Insulin
ADRs
Physiology
Clinical Questions
Miscellaneous

100

What additional component gives Fiasp its ultra-rapid absorption?

Niacinamide (Vitamin B3); L-arginine is added as a formulation stabilizer, not an absorption enhancer

100

What two symptoms of hypoglycemia are not masked by beta-blockers?

Hunger and Sweating

100

What term is used to describe a period of hyperglycemia after a period of hypoglycemia?

The Somogyi effect

100

What method for diagnosing diabetes is unreliable in gestational diabetes?

Hemoglobin A1c

100

What cholesterol lowering medication can help lower blood sugar?

Welchol (colesevelam)

200

How many units of Lantus/Basaglar would be recommended when switching from 50 units of Toujeo?

40 units

200

Why is hypoglycemia more concerning with Acarbose?

It cannot be treated with sucrose containing products such as fruit juice, hard candies, and some soda/pop products

200

How many hours after iodinated contrast should be Metformin be held and why?

48 hours; due to the increased risk of lactic acidosis

200

What is the max dose of Metformin and what vitamin deficiency can it cause?

2,500-2,550 mg/day and Vitamin B12

200

In what year was Metformin introduced to the US market?

1995

300

What insulin has the shortest stability when stored at room temperature and how many days is it?

Afrezza (3 days if opened or 10 days if unopened) 

300

What dietary concerns are there when using a SGLT2i?

Keto based diets 

300

What neuroendocrine hormone antagonizes the release of glucagon and what drug is an analog of this hormone?

Amylin and Pramlinitide (Symlin)

300

What 5 anti-diabetic drugs have proven benefit in CVD?

Jardiance, Invokana, Victoza, Ozempic, and Bydureon

300

From what are GLP-1 RAs derived and what is the peptide called?

The saliva of the gila monster and Exendin 4

400

Where does Humalog get its generic name?

The lysine and proline amino acids are flipped on the B-chain of insulin at the 28th/29th position; lysine and proline, hence Lispro

400

What diabetes medication is responsible for the addition of cardiovascular outcomes in clinical trials for all new diabetic medications?

Rosiglitazone 

400

What intestinal cells secrete endogenous GLP-1? 

L-cells primarily located in the ileum and the large intestine

400

A patient with diabetes is wanting to use cinnamon, but also has liver disease what type of cinnamon should be avoided and what type is preferred?

Cassia cinnamon and Ceylon cinnamon

400

What enzyme do glucose test strips use and how do they work?

Glucose oxidase; produces gluconic acid that increases transmission of electrical current

500

What amino acid is responsible for keeping the A and B chains of insulin connected and what type of bond is responsible for this?

Cysteine and Sulfide Bond

500

What type of specific cancer and syndrome are concerns with GLP-1 RAs?

Medullary thyroid carcinoma (C-cell) and Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

500

What protein is expressed in the muscle tissue during activity and is the reason why muscle tissue does not require insulin for glucose uptake?

GLUT4

500

What is the corrected sodium for a patient in DKA with a serum Na of 126 mEq/L and a BG of 680 mg/dL and what fluids would you give?

135 mEq/L and 1/2NS 

500

What is the name of the monthly intravitreal injection FDA-approved for diabetic retinopathy? 

Lucentis (Ranibizumab)