Diagnosis
Drug Classes
Side Effects
Treatment
100
FPG > 126 - fasting no caloric intake for 8 hours 2-hour PG > 200 during an OGTT. A1C > 6.5% A pt with classic symptoms of hyperglycemia or hyperglycemic crisis, a random glucose > 200mg
What clinical test and corresponding values are needed to confirm a diagnosis of diabetes?
100
Decrease hepatic glucose production
What is MOA of metformin?
100
Sulfonylureas and Meglitinides especially with insulin Meglitinides- Increase insulin secretion repaglinide, nateglinide
Which drug classes are associated most with hypoglycemia?
100
Metformin Metformin may be safely used in patients with estimated glomerular filtration rate (eGFR) as low as 30 mL/min/1.73 m2
What initial monotherapy should be started at the diagnosis of diabetes?
200
A1C> 5.7% First degree relative with diabetes High risk race/ethnicity (AF, Latino, NA, Asian Pacific Islander) Women diagnosed with GDM Physical inactivity HTN > 140/90 HDL <35 and TG >250
Risk factors for developing diabetes?
200
Increase insulin secretion
What is the MOA of sulfonylureas? Glyburide, Glipizide, Glimepiride
200
SGLT2 inhibitors, GLP-1 receptor agonist, Amylin mimetics Amylin mimetics- pramlinitides Decrease glucagon secretion Slows gastric emptying Increases satiety
Which medications are associated with weight loss?
200
At A1C >9% consider metformin + Sulfonylurea, Thiazolidinedione, DPP-4 Inhihibitor, SGLT2 inhibitors, GLP-1 receptor, Insulin (basil)
At what A1C should a patient begin dual drug therapy?
300
Increases insulin secretion Decreases glucagon secretion slows gastric emptying increases satiety
What is MOA GLP-1 receptor agonist? Liraglutide, Lixisenatide, Dulaglutide
300
Symptoms: shakiness, irritability, confusion, tachycardia, hunger, blurred vision, headaches, trembling Treatment: 1. Check blood sugar 2. Eat 15 grams of carbs 3. Wait 15 mins and recheck blood sugar
What are s/s of hypoglycemia and treatment?
300
For A1C > 10 or blood glucose greater than 300 consider combination therapy with basal insulin (glargine, detemir, degludec) Start with 10 units or 0.1-0.2 units/kg/day Adjust 10-15% or 2-4 units once or twice a week until FBG target is reached
What type of insulin and dose should initiated for first time users?
400
African Americans may also have higher levels of fructosamine and glycated albumin and lower levels of 1,5-anhydroglucitol, suggesting that their glycemic burden (particularly postprandially) may be higher.
True or False? African Americans may have higher A1C levels than non-Hispanic whites despite similar fasting and post- glucose load glucose levels.
400
Blocks glucose reabsorption by the kidney increasing glucosuria.
What is MOA of SGLT2 Inhibitors? Canagliflozin,Dapagliflozin, Empaglifozin
400
False: ACE and ARB’s are first line therapy for diabetic kidney disease. ACE inhibitor or ARB therapy has been demonstrated to reduce progression to more advanced albuminuria (>300 mg/g Cr) and cardiovascular events.
True or False? All diabetic patients should be on an ACE or ARB to protect their kidneys.
500
An A1C cut point of >6.5% (48 mmol/mol) identifies one-third fewer cases of undiagnosed diabetes than a fasting glucose cut point of >126 mg/dL (7.0 mmol/L).
Which test catches more diagnoses of diabetes?
500
Increases postprandial incretin concentration which reduces gastric emptying Increases insulin secretion Decreases glucagon secretion
What is MOA of DPP-4 inhibitors?
500
periodic measurement of vitamin B12 levels should be considered in metformin-treated patients, especially in those with anemia or peripheral neuropathy
Long term use of this medication is associated with vitamin B12 deficiency.
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