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By the Numbers
The Long Game
Potent Potables
Updates since
2016-2019
Potpurri
100
When hyperglycemia is present, this is the FPG cut-off for diagnosing diabetes.
What is > or = 126 mg/dL?
100
These are the micro- (3) and macrovascular (1) complications most clinicians monitor for patients with diabetes.
What are retinopathy, neuropathy, nephropathy (microvascular) and ASCVD (macrovasular)?
100
This class of medications offers approximately 0.7% HbA1c lowering by inhibiting degredation of endogenous incretins, thereby increasing insulin secretion in response to elevated BG, decreasing glucagon secretion, slowing gastric emptying, and increasing satiety.
What are the dipeptidyl peptidase-4 inhibitors?
100

For non-critically ill patients with diabetes in the inpatient setting, this insulin regimen is no longer supported as monotherapy.

What is "sliding scale"?

100

Patients with pre-diabetes and any ONE of the following factors should especially be considered for starting metformin.

What is BMI > or = 35 kg/m^2, age < 60 years, or women with prior GDM?

200
Asymptomatic adults of any age with this BMI and one additional risk factor should be screened for diabetes?
What is > or = 25 kg/m^2 (or > or = 23 kg/m^2 for Asian Americans)?
200
Patients with diabetes should perform self foot checks ______ and have a foot exam in a medical office at least _______.
What is daily and yearly?
200
This class of medication can be titrated to achieve nearly any HbA1c target (assuming the patient is adherent).
What is insulin?
200

Owing to studies suggesting similar benefits in older versus middle-aged adults, recommendations were consolidated for patients with diabetes 40–75 years and >75 years of age without ASCVD and a 10-year ASCVD risk score of < 20% to use this intensity of statin therapy.

What is moderate intensity statin therapy?

200

This is the goal fasting plasma glucose (FPG) range.

What is 80-130 mg/dL?

300
This is the clinical HbA1c range of pre-diabetes.
What is 5.7 - 6.4 %?
300
Patients with diabetes within this age range should receive the PPSV23 vaccination (Pneumovax).
What is ages 2 - 64?
300
Despite higher risk for side effects in certain populations, many clinicians recommend this class of medications for efficacy in less progressed diabetes as well as low cost for patients.
What are the sulfonylureas?
300

Patients with an ASCVD risk score of > or = 15% should have this blood pressure goal, unless it causes undue pill/side effect burden.

What is <130/80 mmHg?

300

This is how you would instruct a patient to manage hypoglycemia.

What is "When you notice symptoms of low blood sugar, check your blood sugar. If it is less than or equal to 70 mg/dL, administer 15 g of fast-acting carbohydrate, then wait 15 minutes and re-check your BG. Repeat this process until BG is > 70 mg/dL."

400
Below this blood glucose value (mg/dL), we should counsel patients to manage hypoglycemia.
What is < or = 70 mg/dL?
400
With a "C" rating, the Hepatitis B vaccine series should be administered to unvaccinated adult patients with diabetes who are in this age range.
What is ages 19 to 59?
400
These are the three mechanisms of action of biguanides (a.k.a. the class of medications which includes metformin).
What is to 1) inhibit hepatic gluconeogenesis and 2) glycogenolysis as well as to 3) improve insulin sensitivity in peripheral muscle and fat?
400

First-line antihypertensive management in patients with diabetes should occur using this class(es) of medications?

What are ACE inhibitors, ARBs, thiazide-like diuretics, or calcium channel blockers?

400

This is the term for when a patient has at least 3 episodes of BG < 54 mg/dL without symptoms of hypoglycemia. 

What is hypoglycemia unawareness?

500
This lab AND value indicates when an ACE inhibitor or ARB should be initiated for a patient with diabetes.
What is a urine albumin-to-creatinine ratio of > or = 30 mg/g?
500

Control of these three factors - often managed through diet, exercise, and pharmacotherapy - prevents micro- and macro-vascular complications in diabetes.

What are glycemic, lipid, and blood pressure control?

500
Don't start this class of medications (which improve insulin sensitivity in muscle and fat through modulation of the PPAR-Y receptor) if you want a fast onset of action; these drugs can take 2-3 weeks to see efficacy and up to 3 months for full efficacy of the current dose!
What are the Thiazolidinediones (TZDs)?
500

Due to recent studies, four medications have been recommended to consider in patients with diabetes and established cardiovascular disease to reduce mortality. Name two.

What are empagliflozin (Jardiance), canagliflozin (Invokana), dulaglutide (Trulicity), liraglutide (Victoza), and semaglutide (Ozempic)?

500
The ADA recommends insulin therapy when initial HbA1c is > or = ___ %, while AACE recommends initiating insulin therapy when HbA1c is > or = ___ %.
What is 10% and 9%?