Diabetes

Question 1

T1DM VS T2DM

Question 2

Symptoms of hyperglycemia and hypoglycemia

Question 3

Diagnostic testing values

Answer 3

Remember:
- Two abnormal test results needed to confirm diagnosis.
- Asymptomatic individuals with a result suggestive of DM should have a repeat test on a subsequent day.

Question 4

Blood glucose target values

Question 5

TCU and monitoring parameters

Answer 5

• HbA1c: 6m if stable, 3m if unstable
• BP: 2-6m
• Weight: 2-6m
• Lipids: annually if stable, 3-6m if unstable
• Foot exam: annually if stable, more frequent if unstable
• Eye exam: annually if stable, more frequent if unstable
• Renal panel: annually

For renal panel, screen for:
* Serum Cr and/or eGFR AND
* Urine albumin-creatinine ratio (uACR) OR Protein-creatinine ratio (uPCR)

Question 6

Non-pharm management

Question 7

When should insulin be considered?

Answer 7

• Evidence of ongoing catabolism is present
• Symptoms of hyperglycemia are present
• When A1C or blood glucose levels are very high (i.e. A1C > 10%, blood glucose ≥ 16.7mmol/L)
• Diagnosis of T1DM is a possibility

Question 8

Metformin
- Drug Class
- MOA
- Dose adjs
- ADRs, DDIs
- C/Is
- PK/PD
- When to be considered for therapy
- Others

Question 9

SGLT2i
- Drug names
- MOA
- Dose adjs
- ADRs, DDIs
- C/Is
- PK/PD
- When to be considered for therapy
- Others

Question 10

GLP1 Receptor Agonists
- Drug names
- MOA
- Dose adjs
- ADRs, DDIs
- C/Is
- PK/PD
- When to be considered for therapy
- Others

Question 11

Sulfonylureas
- Drug names
- MOA
- Dose adjs
- ADRs, DDIs
- C/Is
- PK/PD
- When to be considered for therapy
- Others

Question 12

DPP4i
- Drug names
- MOA
- Dose adjs
- ADRs, DDIs
- C/Is
- PK/PD
- When to be considered for therapy
- Others

Question 13

Alpha Glucosidase Inhibitor
- Drug names
- MOA
- Dose adjs
- ADRs, DDIs
- C/Is
- PK/PD
- When to be considered for therapy
- Others

Question 14

Thiazolidinedione
- MOA
- Dose adjs
- ADRs, DDIs
- C/Is
- PK/PD
- When to be considered for therapy
- Others

Question 15

Insulin
- Types
- MOA
- Dose adjs
- ADRs, DDIs
- C/Is
- PK/PD
- When to be considered for therapy
- Therapy outline when initiating insulin
- Others (e.g. insertion technique)

Question 16

Preferred meds for DM + HTN

Answer 16

ACEi / ARB
Target: <130/80mmHg

Question 17

Preferred meds for DM + ASCVD

Question 18

Preferred meds for DM + hyperlipidaemia

Question 19

Preferred meds for DM + CKD

Question 20

Diabetic emergencies: diabetic ketoacidosis and hyperglycemic hyperosmolar state
- Pathophysiology
- Causes/ risk factors

Question 21

Somogyi Effect VS Dawn Phenomenon