Endocrinology Study Guide: Diabetes, Thyroid Disorders, and Medications

•What drugs are used to treat gestational diabetes?
oMetformin and Insulin
•What A1C value indicates diabetes mellitus? Pre-DM?
o6.5% or greater is considered diabetes
o5.7-6.4% pre-diabetes
•What fasting and random values indicate DM?
oFasting plasma glucose—126 or greater is diabetes
oRandom (casual) plasma glucose—anything greater than 200 is diabetes
•What are complications of insulin therapy?
oHypoglycemia
oCan develop lipohypertrophy
▪Accumulation of subcutaneous fat that occurs when it is injected too frequently at the same site
oAllergic reactions
▪Characterized by red and intensely itchy welts, breathing becomes difficult
▪If severe allergy develops:
•Desensitization procedure (small doses to larger doses)
oHypokalemia
▪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?
oHypoglycemic agents
▪Can intensify the hypoglycemia included by insulin
▪Examples: sulfonylureas, glinides, alcohol
oUse with caution with hyperglycemic agents
▪Examples: thiazide and glucocorticoids and sympathomimetics
•What effect do beta blockers have on insulin?
odelay awareness of and response to hypoglycemia by masking the signs that are associated with stimulation of sympathetic nervous system
oImpair glycogenolysis
oPrevent the bodies counter-regulatory response
•What are other therapeutic uses besides DM?
oHyperkalemia
oAids in diagnosis of GH deficiency
oDiabetic ketoacidosis
•Insulin dosage must be coordinated with what?
oCarbohydrate intake
•What is B/P goal in diabetic?
oTo be controlled, within normal 120/80
•What medication can be given to decrease risk of diabetic nephropathy?
oACE inhibitor or ARB