Diabetes Quick Reference Guide 2018 Flashcards
how often should doctors screen for diabetes if patient is at high risk or has presence of risk factors?
6-12 months
how to screen?
FBG and A1C %
target for A1C % in diabetic pateints
<7
Blood glucose- lowering therapies in T2DM
access A1C –> if less than 1.5% above target, monitor for 3 months and then reassess if need metformin, if A1C is greater than 1.5% start metformin immediatly and consider a second antihyperglycemic target, and if patient is symptomatic hyperglycaemia and/or metabolic decompensation start insulin +/- metformin
if your patient has clinical CVD what should you do?
start antihyperglycemic agent
if your patient does not have clinical CVD what should you do?
add an additional antihyperglycemic agent based on the individual by prioritizing patient characteristics
what are some options of antihyperglycemic agents?
GLP-1 receptor agonists SGLT2 inhibitors DPP-4 inhibitors insulin thiazolidinediones alpha-glucosidase inhibitors (acarbose) insulin secretagogues (meglitinide and sulfonylurea) weight loss agent
how to keep patients dafe when they are at risk of hypoglycemia?
recognize, act/treat, prevent, reduce driving risk
why would patients be at risk of hypoglycemia
using insulin, Type 1, or insulin secretagogues
how to keep patients safe when they are at risk of dehydration
hold SADMANS meds. restart once able to eat/drink normally - sulfonylureas other secretagogues -ACE inhibitors Diuretics metformin Angiotensin receptor blockers non-steeroidial anti-inflammatory drugs SGLT2 inhibitors
special considerations for women trying to get pregnant
- A1C should be less than 7%
- stop non-insulin antihyperglycemia agents ( except metformin and or glyburide), stop statins, ACEi
- start folic acid supplements
- insulin if target AIC not achieved on metformin
- start other antkihyperglyceic drugs that are safe with pregnency
- screen for complications
