Diagnosis
First line treatment - cardiovascular and Renal
other
Insulin
Goals/other
100
The A1c value that is criteria for a diagnosis of Diabetes
≥6.5%
(The test should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay.)
100
Prevention and lifestyle changes for adults with overweight or obesity at high risk of type 2 diabetes. Name one
- weight reduction goal of at least -7% (achieve and maintain)
- ≥150 min/week of moderate-intensity physical activity.
- A variety of eating patterns, such as Mediterranean style, intermittent fasting, and low carbohydrate, have shown benefit.
- Reducing daily calorie needs by 500-1000 (Diabetes Prevention Program Trial)
100
These medications have Very high and High efficacy for weight loss
BONUS: list the two specific medications in the category "Very high" and "High"
GLP-1s (listed below)
Very High: Semaglutide, tirzepatide
High: Dulaglutide, Liraglutide
100
At this A1c you can consider early initiation of insulin
≥10%
100
This is the goal A1c for most patients
<7%
200
2 hours post oral glucose tolerance test (OGTT) this blood glucose is criteria for a diabetes diagnosis
≥200 mg/dL
200
This medication ... should be considered in adults at high risk of type 2 diabetes, as typified by the DPP, especially those aged 25–59 years with BMI ≥35 kg/m2, higher fasting plasma glucose (e.g., ≥110 mg/dL [≥6 mmol/L]), and higher A1C (e.g., ≥6.0% [≥42 mmol/mol]), and in individuals with prior gestational diabetes mellitus.
Metformin
200
This is the goal A1c during pregnancy.
<6% if this can be achieved without significant hypoglycemia,
but the goal may be relaxed to <7% if necessary to prevent hypoglycemia
200
List one rapid acting and one long acting
rapid: lispro, aspart, glulisine
long acting: glargine, detemir
200
A side effect of long term use (≥5 years) of Metformin.
Vitamin B12 deficiency
300
A1c criteria for pre-diabetes
5.7-6.4%
300
These medications should be initiated in patients with Diabetes and ASCVD risk
GLP-1 or SGLT2i with proven CVD benefit
GLP-1s w proven CVD benefit: dulaglutide, liraglutide, semaglutide (SUBQ)
SGLT2i w proven CVD benefit: empaglifolzin (Jardiance), canagliflozin
300
treatment for diabetes or gestational diabetes during pregnancy
What should and what should not be used
Should: Insulin
Should Not: Metformin and glyburide, individually or in combination, should not be used as first-line agents for management of diabetes in pregnancy, as both cross the placenta to the fetus and may not be sufficient to achieve glycemic goals. Other oral and noninsulin injectable glucose-lowering medications lack long-term safety data and are not recommended.
300
Add these drugs if injectable therapy is needed to lower A1c before starting insulin
Consider GLP-1 or Dual GIP/GLP-1 in most individuals prior to insulin
Dual GIP/GLP-1 (Tirzepatide)
300
In these situations / patients, a less stringent A1c goal is recommended
individuals with limited life expectancy or where the harms of treatment are greater than the benefits
400
The FPG (fasting plasma glucose) that is criteria for a diagnosis of diabetes.
≥126 mg/dL
400
These medications should be initiated in patients with Diabetes and Heart Failure
SGLT2i w proven HF benefit
-dapagliflozin (Farxiga)
-empagliflozin (Jardiance)
400
Goal for percent of time in range for patients with CGM
>70%
400
The total daily dosing for starting basal insulin (weight based or total)
10 units per day OR 0.1-0.2 units/kg per day
400
Preprandial glucose goal
Postprandial glucose goal
preprandial 80-130 mg/dL
Postprandial <180 mg/dL (measured 1-2 hours after meal)
500
If a person is experiencing classic hyperglycemic symptoms AND has a random blood glucose of ____ this is a criteria of diagnosing diabetes.
BONUS: what are some symptoms of hyperglycemia
≥200
Symptoms of hyperglycemia:
- Urinating large amounts
- Excessive thirst
- Feeling tired
- Frequent hunger
- Dry mouth
- Weight loss
- Blurred vision
- Recurrent infections (e.g., urinary infections, skin infections)
- Wounds (cuts, scrapes) that heal slowly
500
These medications should be initiated in patients with diabetes and CKD (on maximally tolerated ACEi or ARB)
SGLT2i w proven CKD benefit or GLP1 w proven CKD benefit
SGLT2i: canagliflozin, dapagliflozin, empagliflozin
GLP-1: dulagluti, liraglutide, semaglutide (SUBQ)
500
Give the generic for these brand medications(partial credit allowed):
Tradjenta
Januvia
Victoza
Rybelsus
Synjardy
Farxiga
Tradjenta (Linagliptin)
Januvia (Sitagliptin)
Victoza (liraglutide)
Rybelsus (semaglutide)
Synjardy (empagliflozin-metformin)
Farxiga (dapagliflozin)
500
This insulin has the longest duration of action
Insulin degludec (Tresiba)... ≥42 hours
500
For every 1% of A1c = _______ (amount of) estimated average glucose
(if you get within +/- 5-10 I'll give you credit)
28.7 mg/dL ~ approx 30