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My Sugary Blood, include, include, include, include, include, include,…

- - - - african american
    - - more than 40
- - - - HLADR3 or 4
- - - - Mild foot infections
    - - Deep wound and chronic infections
- - - - stimulates glucose oxidation
      - promotes glucose storage
        
        phosphorylation & inactivation of glycogen synthase kinase
      - inhibits gluconeogenesis
      - inhibits glycogenolysis
    - - stimulates glucose uptake
      - promotes glucose storage
    - - promotes lipogenesis
      - inhibits lipolysis
  - - - blood, blood-brain barrier, heart
      - insulin independent
    - - liver, pancreas, small intestine
      - insulin independent, high Km
    - - brain, neurons, sperm
      - insulin independent, low Km
    - - skeletal muscles, adipose, heart
      - insulin sensitive
- - - - Hyaline arteriosclerosis
      - Pericyte degeneration
      - Micro aneurysm
    - - Nerve ischemia
- - - - Regular insulin
    - - NPH insulin
    - - Lispro - Aspart - Glulisine
    - - Detemir - Glargine - Degludec
  - - - DPP-4 inhibitors
        
        Sitagliptin – Saxagliptin - Linagliptin – Alogliptin.
      - . GLP-1 receptor agonists
        
        Albiglutide – dulaglutide – exenatide – liraglutide – semaglutide
    - - Adverse effects: GI
      - Acarbose, Miglitol
    - - Canagliflozin, Dapagliflozin, Empagliflozin.
    - - Biguanides
        
        Metformin
        
        1st line therapy
      - Thiazolidinediones (TZDs)
        
        Pioglitazone – Rosiglitazone
    - - Sulfonylureas
        
        Glyburide – Glipizide – Glimepiride
      - Glinides
        
        Repaglinide – Nateglinide
      - Blocking ATP-sensitive K+ channels
- - - - Compensation
      - Sublimation
      - Rationalization
      - Repression
      - Intellectualization
    - - Projection
      - Displacement
      - Reaction Formation
      - Denial
      - Regression