Diabetes Mellitus Type 2 + Diabetes Medications Mechanisms and
Side Effects
What is the most important environmental factor ● JNC 8 treatment targets: Reduce BP to <
contributing to insulin resistance?- -Obesity 140/90 mm Hg for everyone < 60 including those
is the most important environmental factor with a kidney disorder or diabetes
contributing to insulin resistance ● ADA recommends treating to BP of <140 and
<90 mmHg. Lower treatment targets, ie, 130/80
What is the criteria for pre-diabetes according to mmHg, may be appropriate for individuals at high
the National Health Institutes National Diabetes risk of CVD, if they can be achieved without
Education Program?- -1. Fasting plasma undue treatment burden.
glucose (FPG) 100 to 125 mg/dL (impaired
fasting glucose) or Cholesterol goals in diabetes?- -New statin
2. 2-hour post 75 g oral glucose challenge 140 to guidelines recommend statins in all persons with
199 mg/dL (impaired glucose tolerance) or diabetes mellitus who are 40 to 75 years of age
3. A1c 5.7% to 6.4% with LDL-C levels of 70 to 189 mg per dL even
For all tests, risk of diabetes is continuous, without clinical ASCVD
extending below the lower limit of the range and
becoming disproportionately greater at higher MCC of death in DM patients?- -CAD
ends of the range.
MCC of adult blindness?- -Diabetic
Diagnosis of DM?- -1. Fasting plasma retinopathy
glucose ≥ 126
2. Random plasma glucose ≥ 200 WITH What is the 1st sign of peripheral neuropathy in
symptoms (i.e., polyuria, polydipsia, polyphagia, diabetic patient?- -Ankle reflexes
weight loss) diminished or gone
3. Two-hour post-prandial plasma glucose ≥ 200
4. Hemoglobin A1c ≥ 6.5% What is the difference between the dawn and
somogyi effect?- -*Dawn effect:
Glucose goals (Preprandial, Peak postprandial, hyperglycemia in morning due to release of
HbA1C)?- -Preprandial blood glucose glucagon, epi, and cortisol overnight; leads to
between 80 and 130 mg/dL increased blood glucose in morning; solution =
Peak postprandial (1 to 2 hours after beginning increase bedtime insulin dosage*
of the meal) blood glucose < 180 mg/dL Somogyi: Rebound hyperglycemia in morning s/t
HbA1C levels < 7% hypoglycemia during night from excess insulin
taken at bedtime; solution = reduce bedtime
Microvascular complications of DM?- -1. insulin dosage
Nephropathy
2. Retinopathy T or F: If c-peptide is absent (or very low), then
3. Neuropathy (peripheral, CN, autonomic) this means that the patient is not creating any (or
very little) insulin.- -True. A C-peptide test is
Main macrovascular complication of DM?- - often used to help tell the difference between
Accelerated atherosclerosis type 1 and type 2 diabetes. C-peptide is a
substance made in the pancreas, along with
BP goal in diabetes?- -● ACC/AHA blood insulin. C-peptide and insulin are released from
pressure targets - target for patients with the pancreas at the same time and in about equal
comorbidities: < 130/80 amounts. So a C-peptide test can show how
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Side Effects
What is the most important environmental factor ● JNC 8 treatment targets: Reduce BP to <
contributing to insulin resistance?- -Obesity 140/90 mm Hg for everyone < 60 including those
is the most important environmental factor with a kidney disorder or diabetes
contributing to insulin resistance ● ADA recommends treating to BP of <140 and
<90 mmHg. Lower treatment targets, ie, 130/80
What is the criteria for pre-diabetes according to mmHg, may be appropriate for individuals at high
the National Health Institutes National Diabetes risk of CVD, if they can be achieved without
Education Program?- -1. Fasting plasma undue treatment burden.
glucose (FPG) 100 to 125 mg/dL (impaired
fasting glucose) or Cholesterol goals in diabetes?- -New statin
2. 2-hour post 75 g oral glucose challenge 140 to guidelines recommend statins in all persons with
199 mg/dL (impaired glucose tolerance) or diabetes mellitus who are 40 to 75 years of age
3. A1c 5.7% to 6.4% with LDL-C levels of 70 to 189 mg per dL even
For all tests, risk of diabetes is continuous, without clinical ASCVD
extending below the lower limit of the range and
becoming disproportionately greater at higher MCC of death in DM patients?- -CAD
ends of the range.
MCC of adult blindness?- -Diabetic
Diagnosis of DM?- -1. Fasting plasma retinopathy
glucose ≥ 126
2. Random plasma glucose ≥ 200 WITH What is the 1st sign of peripheral neuropathy in
symptoms (i.e., polyuria, polydipsia, polyphagia, diabetic patient?- -Ankle reflexes
weight loss) diminished or gone
3. Two-hour post-prandial plasma glucose ≥ 200
4. Hemoglobin A1c ≥ 6.5% What is the difference between the dawn and
somogyi effect?- -*Dawn effect:
Glucose goals (Preprandial, Peak postprandial, hyperglycemia in morning due to release of
HbA1C)?- -Preprandial blood glucose glucagon, epi, and cortisol overnight; leads to
between 80 and 130 mg/dL increased blood glucose in morning; solution =
Peak postprandial (1 to 2 hours after beginning increase bedtime insulin dosage*
of the meal) blood glucose < 180 mg/dL Somogyi: Rebound hyperglycemia in morning s/t
HbA1C levels < 7% hypoglycemia during night from excess insulin
taken at bedtime; solution = reduce bedtime
Microvascular complications of DM?- -1. insulin dosage
Nephropathy
2. Retinopathy T or F: If c-peptide is absent (or very low), then
3. Neuropathy (peripheral, CN, autonomic) this means that the patient is not creating any (or
very little) insulin.- -True. A C-peptide test is
Main macrovascular complication of DM?- - often used to help tell the difference between
Accelerated atherosclerosis type 1 and type 2 diabetes. C-peptide is a
substance made in the pancreas, along with
BP goal in diabetes?- -● ACC/AHA blood insulin. C-peptide and insulin are released from
pressure targets - target for patients with the pancreas at the same time and in about equal
comorbidities: < 130/80 amounts. So a C-peptide test can show how
1/2
