Management
New patient with hyperglycemia on fasting labs and A1C 6.8%. No prior history of diabetes.
Lifestyle modifications including calorie restricted diet and exercise, consider biguanides.
Lethargy, headaches, confusion, tremulousness
What are hypoglycemic symptoms.
Biguanide example
What is metformin.
Early satiety. Nausea and vomiting after eatting.
What is a GLP-1.
A1C for patients over 65 years of age.
What is 7.5%.
ASCVD score > 7.5% with Diabetes II
What is high intensity statin therapy.
Increased AV diameter, macular edema, Cotton wool spots, hemorrhages, decreased visual acuity
What is diabetic retinopathy.
Causes polyuria and may promote UTI.
What is an SGLT-2.
Increased anion gap, ketones +, moderately elevated sugar.
What is DKA from SGLT-2.
LDL for all type II diabetics.
70 mg. % or less.
Protein creatinine ratio 100 mg. on micral with A1C of 8.3%.
What is improve glycemic control and add ACE inhibitor or ARB.
Epigastric abdominal pain after starting Exentatide (GLP-1) medication for Diabetes Mellitus II.
What is pancreatitis.
Works by inhibiting insulin release and blocking glucagon secretion.
What is a GLP-1.
Can cause bloating and diarrhea
What are Alpha glucosidase inhibitors.
Acceptable BP range for diabetics.
What is 120-130/ 70-80.
Stocking glove hyperethesias in the hands and feet in a diabetic.
What is Duloxetine or Gabapentin.
Persistant elevated fasting sugar with early morning hypoglycemia.
What is the Dawn Phenomenon.
Promotes increased insulin secretion and can cause hypoglycemia especially in the elderly.
What is a sulfonylurea.
Increases insulin production without hypoglycemia.
What is a DPP-4.
BMI goals for most diabetic patients.
What is 23-25.
BMI 40. A1C 9.5. Blood pressure 160/95. OSA treated with CPAP. On Metformin, Exentatide, Lisinopril, Hctz. and atorvastin.
What is a Bariatric consult.
Non ketotic comatose state in an adult onset diabetic.
What is a hyperosmolar coma.
2 oral diabetic class meds that promote Renal and cardioprotective effects.
What is a SGLT-2 and DPP-4.
May promote peripheral edema and is contraindicated in patients with congestive heart failure.
What is a Thiazolidinedione (TZD).
3 yearly exams that are required for diabetic patients.
What are:
1. Annual eye exams
2. Annual podiatry evaluation
3.Microalbumin