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PR 3152 Finals > Diabetes Management > Flashcards

Diabetes Management Flashcards

1
Q

pre-diabetes ogtt

A

7.8-11.0 mmol/L

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2
Q

pre-diabetes fpg

A

6.1-6.9 mmol/L

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3
Q

target HbA1c

A

<7%
7-8.5 if vulnerable

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4
Q

target FBG

A

4 to 7

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5
Q

target PPG

A

<10

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6
Q

nonpharma

A
  1. quit smoking
  2. weight reduction
  3. exercise (150 min/week. at least 3d/wk of moderate intensity)
  4. diet modification
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7
Q

metformin moa

A

decrease hepatic glucose prod

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8
Q

metformin dosage form

A

500mg, 850mg, 1g

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9
Q

metformin AE

A

GI, anorexia, metallic taste (take with food), (rare) lactic acidosis

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10
Q

metformin CI

A

crcl<30, hypoxia

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11
Q

metformin ddi

A

etoh, cationic drugs, iodine contrast

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12
Q

metformin benefits

A

negligible weight gain
negligible hypogly

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13
Q

su moa

A

SU bind to SU receptor proteins and inhibits Katp channel mediated K+ efflux, triggering calcium dependent release of insulin from b cells

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14
Q

su requirement

A

need functional beta cells to work (not for T1)

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15
Q

su AE

A

hypogly, weight gain

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16
Q

su ddi

A

BB, etOH, Cyp2c9

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17
Q

tzd moa

A

peroxisome proliferator activated receptors agonist to promote glucose uptake into target cells

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18
Q

tzd ae

A

hepatotoxicity (do not initiate if ALT > 3xUNL)
edema
fracture
weight gain

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19
Q

tzd ci

A

active liver disease, HF class III or IV

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20
Q

a glucosidase moa

A

delay glucose absorption and decrease PPG (inhibit brush border enzymes for breakdown of complex carbohydrates)

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21
Q

a glucosidase inhibitor ae

A

flatulence, diarrhoea

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22
Q

a glucosidase inhibitors ci

A

breast feeding, GI diseases

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23
Q

a glucosidase ddi

A

yakult!

24
Q

glp 1 receptor agonist moa

A

binds to beta cells to
- delay gastric emptying
- increase insulin secretion
- decrease food intake

25
Q

glp 1 receptor ae

A

GI NVD, acute pancreatitis

26
Q

glp 1 receptor benefits

A
  • weight loss
  • ascvd benefit
  • ckd minimal benefit
27
Q

dpp4i moa

A

prevents active glp1 from being converted to inactive glp 1

28
Q

dpp4i ae

A

very mild
(sitagliptin) pancreatitis

29
Q

sglt2i moa

A

increased renal glucose excretion, decreased blood glucose

30
Q

sglt2i ae

A

uti, hypot, hypogly, fournier’s gangrene

31
Q

sglt2i benefits

A

ascvd (cana, empa) , hf, ckd

32
Q

meds to take before meal

A

su

33
Q

meds to take with meal

A

alpha glu

34
Q

weight loss inducing meds

A

metformin, glp1, sglt2i

35
Q

weight gain inducing meds

A

su, tzd

36
Q

meds targeting PPG

A

SU, GLP1, TZD

37
Q

meds targeting FPG

A

metformin, SGLT2, TZD

38
Q

insulin moa glucose

A

increase glucose uptake, inhibits hepatic glucose output

39
Q

insulin moa fat

A

enhance fat storage, prevents lipolysis

40
Q

insulin moa protein

A

increase protein synthesis, inhibits proteolysis

41
Q

rapid acting insulin types

A

aspart lispro glulisine
15 min before meal

42
Q

short acting insulin types

A

regular / actrapid
30 min before meal

43
Q

long acting insulin types

A

detemir glargine

44
Q

intermediate acting types

A

nph

45
Q

when injectables started, tzd?

A

discontinue tzd / reduce by 50%

46
Q

when injectables started, su?

A

discontinue (esp if mealtime insulin initiated) / reduce by 50%

47
Q

when injectables started, dpp4i?

A

discontinue

48
Q

mixtard 30 components

A

70% nph, 30% regular

49
Q

conversion of mixtard to glargine

A

20% reduction of NPH

50
Q

target range for fpg

A

5 to 7

51
Q

hyperglycemic hyperosmolar state is which type of diabetes

A

type 2

52
Q

diabetic ketoacidosis happens in which type of diabetes

A

type 1

53
Q

dawn phenomenon

A

release of cortisol in waking hours

54
Q

somogyi effect

A

bg levels drop sharply at night, body releases glucagon, bg increases

55
Q

uses of aspirin in DM

A

those with diabetes and Hx of ASCVD

PR 3152 Finals (6 decks)

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