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Medicine (MD/DO)
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USMLE Step 1
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Endocrinology
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Glucose Homeostasis

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Endocrinology | Medicine (MD/DO) School Study Aid

Glucose Homeostasis
8 Picmonics to Learn | 16 mins
Insulin
Rapid Acting
Insulin Lispro (Humalog)
Insulin Aspart (Novolog)
Insulin Glulisine (Apidra)
Short Acting
Regular Insulin (Humulin R)
Intermediate Acting
Isophane NPH (Humulin N)
Long Acting
Detemir (Levemir)
Glargine (Lantus)
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2 mins
Hyperglycemia
Mechanism
Insulin Resistance
Too Little Insulin/Medication
Infection/Illness
Corticosteroids
Assessment
Elevated Blood Glucose
Polyphagia
Polydipsia
Polyuria
Hypotension
Fatigue/Drowsiness
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1 min
Corrected Na+ for Hyperglycemia
Equation
[(Glucose-100) * 0.016 ] + Na+
Steps
Glucose-100
Multiply * 0.016
Add Na+
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1 min
Hypoglycemia Assessment
Mechanism
Too much insulin
Decreased glucose
Assessment
< 70 mg/dL
Change in LOC
Lethargic
Confusion and Irritability
Tremors
Diaphoresis
Tachycardia
Vision Changes
Weakness
Seizures
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2 mins
Glucagon (GlucaGen)
Mechanism
Increases Glucose
Indications
Hypoglycemic Emergency
Side Effects
Nausea and Vomiting
Considerations
Reconstitute Powder
Consume Oral Carbohydrates
50% Dextrose IV (If No Effect)
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2 mins
Insulin Synthesis
Synthesis
Preproinsulin
Rough Endoplasmic Reticulum
Proinsulin 
Golgi Body
Beta Cells Release Insulin
Beta Cells Release C-peptide
Clinical Relevance
Insulinoma
Sulfonylureas
Surreptitious Insulin Use
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2 mins
Insulin Regulation
Master Regulator
Glucose
Incretins Released with Oral Glucose
GLP-1
GIP
Positive Regulators
Beta-2 Receptor Stimulation
M3 Acetylcholine Receptor Stimulation
Negative Regulators
Alpha-2 Receptor Stimulation
Somatostatin
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2 mins
Hypoglycemia Intervention
Interventions
Mild to Moderate Hypoglycemia
Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
Complex Carbohydrate (Whole Grains, Vegetables)
Severe Hypoglycemia or Unconscious
50% Dextrose
Glucagon
Considerations
Monitor Blood Glucose Q 10-15 Minutes
Give Small Meal After Intervention
Patient Education
Hypoglycemia Prevention
Encourage Self-Monitoring
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3 mins

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