Insulin- response to increase glucose by beta cells produced by pancreas, lowers blood glucose by increasing transport of glucose into cells and promotes conversion of glucose to glycogen, promotes conversion of amino acids to proteins in muscle stimulates triglyceride formation, and inhibits the release of free fatty acids. Contraindicated in hypoglycemia, not when infections, stress or change in diet. Addictive hypoglycemic effect with oral hypoglycemic agents
Glucagon- decreased levels of glucose secreted by alpha cells
Insulin used in type2 when diet and oral meds don’t work
Insulin- 3 daily injections with combo of short acting and intermediate acting
Prior to breakfast- combination of short acting (regular) and intermediate acting (nph)
Before dinner- short acting (regular)
Bedtime- intermediate acting (nph)
LISPRO- rapid acting insulin
Oral hypoglycemics- sulfonylureas, megalitinides, biguanide. Intact pancreatic function required. lower blood glucose by stimulating endogenous insulin secretion by beta cells of the pancreas and by increasing sensitivity to insulin at the intracellular receptor sites. Contraindicated in type 1, pregnancy or lactation
Alpha- glucosides inhibitors delay digestion of ingested carbs thus lowering blood glucose, especially after meals. It may be combined with sulfonylureas.
Thiazolidinesdiones increase insulin sensitivity.
Metformin may cause lactic acidosis
Sulfonylureas use with caution in pt with cv disease
Disulfiram like reaction when oral hypoglycemics taken with alcohol
Alcohol, corticosteroids, rifampin, glucagon, and thiazide diuretics may decrease effectivness of oral hypoglycemics
METFORMIN DECREASES INSULIN RESISTANCE- it decreases glucose production by the liver; decreases intestinal absorption of glucose; improves insulin receptor sensitivity in the liver, skeletal muscle, and adipose tissue, resulting in decreased insulin resistance.
Miglitol and Pioglitazone do not cause hypoglycemia when taken...