Term
| Diagnosis of diabetes: classic diabetes symptoms (poly's) and weight loss, and a __ __ glucose of greater than or equal to __. |
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Definition
| - random plasma glucose of greater than or equal to 200 mg/dl |
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Term
| Prediabetes is diagnosed by an __ __ __ __ of between _ and __, or an __ __ __ __ of between __ and __. |
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Definition
- Impaired Fasting Glucose Tolerance of greater than 100 and below 126
- Oral Glucose Tolerance Test (OGTT)of greater than 140 and below 200 |
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Term
| A __ __ _ _of greater than or equal to 126 is diagnostic for DM. |
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Definition
| - Fasting Plasma Glucose (FPG) |
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Term
| OGTT greater than or equal to __ is diagnostic of DM. |
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Definition
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Term
Diagnostic for DM:
- random palsma glucose greater than or equal to ___
- FPG of greater than or equal to ___
- OGGT of greater than or equal to __ |
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Definition
- 200 mg/dl
- 126 mg/dl
- 200 mg/dl
you can also use HbA1C to diagnose diabetes |
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Term
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Definition
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Term
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Definition
- PO medications: Sulfonylureas, Meglitides, Biguanides, Thiazolidinediones, alpha-Glucosidase inhibitors, Dipeptidyl Peptidase-4 Inhibitors (DPP-4)
- Incretin mimetics
- Insulin |
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Term
Don’t forget about lifestyle modifications in the treatment plan:
Diet, exercise, weight control
Regular checkups/blood tests
Regular eye/dental exams
Tobacco cessation
Limit EtOH consumption
Foot care/protection |
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Definition
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Term
| Secretagogues are po meds for diabetics and include ___ and ___. |
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Definition
- Sulfonylureas (Glyburide, Glipizide, Gilmepiride)
- Meglitinides (Repaglinide, Nateglinide) |
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Term
|
Definition
- 2nd generation sulfonylurea secretagogue
- trade names: Micronase, DiaBeta, Glynase
- half life of 1-2 hours, but has active metabolite so has 24 hour action
- 2.5 mg/d |
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Term
|
Definition
- sulfonylurea secretagogue second generation
- trade name: Glucotrol
- 5-40 mg/d
- t1/2= 2-4 hours |
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Term
|
Definition
- sulfonylurea secretagogue second generation
- trade name: Amaryl 1 mg/d |
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Term
| Contraindications to Sulfonylureas: |
|
Definition
- Ketoacidosis/diabetic coma
- hypersensitivity to the med |
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Term
| Black box warning on sulfonylureas: |
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Definition
| 1st generation may increase risk of cardiovascular mortality |
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Term
| Caution use of sulfonylureas with what health issues? |
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Definition
- renal disease
- hepatic disease
- hypoglycemia
- metabolic stress |
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Term
| Non-sulfonylurea secretagogues bind to sulfonylurea receptor and have same action as sulfonylureas. If sulfonylureas have been tried and did not work, these probably will not work either. |
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Definition
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Term
| 2 non-sulfonylurea secretagogues: |
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Definition
- Meglitinide= Repaglinide= Prandin
- D-phenylalanine derivative= Nateglinide= Starlix |
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Term
| Non-sulfonylurea secretagogues are __ acting so they must be taken __ times a day. |
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Definition
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Term
| SE of non-sulfonylurea secretagogues: |
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Definition
- hypoglycemia
- weight gain
- GI disturbance
- arthralgia |
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Term
| Contraindications to non-sulfonylurea secretagogues : |
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Definition
|
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Term
| what enzyme is involved with metabolism of Repaglinide? |
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Definition
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Term
| Enzyme involved in metabolism of Nateglinide: |
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Definition
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Term
| Big advantage of Biguanides (i.e. Metformin): |
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Definition
| DOES NOT CAUSE HYPOGLYCEMIA OR WEIGHT GAIN |
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Term
| __ is often first line drug for DM. It can be given to __ y/o and older. It requires multiple dosing regimens. It works by decreasing __ __, decreasing __ __ of glucose, and ___ glucose uptake by skeletal muscle cells. |
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Definition
- Metformin
- 10 y/o and older
- decreasing hepatic gluconeogenesis
- decreasing GI absorption of glucose
- increasing glucose uptake by skeletal muscle cells |
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Term
|
Definition
- GI disturbance (doe related)
- weight loss
- metallic taste |
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Term
| Contraindications to Metformin: |
|
Definition
- renal dysfunction (creatinine greater than 1.4) or abnormal creatinine clearance
- CHF
- acute or chronic metabolic acidosis |
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Term
| Black box warning for Biguanides (Metformin): |
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Definition
lactic acidosis: rare but deadly 50% of the time
MONITOR CREATNINE IN ALL PATIENTS, CHECK GFR IN ELDERLY |
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Term
| What do you need to check in all patients on Metformin? |
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Definition
- creatinine
- check GFR in elderly |
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Term
| 2 types of drugs for DM that do NOT cause hypoglycemia: |
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Definition
- Biguanides (Metformin)
- Thiazolidinediones (TZDs) |
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Term
| 2 drugs that are often first line for DM: |
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Definition
-Biguanides (Metformin)
- Thiazolidinediones |
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Term
| TZDs are often first line of therapy as monotherapy or combined with __, __ (but not Avandia), or sulfonylureas. |
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Definition
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Term
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Definition
- increase insulin sensitivity in muscle, liver, and adipose tissue
- decrease insulin resistance |
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Term
|
Definition
| - contraindicated for NYHA class III and IV, myocardial ischemia |
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Term
|
Definition
- CHANGE IN SERUM LIPIDS (LDL AND HDL)
- MACULAR EDEMA
- weight gain (fluid retention)
- anemia (dilutional)
- ovulation (beware in perimenopausal women) |
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