APPE diabetes management Overview

Question 1

Rapid Acting Insulins

Answer 1

Examples:
Lispro
Aspart
Glulisine

peak: 1-1.5 hr
Lasts: ~3-4hr

Typically used for PPG

Rapid insulins do not LAG

Question 2

Short Acting

Answer 2

Regular

peak: 2.5 hr
Lasts: 4-6hr

Regular and Short

Question 3

Intermediating Acting

Answer 3

Examples:
NPH

peak: 8 hr
Lasts: ~10-16hr

Intermediate is Not Particularly Hasty

Question 4

Long Acting

Answer 4

Examples:
Glargine
Detamir

peak: no peak
Lasts: ~24hr

Typically used for FBG

God Damn 24 hours is a long time

Question 5

Metformin

Answer 5

MOA:
1.Inhibits hepatic gluconeogenesis
2. Increase peripheral glucose uptake (increase insulin sensitivity)
3. decrease intestinal absorption

BBW: LACTIC ACIDOSIS

Dosing:IR
Initial: 500 mg once or twice daily
Dosage adjustments: 500 or 850 increments q7 days
Maintenance: 1000 mg BID or 850 mg bid
mdd: 2.55 g/day

Dosing: XR
Initial 500 mg to 1000 mg once daily
dosage adjustments: titration usually done by 500mg q7 days
maintenance: 2g/day

Adverse Effects:
GI upset
b12 deficiency
Lactic Acidosis (Esp. in renal insufficiency)

Expected A1C lowering: 1-2%

Question 6

Sulfonylureas

Answer 6

MOA: Stimulate insulin release from