Advanced Pharmacology – Module 6
Diabetes & Insulin Therapy Study
Guide (Gestational Diabetes,
Hypoglycemia, and Drug
Interactions)Complete Verified
Questions Provided with A+ Graded
Rationales Latest Updated 2026
What drugs are used to treat gestational diabetes?
It can often be controlled by diet and medical nutritional therapy. If this does not control
glucose levels, insulin is required.
What HbA1c value indicates DM?
An A1c > 6.5%.
What HbA1c value indicates pre-DM?
An A1c of 5.7-6.4%.
What fasting and random values indicate DM?
FPG > 126 mg/dL
Random ≥ 200 mg/dL
What are the complications of insulin therapy?
Hypoglycemia: Blood glucose below 70 mg/dL.
IF BSG level < 70 mg/dL.
- Rapid treatment is mandatory.
- Fast-acting oral sugar (e.g., glucose tablets, orange juice, sugar cubes, 1/2 can of REAL soda).
Weight gain.
The greater the reduction in blood glucose, the greater the weight gain unless they diet and
exercise.
,Lipohypertrophy
This adverse effect results in an abnormal growth of fat resulting from months and years of
injecting into the same site.
Lipoatrophy:
Concavities around the injection site result from the loss of adipose tissue, likely from insulin
antibody destruction.
What are the consequences of insulin deficiency?
Dehydration, frequent urination, weight loss, obesity, and heart problems
. Catabolic mode.
- Increased glycogenolysis: the generation of free glucose by breaking down glycogen.
- Increased gluconeogenesis.
- Reduced glucose utilization
What are the dug interactions of insulin therapy?
Hypoglycemic agents
i- Drugs that lower blood glucose levels and can intensify hypoglycemia induced by insulin.
- Sulfonylureas, glinides, and alcohol (used acutely or long term in excessive doses)
S/S: night sweats, nightmares, sleep disturbances, and early morning headaches.
Hyperglycemic agents:
- Drugs that raise blood glucose and can counteract the desired eLects of insulin.
- Thiazide diuretics, glucocorticoids, sympathomimetics.
Drugs that INCREASE the Risk of Hypoglycemia
ARBs, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline,
pramlintide, propoxyphene, salicylates, and sulfonamide antibiotics
Drugs that DECREASE the Risk of Hypoglycemia
Antipsychotics, corticosteroids, diuretics, estrogens, niacin, thyroid hormones,
sympathomimetic agents, protease inhibitors, somatropin, and oral contraceptives
,What are the adverse effects of the use of insulin?
The dawn phenomenon
The Somogyi effect
Hypoglycemia, hypokalemia, lipodystrophy, and local or systemic allergic reactions can occur
with insulin.
The dawn phenomenon
So-called worsening hyperglycemia that occurs in the early morning hours is caused by growth
hormone surges that occur during sleep.
The Somogyi effect
The rebound of hyperglycemia occurs after an early morning episode of insulin-induced
hypoglycemia.
What effect do beta blockers have on insulin?
They can delay awareness of and response to hypoglycemia by masking signs that are
associated with stimulation of the sympathetic nervous system that hypoglycemia normally
causes.
Also, β-blockade impairs glycogenolysis, which is the body's natural response to counteract a
drop in blood sugar.
What are other therapeutic uses of insulin besides DM
The non-diabetic uses of insulin include the following:
- wound healing
- parenteral nutrition
- antiaging
- body building
- cardioprotection in acute coronary syndromes
- threat hyperkalemia
- cell culture
- cancer treatment
- organ preservation
- management of septic shock
- β blocker overdose.
Insulin dosage must be coordinated with what?
, Daily activities
What you eat (Carbohydrates)
How much and when do you exercise
What is the BP goal for diabetics?
The ADA recommends <140/90 mm Hg in patients with DM.
What medications can be given to decrease the risk of diabetic nephropathy?
You must decrease HTN
- ACE inhibitor (lisinopril)
- ARB (losartan)
What role does exercise play in treating type 1 and type 2 DM?
Patients are recommended to exercise for 150 min/wk.
What are the rapid acting insulins?
Lispro (Humalog): duration is 3-5 hrs.
Aspart (Novolog): duration is 3-5 hrs
Glulisine (Apidra): duration is 3-4 hrs
What are the short acting insulins?
Regular (Humulin R, Novolin R): duration is 6-8 hrs.
What are the intermediate acting insulins?
NPH (Humulin N, Novolin N): duration is 14-26 hrs.
What are the long acting insulins?
Glargine (Lantus); duration is 24 hrs.
Detemir (Levemir): duration is 14-24 hrs.
What are the ultra long acting insulins?
Degludec (Tresiba): duration is 42 hrs.
What are the only drugs approved for adolescents with T2D?
Insulin
Metformin
Liraglutide
When are short-duration insulins used?
Diabetes & Insulin Therapy Study
Guide (Gestational Diabetes,
Hypoglycemia, and Drug
Interactions)Complete Verified
Questions Provided with A+ Graded
Rationales Latest Updated 2026
What drugs are used to treat gestational diabetes?
It can often be controlled by diet and medical nutritional therapy. If this does not control
glucose levels, insulin is required.
What HbA1c value indicates DM?
An A1c > 6.5%.
What HbA1c value indicates pre-DM?
An A1c of 5.7-6.4%.
What fasting and random values indicate DM?
FPG > 126 mg/dL
Random ≥ 200 mg/dL
What are the complications of insulin therapy?
Hypoglycemia: Blood glucose below 70 mg/dL.
IF BSG level < 70 mg/dL.
- Rapid treatment is mandatory.
- Fast-acting oral sugar (e.g., glucose tablets, orange juice, sugar cubes, 1/2 can of REAL soda).
Weight gain.
The greater the reduction in blood glucose, the greater the weight gain unless they diet and
exercise.
,Lipohypertrophy
This adverse effect results in an abnormal growth of fat resulting from months and years of
injecting into the same site.
Lipoatrophy:
Concavities around the injection site result from the loss of adipose tissue, likely from insulin
antibody destruction.
What are the consequences of insulin deficiency?
Dehydration, frequent urination, weight loss, obesity, and heart problems
. Catabolic mode.
- Increased glycogenolysis: the generation of free glucose by breaking down glycogen.
- Increased gluconeogenesis.
- Reduced glucose utilization
What are the dug interactions of insulin therapy?
Hypoglycemic agents
i- Drugs that lower blood glucose levels and can intensify hypoglycemia induced by insulin.
- Sulfonylureas, glinides, and alcohol (used acutely or long term in excessive doses)
S/S: night sweats, nightmares, sleep disturbances, and early morning headaches.
Hyperglycemic agents:
- Drugs that raise blood glucose and can counteract the desired eLects of insulin.
- Thiazide diuretics, glucocorticoids, sympathomimetics.
Drugs that INCREASE the Risk of Hypoglycemia
ARBs, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline,
pramlintide, propoxyphene, salicylates, and sulfonamide antibiotics
Drugs that DECREASE the Risk of Hypoglycemia
Antipsychotics, corticosteroids, diuretics, estrogens, niacin, thyroid hormones,
sympathomimetic agents, protease inhibitors, somatropin, and oral contraceptives
,What are the adverse effects of the use of insulin?
The dawn phenomenon
The Somogyi effect
Hypoglycemia, hypokalemia, lipodystrophy, and local or systemic allergic reactions can occur
with insulin.
The dawn phenomenon
So-called worsening hyperglycemia that occurs in the early morning hours is caused by growth
hormone surges that occur during sleep.
The Somogyi effect
The rebound of hyperglycemia occurs after an early morning episode of insulin-induced
hypoglycemia.
What effect do beta blockers have on insulin?
They can delay awareness of and response to hypoglycemia by masking signs that are
associated with stimulation of the sympathetic nervous system that hypoglycemia normally
causes.
Also, β-blockade impairs glycogenolysis, which is the body's natural response to counteract a
drop in blood sugar.
What are other therapeutic uses of insulin besides DM
The non-diabetic uses of insulin include the following:
- wound healing
- parenteral nutrition
- antiaging
- body building
- cardioprotection in acute coronary syndromes
- threat hyperkalemia
- cell culture
- cancer treatment
- organ preservation
- management of septic shock
- β blocker overdose.
Insulin dosage must be coordinated with what?
, Daily activities
What you eat (Carbohydrates)
How much and when do you exercise
What is the BP goal for diabetics?
The ADA recommends <140/90 mm Hg in patients with DM.
What medications can be given to decrease the risk of diabetic nephropathy?
You must decrease HTN
- ACE inhibitor (lisinopril)
- ARB (losartan)
What role does exercise play in treating type 1 and type 2 DM?
Patients are recommended to exercise for 150 min/wk.
What are the rapid acting insulins?
Lispro (Humalog): duration is 3-5 hrs.
Aspart (Novolog): duration is 3-5 hrs
Glulisine (Apidra): duration is 3-4 hrs
What are the short acting insulins?
Regular (Humulin R, Novolin R): duration is 6-8 hrs.
What are the intermediate acting insulins?
NPH (Humulin N, Novolin N): duration is 14-26 hrs.
What are the long acting insulins?
Glargine (Lantus); duration is 24 hrs.
Detemir (Levemir): duration is 14-24 hrs.
What are the ultra long acting insulins?
Degludec (Tresiba): duration is 42 hrs.
What are the only drugs approved for adolescents with T2D?
Insulin
Metformin
Liraglutide
When are short-duration insulins used?
