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Clin Lab Med Final > Diabeatus > Flashcards

Diabeatus Flashcards

1
Q

Criteria for dx DM

A

1) HcbA1c >6.5 or
2) FBG >126 or
3) 2 hour BG >200 after 75 g OGTT or
4) Random BG >200 in pt w/ hyperBG sx
5) In abscence of sx of hyperBG, the first 3 options should be confirmed with repeat testing

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2
Q

Drugs to stim insulin release

A

Sulfonureas/glucotrol/amaryl

Meglitinides/repaglinide/prandin

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3
Q

Insulin sensitizers

A

Biguanides/metformin/glucophage

Thiazos/actos

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4
Q

Alpha glucosidase inhibitors

A

CHO blockers
acarbose/precose
Miglitol/glyset

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5
Q

DPP-4 inhibitors

A

-gliptins

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6
Q

How to start Metformin

A

Begin with 500 mg before largest meal

Increase 500 mg weekly, before bfast and dinner

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7
Q

Maximum rec metformin dose

A

2550 mg/d (most clinicians stop at 2 g)

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8
Q

Traditional rec tx order of DM2

A

Lifestyle changes
Oral agents
Bedtime humulin N (NPH)

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9
Q

Newer rec tx

A

Once daily peakless, long acting insulin glargine/lantus at bedtime

(after lifestyle, oral agents)

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10
Q

How to start bedtime insulin

A

Giver intermed Humulin N
or long acting Lantus/glargine
0.15 units/kg (max 15) or 10-15 units and monitor

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11
Q

Lispro

A

humalog

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12
Q

Aspart

A

Novolog

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13
Q

Glulisine

A

Apidra

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14
Q

Regular

A

Humulin R

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15
Q

NPH

neutral protamine Hagedorn

A

Humulin N

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16
Q

Glargine

A

Lantus

17
Q

Detemir

A

Levemir

18
Q

Onset <15 min
Peak 1 hour
Duration 2-4 hours

A

Rapid

Lispro/humalog

19
Q

Onset 0.5-1 hr
Peak 2-3 hours
Duration 3-6 hours

A

Regular/humulin R

20
Q

Onset 2-4 hours
Peak 6-12 hours
Duration 10-16 hours

A

NPH

21
Q

Onset 1-2 hours
Peak NONE
Duration 20-24+ hours

A

Glargine/Lantus

22
Q

70/30

A

NPH/regular

23
Q

75/25

A

NPL/lispro

24
Q

Calculate insulin dose

  • start with 50% predicted daily dose and gradually increase
  • Give 2/3 before bfast and 1/3 before dinner
A

1-1.2 u/kg/day OBESE

0.5-0.7 u/kg/d non-obese

25
Q

Basal insulin should meet

A

50% of daily needs

26
Q

Bolus insulin should provide

A

10-20% of daily insulin requirement per meal

27
Q

More proactive approach that is replacing reactive approach of SSI

A

Carb counting

28
Q

Waning of insulin action (morning hyperglycemia)

A

Prior evening insulin fx wore off

Tx: increase dose or change timing

29
Q

Dawn Phenomenon (morning hyperglycemia)

A

D/t increase in GH btwn 3-7am

Tx: increase evening insulin dose or change timing

30
Q

Somogyi phenomenon (morning hyperglycemia)

A

Rebound hyperglycemia d/t nocturnal hypoglycemia
Tx: reduce supper or bedtime insulin dose
and/or
have bedtime snack

31
Q

Newer regimen for insulin

A

Peakless as basal insulin

rapid acting before each meal

Clin Lab Med Final (5 decks)

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