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34 Cards in this Set
- Front
- Back
- 3rd side (hint)
Goal A1C
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<7% or <6.5%
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Goal FPG
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70-130 or <110
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2-hr Post Prandial Glucose
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<180 or <140
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Microalbuminuria
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30-299 mg/dl
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Macroalbuminuria
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300+
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Total Cholesterol
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<200
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Triglycerides
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<150
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LDL
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<100 or <70
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HDL
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>45
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Blood Pressure
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<130/80
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Step 1 (Tier 1)
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Lifestyle Modification
+ Metformin |
Reduces A1C by 2-4%
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Step 2 (Tier 1)
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Addition of:
Basal insulin OR Sulfonylurea (glip, glim, gly) |
Reduces A1c by 2.5-5.5%
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Step 3 (Tier 1)
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Addition of:
Intensive insulin |
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Metformin
--- Glucophage |
↑ peripheral glucose uptake (sensitizer)
↓ hepatic glucose production |
Biguanide
↓ 1-2% A1C |
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Pioglitazone
--- Actos |
↑ uptake of glucose (sensitizer)
↓ hepatic glucose production |
Thiazolidinedione (Glitazone)
↓ 0.5-1.4% A1C |
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Rosiglitazone
--- Avandia |
↑ uptake of glucose (sensitizer)
↓ hepatic glucose production |
Thiazolidinedione (Glitazone)
↓ 0.5-1.4% A1C |
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Nateglinide
--- Starlix |
↑ insulin secretion (rapid/short) in presence of glucose
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Meglitinide
↓ 0.5-1.5% A1C |
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Rapaglinide
--- Prandin |
↑ insulin secretion (rapid/short) in presence of glucose
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Meglitinide
↓ 0.5-1.5% A1C |
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Exenatide
--- Byetta |
↑ glucose-dependent insulin secretion
↓ food intake (wt loss) ↓ glucagon secretion |
GLP-1 Analog (Incretin Mimetic)
↓ 0.5-1% A1C |
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Liraglutide
--- Victoza |
↑ glucose-dependent insulin secretion
↓ food intake (wt loss) ↓ glucagon secretion |
GLP-1 Analog (Incretin Mimetic)
↓ 1-1.5% A1C |
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Glyburide
--- Diabeta |
↑ insulin secretion
+ other effects |
Sulfonylurea
↓ 1-2% A1C |
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Glipizide
--- Glucotrol |
↑ insulin secretion
+ other effects |
Sulfonylurea
↓ 1-2% A1C |
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Glimperide
--- Amaryl |
↑ insulin secretion
+ other effects |
Sulfonylurea
↓ 1-2% A1C |
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Saxagliptin
--- Onglyza |
↑ incretin secretion
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DPP-4 inhibitors
↓ 0.5-0.9% A1C |
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Sitagliptin
--- Januvia |
↑ incretin secretion
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DPP-4 inhibitors
↓ 0.5-0.9% A1C |
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Vildagliptin
--- Galvus |
↑ incretin secretion
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DPP-4 inhibitors
↓ 0.5-0.9% A1C |
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Acarbose
--- Precose |
Block the enzymes that digest starch in the small intestines
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α-glucosidase inhibitor
↓ 0.5-0.8% A1C |
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Voglibose
--- Voglib |
Block the enzymes that digest starch in the small intestines
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α-glucosidase inhibitor
↓ 0.5-0.8% A1C |
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Pramlintide
--- Symlin |
↓ glucagon secretion PP
↓ hepatic glucose production ↓ gastric emptying |
Amylin Analog (Amylin Mimetic)
↓ 0.5-1% A1C |
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DKA
Diabetic Ketoacidosis |
Hyperglycemia
Ketosis Acidosis |
Intensive fluids, immediate insulin, potassium replacement, treatment of underlying disease state
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HHS
Hyperosmolar Hypergylcemic State |
severe hyperglycemia
dehydration serum osmolarity Normal anion gap Presence of insulin! |
Fluid replacement, treat DM with PO agents or insulin
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HYPOglycemia
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<50-60
Cold sweats, faintness, dizziness, HA, tachycardia, nervousness, blurred vision, hunger, personality changes |
15 g glucose, wait 15 mins, repeat if necessary
Glucagon injection (if pt unresponsive) |
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Macrovascular Complications
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IDH/CAD
CVD PVD |
Achieve A1C <7 or <6.5,
Lipid goals, BP, ASA (if M50+/F60+ w. 1+ risk factor) Quit Smoking |
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MICROvascular complications
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Retinopathy
Nephropathy Neuropathy |
A1C control, BP control, ACEI in T1/2D with microalbuminuria, ACEI/ARB in T2D with macroalbuminuria
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