Exam 3 Study Questions and answers

What drugs are used to treat gestational diabetes? o Metformin and Insulin  What A1C value indicates diabetes mellitus? Pre-DM? o 6.5% or greater is considered diabetes o 5.7-6.4% pre-diabetes  What fasting and random values indicate DM? o Fasting plasma glucose—126 or greater is diabetes o Random (casual) plasma glucose—anything greater than 200 is diabetes  What are complications of insulin therapy? o Hypoglycemia o Can develop lipohypertrophy  Accumulation of subcutaneous fat that occurs when it is injected too frequently at the same site o Allergic reactions  Characterized by red and intensely itchy welts, breathing becomes difficult  If severe allergy develops:  Desensitization procedure (small doses to larger doses) o Hypokalemia  Promotes the uptake of potassium cells and insulin activates a membrane-bound enzyme with sodium potassium and ATPase that pumps potassium into the cells and sodium out  Drug interactions? o Hypoglycemic agents  Can intensify the hypoglycemia included by insulin  Examples: sulfonylureas, glinides, alcohol o Use with caution with hyperglycemic agents  Examples: thiazide and glucocorticoids and sympathomimetics  What effect do beta blockers have on insulin? o delay awareness of and response to hypoglycemia by masking the signs that are associated with stimulation of sympathetic nervous system o Impair glycogenolysis o Prevent the bodies counter-regulatory response  What are other therapeutic uses besides DM? o Hyperkalemia o Aids in diagnosis of GH deficiency o Diabetic ketoacidosis  Insulin dosage must be coordinated with what? o Carbohydrate intake  What is B/P goal in diabetic? o To be controlled, within normal 120/80  What medication can be given to decrease risk of diabetic nephropathy? o ACE inhibitor or ARB