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29 Cards in this Set
- Front
- Back
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At what level does glucose start to spill into the urine?
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180 mg/dL
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For a Type I Diabetic, what should the insulin regimen be?
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Basal insulin - 50%
-intermediate and long acting Prandial insulin - 40-60% -rapid and short acting insulins |
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What is Type II Diabetes characterized by?
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Impaired insulin secretion
Insulin resistance Increased hepatic glucose production |
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How do you diagnose metabolic syndrome?
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3 of the 4 to diagnose:
D - dyslipidemia R - Insulin Resistance O - Obesity P - Blood Pressure |
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If a recently diagnosed diabete patient presents with microvascular disease, how long does this suggest the patient has had DM?
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7-10 years
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When is HbgA1C measured?
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quarterly in patients who do not meed treatment goals
semiannually in patients meeting treatment goals |
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What are contraindications for alpha-glucosidase inhibitors?
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Malaborption, IBD, intestinal obstruction, and renal impairment
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How are alpha-glucosidase inhibitors used?
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As a monotherapy or in combination with: sufonylureas, metformin, or insulin
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How does metformin work?
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It decreases hepatic glucose production.
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What are the benefits of using metformin?
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1. No hypoglycemia
2. Lowers plasma free fatty acid levels. 3. Decrease total cholesterol and TG 4. Modest weight loss. |
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What are some adverse effects of metformin?
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Nausea, vomiting, diarrhea
-Take with food to minimize GI problems Lactic Acidosis |
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What is the big contraindication with metformin?
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Renal impairment!
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True or False:
Metformin needs to be held for 48 hours after a procedure. |
True
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How much does metformin reduce the A1C by?
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1.5-1.7%
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What is the dosage for metformin?
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Starting dose - 500 mg bid
Titrate to 2000 mg divided bid |
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What are some examples of meglitinides?
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Starlix and Prandin
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What are two important adverse effects of meglitinides?
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Mild hypoglycemia
Modest weight gain |
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Are meglitinides good for people who don't eat regular meals?
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No
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What is 2nd line for Type 2 DM?
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Sulfonylureas
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What are some examples of sulfonylureas?
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Glipizide, Glyburide, Glimepiride
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Which sulfonylurea causes more hypoglycemia and weight gain?
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Glimepiride
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What are the adverse effects of sulfonylureas?
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Hypoglycemia
Disulfiram-like reaction with ETOH |
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Can you use sulfonylureas with hepatic or renal disease?
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No
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What are some examples of TZD's?
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Actos and Avandia
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Which TZD is the best for lipid lowering?
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Actos
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What are some adverse effects of TZDs?
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Hepatotoxicity, Anemia, peripheral edema, and weight gain.
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You can't use TZDs with what drug and why?
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Glyburide because you have an increased risk of hypoglycemia.
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Which incretin doesn't have hypoglycemia?
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Januvia
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How does pramlintide (Symlin) work?
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slows gastric emptying, inhibits glucogon production, decreases postprandial glucose, and decreases appetite.
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