2nd generation Sulfonylureas? | Glipizide (Glucotrol), Glyburide (Diabeta, Micronase) |
| What is the action of Sulfonylureas? | stimulation of the pancreas to secrete more insulin |
| What is the action of Biguanides? | increase insulin sensitivity, decrease glucogenesis, decrease glucose absorption |
| What are some Alpha-glucosidase inhibitors? | Acarbose (Precose), Miglitol (Glyset) |
| What is the action of Alpha-glucosidase? | to bind to disaccharidases more readily than sucrose, so less glucose is absorbed by the gut |
| Name Thiazolidinediones and it's action? | Actos; increase insulin sensitizing |
Created by:
KimmiNP
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