Complications
DM Type I Tx
DM Type II Tx - Part 1
DM Type II Tx - Part 2
Miscellaneous
100
Treated with amox/clav OR TMP/SMX PLUS metronidazole OR Clindamycin
What is diabetic foot ulcer?
100
Name of an intermediate acting insulin
What is insulin NPH?
100
This class of medications target post-prandial hyperglycemia and do not cause hypoglycemia.
What are alpha-glucosidase inhiitors?
100
Inhibits the reabsorption of glucose from the kidneys back into the blood, leading to increased glucose in the urine and decreased blood glucose.
What are sodium-glucose cotransporter-2 (SGLT2) inhibitors?
100
Patient consistently reports a bedtime glucose of >70 mg/dL; however, her AM FSBG is increased. There is a nocturnal increase in insulin requirements. Solution is to increase evening insulin.
What is dawn phenomenon?
200
Sudden onset No urine glucose BG <600 mg/dL Ketones present Low pH
What is diabetic ketoacidosis (DKA)?
200
Insulin lispro, insulin aspart, insulin glulisine
What are rapid-acting insulins?
200
This class of medications can lower A1c by 1-2% and cause weight gain and hypoglycemia.
What are sulfonylureas?
200
Disadvantages of this medication include cough, sore throat, dry mouth, and SOB.
What is Exubera?
200
Microvascular (retinopathy, nephropathy, neuropathy) and macrovascular (CAD, PVD)
What are long-term complications of diabetes?
300
Caused by Staph, Strep, Enterobacter, Klebsiella, Proteus, Pseudomonas, and anaerobes
What are diabetic foot ulcers?
300
This insulin has an acidic pH and forms microprecipitates upon injection.
What is insulin glargine?
300
MOA: Slows gastric emptying, decreases hepatic glucose output, & increases satiety.
What is pramlintide?
300
These two medications are injections, but they are NOT insulin.
What are exenatide and liraglutide?
300
Patient has BG readings <70 mg/dL between 2:30am-3:30am. But patient is still waking up with hyperglycemia. Counter-regulatory hormones are over correcting for overnight hypoglycemia and evening insulin dose is excessive. Solution: decrease evening NPH dose
What is Somogyi phenomenon or effect?
400
blurred vision, sweaty palms, confusion, sweating, trembling, fatigue, hunger, numbness BG <70 mg/dL
What are symptoms of hypoglycemia?
400
This insulin has a 30 minute onset and is a component in split-mixed insulins.
What is regular insulin?
400
Meformin is contraindicated in with these Scr values. (Hint: consider males and females)
What is <1.4 for women and <1.5 for men?
400
This class of medications increase insulin secretion, but are structurally different from sulfonylreas and have less weight gain and hypoglycemia risk.
What are meglitinides?
400
DAILY DOUBLE: Counsel a patient who will be starting metformin
Name (Brand and generic) Dosing (titrate to twice daily) SE (GI upset/diarrhea and lactic acidosis) Ways to alleviate GI upset (take with meal)
500
Slow onset (+) urine glucose BG >800 mg/dL No ketones pH normal
What is hyperosmolar hyperglycemic nonketotic syndrome (HHNS)?
500
This insulin has the addition of fatty acid chains which results in a high degree of protein binding.
What is insulin determir?
500
The following medication can contribute to weight gain, shortness of breath, and edema in the extremities.
What is pioglitazone?
500
These 3 dipeptidyl peptidase-4 (DPP-4) inhibitors decreased A1c 0.6-1.5% and are generally well-tolerated with no weight gain.
What are sitagliptin, saxagliptin, and linagliptin?
500
DAILY DOUBLE: Counsel patient on hypoglycemia recognition and treatment options.
BG <70 mg/dL half can of coke (non-diet) 4 glucose tablets 1/4 cup of orange juice 4 piece of hard candy (not sugar free) ex. peppermint
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