Exam 3 lecture 2 Flashcards
Mixes type 2 dosing
N/R-0-N/R-0
N/R-0-R-N when hypoglycemia at night is an issue
In type 2 diabetics, if injectable therapy is needed to reduce A1c, first thing we consider is
GLP-1
What are some GLP-1 drugs
Ozempic, trulicity, victoza
In type 2 diabetics, if patient is already on a GLP-1 and A1c is not at target, we use_______
what dose? Adjustments?
Basal insulin
10 units per day or 0.1-0.2 units/kg/day
increase by 2 units every 3 days until goal is reached
When do we consider bolus insulin dose? What if hypoglycemia happen how do we adjust?
0.5 units/kg/day
If hypoglycemia, lower dose by 10-20%
for bolus, do 4 units per day or 10% of basal dose
When to target FBS? When to target PPG?
With A1c>10%, 70% of the problem involves FBS
With A1c<7.5%, 70% of problem involves PPG
How to adjust insuli dosage?
Increase/decrease dosage by 2 units until goals are met
What is the Insulin Carb ratio?
A guide for how much insulin should be taken to cover the amount of carbohydrate in a meal or snack
On average, how much CHO does 1 unit of insulin cover for aduts? For children
10-15 grams of CHO for adults
20-30 gms of cho for children
How to estimate dosage of insulin that will cover carbohydrate
rule of 500
Take 500 and divide it by the TOTAL number of insulin. That should give you an insulin to carbohydrate ration (1 unit of insulin covers ____ amount of carbohydrate) Patients can adjust dose based on amount of carb intake oer meal
Most people are on a different carb ratio every meal.
How do we estimate how much 1 unit of insulin lowers blood glucose by
rule of 1800. Take 1800 and divide by total insulin dose. That will give you how much 1 unit of insulin lowers blood glucose by
how to write CF in correct format
example- 2:50>150
This means add 2 units of insulin for every 50 units of blood sugar above 150 mg/dl
When using a CF at bedtime, what adjustment should we make
Halve it (unless you eat a meal at bedtime)
CF for ultra short vs regular insulin
Ultra short-1800
regular-1500
What are some things we need to consider when a patient wakes up and has high blood sugar
Bedtime eating/drinking habits
too small of a dose of insulin
somogyi effect
