Diabetes Managment

Question 1

What is the first line medication for diabetes type 1?

Answer 1

Metformin

Question 2

What other agents should be added to the pharmacological treatment of a patient in addition to metformin?

Answer 2

Insulin

Question 3

Long term use of metformin can lead to a a deficiency in what vitamin?

Answer 3

B12

Question 4

For people under the use of metformin, check vit B12 levels every

Answer 4

3-6 months

Question 5

The early introduction of insulin should be considered if there is ongoing evidence of what conditions?

Answer 5

Catabolism, symptoms of hyperglycemia, or when A1C levels are more than 10% or when blood glucose is more than 300 mg/dL

Question 6

What type of therapy should be considered in patients with newly diagnosed type 2 diabetes who have a A1C that is more than or equal to 1.5% above their glycemic target?

Answer 6

Dual therapy

Question 7

Which two medications are best for peoole with type 2 diabetes who have ASCVD?

Answer 7

SGLT-2 inhibitors and GLP-1 agonists

Question 8

Which medications are best preferred for patients who have ASCVD who are at high risk for heart failure or in whom heart failure coexists ?

Answer 8

SGLT-2 inhibitors

Question 9

In patients with type 2 diabetes who who also have chronic kidney disease, what two medications are recommended?

Answer 9

SGLT-2 inhibitors or GLP-1 agonists

Question 10

What medication would you use on a patient with type 2 diabetes who needs a greater glucose-lowering effect of an injectable medication?

Answer 10

GLP-1 agonists are preferred to insulin

Question 11

The medication regimen of a patient with diabetes needs to be revaluated every

Answer 11

3-6 months and adjusted as needed to incorporate new patient factors

Question 12

Dual therapy should be considered in a patient who has a A1C of greater than or equal to

Answer 12

9%

Question 13

When should combination injection therapy be considered?

Answer 13

A1C is greater than or equal to 10%, blood glucose is greater than or equal to 300 mg/dl, or patient is markedly symptomatic

Question 14

What is the most common adverse effect related to metformin?

Answer 14

Diarrhea

Question 15

What should you do if a patient doesnt achieve the A1C target after approximately 3 months of monotherapy treatment?

Answer 15

Proceed to two drug combination

Question 16

Which transporter transports metformin?

Answer 16

OCT 1/2

Question 17

Which enzyme does metformin deactivate?

Answer 17

MGPD

Many Gifts Needed Please Donate

Question 18

People who are on sulfonylureas for a long period of time are at a risk of developing what?

Answer 18

Type 1 diabetes

Question 19

Glitazones and thazolidinediones improve

Answer 19

Lipid metabolism and glucose homeostasis

Question 20

What are some immunological effects of thiazolidinediones?

Answer 20

Macrophages will reduce inflammation, increase in the differentiation of T reg cells ( they are going to increase insulin sensitibilization), the dendritic cells will be involved in increased lipid metabolism, increased antigen preentation, increased activation and increased migration

Question 21

What are some common side effects of GLP-1 agonist?

Answer 21

Nausea, vomiting, diarrhea, nasopharingitis and headache

Question 22

Exenatide is not recommended with a eGFR of less than

Answer 22

30

Question 23

Alpha glucosidase inhibitor will induce

Answer 23

Diarrhea

Question 24

Does metformin provide potential benefit for patients with ASCVD?

Answer 24

Yes

Question 25

Metformin is contraindicated with an eGFR of less than

Answer 25

30 mL/min/1.73 m2

Question 26

Which SGLT-2 inhibitors have a beneficial effect on patients with ASCVD?

Answer 26

Empaglifozin

Canaglifozin

Question 27

Which SGLT-2 inhibitors have a benefit in hesrt failure patients?

Answer 27

Empaglifozin
Canaglifozin
Dapaglifozin

Question 28

Which SGLT-2 inhibitors provide a benefit when it comes to progression of DKD?

Answer 28

Canaglifozins, empaglifozins, dapaglifozin

Question 29

Which SGLT-2 inhibitor poses a risk for amputation?

Answer 29

Canaglifozin

Question 30

Which medications pose a risk for Fourniers gangrene?

Answer 30

SGLT-2 inhibitor

Question 31

which GLP-1 agonist poses a benefit for diabetic patients who suffer from ASCVD?

Answer 31

Lixisenatide

Question 32

Which GLP-1 agonist provides a benefit towards progression towards diabetic kidney disease?

Answer 32

Liraglutide

Question 33

When it comes to renal effects, which GLP-1 agonist requires dose adjustment?

Answer 33

Exenatide, lixisenatide

Question 34

Do GLP-1 agonist present with a risk of C-cell tumors?

Answer 34

Yes

Question 35

Which GLP-1 agonist is taken orally?

Answer 35

Semaglutide

Question 36

Which DPP-4 inhibitor poses a potential risk for HF?

Answer 36

Saxaliptin

Question 37

Which thiazolidinedione poses a benefit for diabetic patients suffering from ACVSD?

Answer 37

Pioglitazone

Question 38

which thiazolidinedioned are associated with an increased risk of heart failure?

Answer 38

Pioglitazone and rosiglitazone

Question 39

Is glyburide recommended for its renal effects?

Answer 39

No

Question 40

Which sulfonylureas need to be initiated conservatively to avoid hypoglycemia?

Answer 40

Glipizide and glimepride

Question 41

If you have a diabetic patient who has ASCVD which medication or medications are the first line treatment?

Answer 41

GLP-1 agonist or SGLT-2 inhibitor if eGFR is adequate

Question 42

If you have a patient with HF or CKD which medication is the first line treatment?

Answer 42

SGLT-2 inhibitor

Question 43

Which two medications should be avoided in the setting of heart failure?

Answer 43

TZD and saxagliptin

Question 44

If you had to choose between medications that minimize hypoglycemia which one would be ideal?

Answer 44

GLP-1 agonist

Question 45

If you are treating a patient with three medications and the A1C target is still not ideal? What medication would you add as a last resort?

Answer 45

Sulfonylureas (later generation) and also basal insulin with low risk of hypoglycemia