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Diabetes Flashcards

1
Q

Diagnosis

Diabetes diagnosis criteria

A
  • Fasting glucose ≥ 126
  • HbA1C ≥ 6.5%
  • 2 hr glucose test ≥ 200
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2
Q

Goals

Diabetes goal

ADA guideline goal

A
  • pre-prandial 80-130
  • post prandial <180
  • HbA1C < 7 %
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3
Q

Criteria to start ACEi/ARB

A
  • microalbuminuria > 30
  • eGFR < 60
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4
Q

Criteria to start ASA

Secondary prevention

A

h/o MI or stroke in high risk patients

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5
Q

Criteria to start ASA

Primary prevention

A

ASCVD > 10%

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6
Q

Criteria to start a STATIN

Age < 40

A

only if ASCVD/risk factors

Risk factors: LDL ≥ 100, HTN, smoker, family hx, albuminuria

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7
Q

Criteria to start a STATIN

Age 40-75

A

If ASCVD/risk factors
high intensity statin

Risk factors: LDL ≥ 100, HTN, smoker, family hx, albuminuria

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8
Q

Criteria to start a STATIN

Age 40-75

A

No risk factors
moderate intensity statin

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9
Q

Criteria to start a STATIN

Age >75; no risk factors

A

moderate intensity statin

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10
Q

Criteria to start a STATIN

Age >75; ASCVD/Risk factors

A

moderate-high intensity statin

Risk factors: LDL ≥ 100, HTN, smoker, family hx, albuminuria

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11
Q

Immunizations recommended for diabetic patients

A
  • Influenza
  • COVID
  • Hep B
  • Tdap
  • Pneumococcal
  • Shringrix
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12
Q

OTC/Herbal

Natural products with benefit in diabetes

A
  • Chromium
  • Cinnamon
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13
Q

Rapid Acting Insulin

Generic + Brand

A
  • Lispro- Humalog, Admelog, Lyumjev
  • Aspart- Novolog, Fiasp
  • Glulisine- Apidra
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14
Q

Insulin

Regular insulin available IV?

A

Apidra (Glulisine)

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15
Q

Standard insulin concentration & vial size

A

100U/mL
Available in 10 mL

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16
Q

Standard insulin concentration & pen size

A

100U/mL
Available in 3 mL

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17
Q

Insulin Brand Names

Novolog, Fiasp

type of insulin

A

Aspart

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18
Q

Insulin Brand Names

Humalog, Admelog, Lyumjev

type of insulin

A

Lispro

Rapid Acting

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19
Q

Insulin Brand Names

Apidra

type of insulin

A

Glulisine

Rapid Acting

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20
Q

Insulin Brand Names

Levemir

type of insulin

A

Detemir

Long acting

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21
Q

Insulin Brand Names

Lantus, Semglee, Toujeo, Basaglar

type of insulin

A

Glargine

Long acting

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22
Q

Insulin Brand Names

Tresiba

type of insulin

A

Degludec

Long Acting

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23
Q

Type of insulin

Short Acting Regular Insulin

A

Humulin R
Novolin R

Humulin R comes OTC

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24
Q

Type of insulin

Intermediate Acting Insulin

A

NPH
Humulin N
Novolin N

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25
SE of Insulin (3)
* Hypoglycemia * Weight Gain * Hypokalemia
26
Dosing for Insulin | T1DM
0.5-0.8 U/kg/day
27
Dosing of Insulin | T2DM
0.1-0.2 U/Kg/day
28
# Insulin conversions Toujeo to other insulin
TD * 0.8
29
# Insulin conversions Long acting to NPH
unit to unit given BID | NPH = intermediate N= cloudy
30
# Insulin conversions NPH QD to glargine
unit to unit QD
31
# Insulin conversions NPH BID to glargine
TD * 0.8 QD
32
NPH to detemir
unit to unit QD or BID
33
# **Hypoglycemia** Treatment
Rule of 15 * 5-6 lifesavers * 2 sugar cubes * 4 oz of OJ * 6 jelly beans * 3-4 glucose tabs
34
# DKA Treatment | (++) ketones, fruity breath, polydysia, polyuria
* **Hydration 0.9% NS * Insulin 0.1 U/Kg/hr - k must be ≥ 3.3 * Dextrose if glucose drops to 200-250 * K replacement- 20-40 mEq/hr * Bicarb if pH < 6**
35
SE of Metformin
* Diarrhea * Nausea * Lactic acidosis * ↓ B12 * Weight loss ✓
36
CI of metformin
eGFR of < 30
37
Glimepiride (Amaryl) Glipizide (Glucotrol) Glyburide (Glynase, Diabeta)
Sulfonylureas | **- ide**
38
Which SU is good for patient with renal impairment?
Glipizide
39
CI of SU
Sulfa allergy
40
Repaglinide (Prandin) Nateglinide (Starlix)
Megliti**nides** | **-glinide** ## Footnote MOA: stimulates insulin secretion → Take with meals - if you skip a meal, skip the dose
41
SE of Meglitinides
* Weight gain * Hypoglycemia
42
Pioglitizone (Actos)
Thiazolidinediones (TZDs)
43
Major CI of Actos
HF
44
SE of Pioglitazone
* edema * hepatic failure * ↑ risk of fractures * bladder cancer | peepee glitizone - bladder cancer
45
Liraglutide (Victoza) Exenatide (Byetta) Dulaglutide (Trulicity) Semuglutide (Ozempic, Rybelsus)
Glucagon-like peptide (GLP-1) agonist | **-tide**
46
SE of GLP1 Agonist
* G- gallbladder dz, GI symptoms (N/V, Diarrhea) * L- weight loss * P- pancreatitis * 1(T)- thyroid tumors
47
# Formulation PO GLP 1
Rybelsus- Semaglutide | take on empty stomach keep in OG packaging
48
# Formulation Weekly GLP-1 Agonist
* Bydureon- Exanatide ER * Trulicity-Dulaglutide * Ozempic- Semaglutide
49
# Formulation Daily GLP-1 Agonist
* Victoza- Liraglutide- SQ * Rybelsus- Semaglutide - PO * Byetta- Exanatide- SQ BID
50
Longest acting SU
Glyburide
51
Sitagliptin (Januvia) Alogliptin (Nesina) Linagliptin (Tradjenta) Saxagliptin (Onglyza)
DPP4 Inhibitors | **-gliptins** ## Footnote all PO QD
52
SE of DPP4
* Pancreatitis * Pain in the joints | 2 P's
53
DPP 4 that does not require renal adjustments
linagliptin (Tradjenta)
54
# DDI DPP4 CYP3A4 Substrates
* Linagliptin * Saxagliptin
55
Liraglutide does for weight loss
Saxenda 3 mg | for Diabetes 1.8
56
Sitagliptin dose for CrCl 30-49
50 mg
57
Sitagliptin dose for CrCl <30
25 mg
58
Alogliptin dose for CrCl 30-60
12.5 mg
59
Alogliptin dose for CrCl <30
6.25 mg
60
Canagliflozin (Invokana) Dapagliflozin (Farxiga) Empagliflozin (Jardiance) Ertugliflozin (Steglatro)
SGLT2 Inhibitors | all QD take in the AM
61
SE of SGLT2 Inhibitors
* G- genital infections (UTI, Pyelo) * L- ↑LDL, Loss of weight ✓ * ↓BP * Bone fractures (osteoporosis)
62
Invokana CI
eGFR < 30
63
Farxiga CI
eGFR < 45 | eGFR < 24 in CKD
64
Jardiance CI
eGFR < 30
65
# Insulin Calc Insulin- Carb Ratio for Regular Insulin
Rule of 450 450 / TDD of insulin
66
# Insulin Calc Insulin- Carb Ratio for Rapid Insulin
Rule of 500 500 / TDD of insulin
67
# Insulin Calc Correction Factor for Regular Insulin
Rule of 1500 1500 / TDD of insulin
68
# Insulin Calc Correction Factor for Rapid Insulin
Rule of 1800 1800 / TDD of insulin
69
What causes hyperglycemia
* Antipsychotics * Beta Blockers * B3- Niacin * Diuretics * Tacrolimus, Cyclosporine * Protease Inhibitors * Statins * Steroids
70
Meds that cause hypoglycemia
* Beta blockers * Quinolones * Tramadol * Insulin * SU * Meglitinides
71
MDD of Metformin
Glucophage: 2550 mg/ day Glucophage XR: 2000 mg/day Fortamet: 2500 mg/day

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