Endocrine Disorders Flashcards
ADA screening recommendations for dm
annual if bmi >25 and one/more risk factors for dm
every 3 yrs otherwise
prediabetes values
hga1c- 5.7-6.4%
FPG- 100-125
OGTT- 140-199
types ii dm values
hga1c- >6.5%
fpg- >126
ogtt- >200
random glucose with symptoms- >200
hga1c suggested goals
most adults- <7%
healthy older adults- <7.5%
physical exam monitoring for dm type ii
foot exam every 3 months
eye exam annually
recommendations for frequency of a1c testing in type ii dm
every 3 months if not at goal
otherwise every 6 months
biguanide example
metformin
sulfonylurea 2nd examples
glimepiride
glipzide
glyburide
meglitinides med example
repglinide
nateglinide
dpp-4 inhibit med examples
alogliptin
linagliptin
saxagliptin
sitagliptin
glp-1 med examples
exenatide
liraglutide
dulaglutide
semaglutide
tzd med examples
pioglitazone
rosiglitazone
sglt2 med examples
canaglifozin
dapaglifozin
empaglifozin
ertuglifolozin
sulfonylurea MOA and SE
potentiates insulin secretion
hypoglycemia, weight gain
dpp-4 moa and se
slows inactivation of incretin
“gliptins”, don’t use initially
glp-1 moa and se
increases synthesis of insulin in response to BG rise
no hypoglycemia, weight loss
tzd moa and se
improves insulin sensitivity
NOT for HF, increased risk of fracture
SGLT-2 inhibitor MOA and SE
prevents reabsorption of renal glucose
UTI, yeast infection
pt with hx of heart failure- dm med rec?
sglt2
initiation of basal insulin
start at 0.1-0.2 u/kg or 10 units
adjust by 2-4 units once-twice weekly to reach FBG goal
most sensitive measure of thyroid disease
tsh
produced by anterior pituitary
primary hypothyroidism labs
TSH: high
T4: low
T3: normal
subclinical hypothyroidism labs:
TSH: high
T4: normal
T3: normal
primary hyperthyroidism labs
TSH: low
T4: high
T3: normal/elevated
most common cause of hypothyroidism
hashimoto’s thyroiditis
subclinical hypothyroidism tx
treat if TSH>10
levothyroxine replacement dose if young
1.6 mcg/kg/day
levothyroxine replacement dose if middle age
50 mcg
older adult levothryoxine replacement
25mcg
recheck TSH how long after replacement starts
4-6 weeks
metformin contra if
decreased GFR
elevated ALT, AST
fasting blood glucose goal diabetes
80-130
older adult fasting blood glucose goal
90-130
postprandial glucose goal
<180
