Diabetes Flashcards
(30 cards)
start screening for DM at what age ?
35
In T1DM when to start celiac screening ?
At diagnosis then every 2 years
Newly diagnosed DM
What is the appropriate management (according to HbA1c)
HbA1c <7.5 : life style
HbA1c 7.5-9.5 : life style + metformin
HbA1c >9.5 : insulin
What is your approach to
Metformin monotherapy failure?
If HbA1c <8.5 : add sulfonylurea
HbA1c >8.5 : add insulin
What is the management of DKA?
Insulin infusion (regular)
IVF - dextrose
Potassium
the appropriate rate for serum glucose reduction in patient with DKA is […]
100 mg/dl/h
6 mmol/L/h
#prevent cerebral edema
DM complications:
Microvascular:
Nephropathy
Opthalmopathy, glaucoma
Macrovascular:
CVD
Stroke
PVD
Osmotic damage:
Neuropathy
Cataract
Down Regulation
Morning hyperglycemia
🔹nocturnal 🔝GH = hyperglycemia
🔆 3 am glucose 🔺
Inc evening insulin dose
Somogyi effect
Morning hyperglycemia
🔹rebound response to nocturnal hypoglycemia
🔆 3 am glucose 🔺
Dec evening insulin dose
Honeymoon period
T1DM
Initial episode of DKA followed by symptom free interval, recurrent hypoglycemia
Dec insulin dose
What diabetic medications may cause weight gain ?
Insulin
Sulfonylurea
Thiazolidinediones
What diabetic medications may cause hypoglycemia ?
Insulin
Sulfonylurea
Pramlintide ( Amylin analog )
[…] is the antidiabetic of choice in IHD
GLP-1 analogs
“Exenatide, liraglutide”
[…] is the antidiabetic of choice in HF & CKD
SGLT-2 inhibitors
“-glifs”
What antidiabetic medication reduce mortality ?
SGLT-2 inhibitors
“-glifs”
Patient with painful diabetic neuropathy
Can benefit from […]
Amitriptyline (TCAs)
Pregabaline
Gabapentin
Side effects of
Biguanides
-Lactic acidosis
-Vit B12 deficiency
-❌Renal insufficiency
Side effects of
Thiazolidinediones
-HF
-Edema
-wt 🔺
-fractures
Side effects of
Sulfonylurea
-Hypoglycemia
-wt 🔺
-❌Renal insufficiency
-(1st gen): Disulfirum-like reaction
Side effects of
Maglitinides
-Hypoglycemia
- wt 🔺
Side effects of
GLP-1 analogs
-N/V
-pancreatitis
Side effects of
SGLT-2 inhibitors
-Glucosuria
-Dehydration
What group of antidiabetic medication is
”glits”
💊Pioglitazone
💊Rosiglitazone
Thiazolidinediones
What group of antidiabetic medication is
”glifs”
💊Empagliflozin
SGLT-2 inhibitor