Diabetes

Question 1

Diagnosis of DM

Answer 1

1. A1C > 6.5
2. Random Glucose >200
3. Fasting >126

Question 2

Calculate average blood sugar from A1C

Answer 2

7% = 156

Every 1% increases by 30

Question 3

Exam for DM

Answer 3

Peripheral neuropathy, vibratory
Anthancrosis nigricans
Eye exam
B/P, kidney function
Carotid Bruits
Foot Exam

Question 4

Associated Meds for DM

Answer 4

ASA 81 mg
Statin
ACE or ARB for HTN/ albuniuria
Pneucmoccal Vaccination

Question 5

DM- First Line Drug, Dosage, Contraindication

Answer 5

Metformin

Contra: CHF, ESLD, CrCl

Question 6

DM- Second Line Drug, Dose, Contra

Answer 6

Glipizide 5 QD -> 10 BID

Contra: Sulfa allergy,

Question 7

When to start Insulin in DM

Answer 7

A1C > 8 and on two medications. Keep metformin. D/c the other.
Start long acting @ .1 u/kg/day.
Increase by 2 units every third night until fasting BS is

Question 8

What’s the first intervention for DM II?

Answer 8

Lifestyle modifications

Question 9

When do you refer to nephrology?

Answer 9

GFR less than 60

Question 10

What is C-Peptide?

Answer 10

Cleaved from proinsulin to form insulin. Marker of insulin. >.5 = type II,

Question 11

What other disease should you monitor for with diabetics?

Answer 11

T4 for thyroid disorders

Question 12

Sulfonylureas

Answer 12

Glipizide, glyburide
Stimulates release of insulin
Can cause hypoglycemia, don’t give if sulfa allergy

Question 13

Biguanides

Answer 13

Metformin

Inhibits hepatic glucose production and improves sensitivity

Question 14

Thiazolidinediones

Answer 14

Rosiglitazone, pioglitazone
Reduces insulin resistance
Can cause hypoglycemia, reduces affects of OC
Contra: heart failure

Question 15

Alpha Glucosidase Inhibitors

Answer 15

Acarbose
Inhibits absorption of glucose in GI tract
Contra: bowel diseases

Question 16

Meglitinide Analoges

Answer 16

Repaglinide
Helps secrete insulin in response to meal by increasing amount of incretins
Adver: hypoglycemia, URIs

Question 17

Dipeptidyl Peptidase-4 hinhibitors

Answer 17

Sitagliptin (januvia)

Potentiates actions of sulfonylureas and insulin

Question 18

SGLT-2 Inhibitors

Answer 18

Canagliflozin (Invokana)

Blocks reabsorption of glucose in kidney.