Term
| Which meds are insulin sensitizers? |
|
Definition
|
|
Term
| When would you NOT want to use metformin from the get go? |
|
Definition
| renal impairment (Cr >1.5) |
|
|
Term
| What must you be cautious about with using metformin in a patient with liver dysfunction? |
|
Definition
|
|
Term
| What can help with cutting down the GI upset associated with metformin? |
|
Definition
| taking it with meals, titrating up slowly |
|
|
Term
| What meds preserve beta cell function? |
|
Definition
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|
Term
| What patients would you NOT want to give GLP-1 agonists to? |
|
Definition
|
|
Term
| What patients would you NOT want to give TZDs to? |
|
Definition
| h/o heart failure (causes fluid retention, exacerbation of CHF) |
|
|
Term
| GLP-1 analogs are glucose-_________ whereas sulfonlyureas are glucose-_________. |
|
Definition
|
|
Term
| Which SU is the safer one? |
|
Definition
| glimiperide (3rd generation) |
|
|
Term
| How do TZDs and GLP-1 agonists preserve beta cell function? |
|
Definition
| delay the need for insulin |
|
|
Term
| When do you start insulin? |
|
Definition
-3 oral agents and still not to A1c goal
-2 oral agents and a long was from A1c goal
-any pt. with moderate to severe renal impairment
basically, if you need more than a 4% decrease in A1c to reach goal, go ahead and start insulin |
|
|
Term
| What type of insulin is not recommended for use anymore? |
|
Definition
|
|
Term
| When is basal insulin usually dosed? |
|
Definition
|
|
Term
| How is pre-mixed insulin usually dosed? |
|
Definition
|
|
Term
| How is rapid/fast-acting insulin dosed? |
|
Definition
|
|
Term
| For pre-mixed insulin, the first number is the _________ and the second number is the _________. |
|
Definition
intermediate-acting
rapid-acting |
|
|
Term
| What is the usual starting dose for basal insulin? |
|
Definition
|
|
Term
| What goal are you looking for when using the 3-0-3 titration for basal insulin? |
|
Definition
| average fasting glucose is 80-110 |
|
|
Term
| What is good about the 3-0-3 titration system for basal insulin? |
|
Definition
| numbers come down slowly, so there is less risk of hypoglycemia |
|
|
Term
| What goals of the labs do you want in a diabetic patient? |
|
Definition
|
|
Term
| What needs to be dropped when initiating mealtime insulin? |
|
Definition
| non-insulin injectables and SUs |
|
|
Term
| What is the usual initial dose for mealtime insulin? |
|
Definition
| 10% basal dose at largest meal of the day |
|
|
Term
| What do you need to tell the patient to do with their pre-mixed insulin? |
|
Definition
|
|
Term
| Which 2 classes of drugs should not be used together because it is pointless? |
|
Definition
| GLP-1 analogs and DPP-4 inhibitors |
|
|
Term
| How many units does a mL of insulin contain? |
|
Definition
|
|
Term
| How many units does 1 vile of insulin contain? |
|
Definition
|
|
Term
| If a patient is on only oral agents for their diabetes, how often should they be checking their sugar? |
|
Definition
| at least once a day--FASTING |
|
|
Term
| If a patient is on oral agents and basal insulin, how often should they be checking their sugar? |
|
Definition
at least once a day--FASTING
may also check a 2 hr post-prandial to assess prandial excursions |
|
|
Term
| If a patient is on oral agents and both basal and mealtime insulin, how often should they be checking their sugar? |
|
Definition
| fasting and before each meal (at least 4 times a day) |
|
|
Term
| What meds are pretty much required in diabetic patients? |
|
Definition
ACE inhibitor or ARB
statin
ASA 81 mg |
|
|
Term
| What is the leading cause of adult blindness in the the U.S.? |
|
Definition
|
|
Term
| What is the most common cause of chronic kidney failure and end stage renal disease in the U.S.? |
|
Definition
|
|
Term
| What is the primary cause of death in diabetics? |
|
Definition
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