Diabetes Flashcards
DM diagnositc labs? (4)
(Confirms DM if these criteria)
HbA1c ≥ 6.5% or
Fasting glu ≥ 126 or
2hr glu post tolerance test ≥ 200 or
Random glu in pt w/ hyperglycemia sxs ≥ 200
DM Glycemic Control targets? (3)
FPG (fasting plasma glu) = 70 - 130
2hrs post meal < 180
HbA1c < 7%
Tx stages for DM II? (5)
1) lifestyle ∆
2) LS∆ + oral
3) LS∆ + oral (a.m.) + NPH or glargine insulin (p.m.)
4) LS∆ + insulin BID (rapid and interm)
5) LS∆ + rapid insulin pre-meals + long insulin x 1
DM tx: Oral Insulin Secretagogues
Stim Insulin secretion:
Sulfonylureas, Meglitinides
DM tx: Oral Insulin Sensitizers
↑ liver/mm sensitivity to insulin,
↓ glucose and insulin levels:
Biguanides
Thiazolidinediones
DM tx: Oral Carb blockers
α-glucosidase Inhibitors
DM tx: Oral DPP-4 Inhibitors
Stop GLP-1 degradation,
↑ action of incretins
DM tx: SQ Incretin Mimetics
GLP-1 Agonists
Oral DOC for DM 2 w/ N liver/kidney fxn?
Metformin
Initiating bedtime insulin?
Interm or long-act at bedtime,
prevents ↑ FBS (fast blood sug) in a.m.
Rapid-acting Insulin:
Onset
Peak
Duration
Onset: < 15min
Peak: 1 hr
Duration: 2-4 hrs
Short-acting (Regular) Insulin:
Onset
Peak
Duration
Onset: < 0.5 - 1 hr
Peak: 2-3 hrs
Duration: 3-6 hrs
Intermediate-acting Insulin:
Onset
Peak
Duration
Onset: 2-4 hrs
Peak: 6-12 hrs
Duration: 10-16 hrs
Long-acting Insulin:
Onset
Peak
Duration
Onset: 1-2 hrs
Peak: none
Duration: 20-24 hrs
Goals of Insulin Tx? (3)
1) normal fasting glu
2) normal postprand glu
3) avoid hypoglycemia