Insulin
what is secreted from the alpha, beta and delta cells of the pancreas
a: glucagon
b: insulin
delta: somatostatin
what is the main adverse reaction to insulin
hypoglycemia
what medication mimics incretin
GLP-1 agonists
what is the MOA and DOA of metformin and what deficiency can it cause
inhibits hepatic glucose output, 6 hr, b12
which insulins are basal insulins and how do they work
NPH, glargine, detemir, degludec, NPL; suppress hepatic glucose production
what medication is administered in a hyperglycemic emergency
regular insulin IV
contra of afrezza
COPD, asthma, chronic lung disease
what is the short acting GLP-1 agonist and when should it be avoided
exenatide avoid in gastroparesis or if eGFR<30
sulfonylureas may increase this risk other than hypoglycemia
CV events
which two insulins are almost identical to human insulin
glargine and degludec
what is the intermediate acting insulin and how is it administered
NPH: SC
pramlintidine BBW
severe hypoglycemia
what is responsible for 60-70% of post prandial insulin secretion
incretin
which sulfonylurea is ER
glipizide
which insulin is an acylated insulin
detemir
these three medications have a onset of action of 5-15 min
insulin lispro, aspart, glulisine
BBW of GLP-1 agonists. Which type of diabetes should they not be used in
Thyroid C-cell tumor, type 1
which group of medications requires caution for euglycemic DKA
SGLT-2
what is the MOA of TZDs and what is their endings
agonist for peroxisome proliferator resulting in increased insulin sensitivity by acting on adipose, muscle, and liver to increase glucose utilization and decrease glucose production; zones
how should insulin be injected. What areas have the fastest and slowest injection rates
in an area of 2.5 cm of fat. Pinch fat. Insert needle perpendicular in a 27g needle and hold in place for 10s.
Fastest: abdominal wall
Slowest: leg and buttocks (varies inversely with subcutaneous fat thickness
what is the longest acting basal insulin
insulin degludec
BBW of TZDs
CHF
what is the first oral GLP-1 agonist to be approved
Semaglutide
All DPP-4 inhibitors need renal dosing except
linagliptin
Pramlintidine MOA
synthetic amylin analog that delays gastric emptying and decreases postprandial glucagon secretion