Exam 3 lecture 8 Flashcards

1
Q

Which readings is ahead in terms of time BG finegr prick or ISF glucose?

A

BG may lead ISF by a few minutes
This is referred to as the lag

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2
Q

Why is there a lag bn ISF and BG testings

A

Glucose enters blood stream before it enters the interstitial fluid.

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3
Q

When will there be big differences between BG and cgm

A

sfter food, after insulin, after exercise

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4
Q

4 different types of CGM

A

real-time, intermittently scanned, professional, unblinded

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5
Q

AGP acronym

A

Ambulatory glucose profile

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6
Q

GMI acronym

A

Glucose management indicator

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7
Q

What are some real time CGMs

A

G6, G7

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8
Q

What are some intermittently scanned CGMs

A

Freestyle libre 2

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9
Q

what is an AGP report

A

Combines input from multiple days on one graph to see trend

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10
Q

What is a GMI

A

conversion of CGM, derived mean glucose to an estimate of current A1c

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11
Q

What is TIR? goal in normal vs High risk pts?

A

Time in range
between 70-180
goal>70% TIR
High risk goal- 50%

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12
Q

TBR? goal in normal vs high risk pts?

A

% of time below 70 (lvl 1)
% of time below 54 (lvl 2)

<70= goal <4% for most, high risk <1 %
<54= goal< 1% for most, 0% for high risk

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13
Q

TAR? Goal in normal vs high risk pts?

A

% of time > 180
% of time >250

> 180 goal <25%, high risk < 50%
250 goal <5%, high risk <10%

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14
Q

Which of the dexcome or libres require fingerstick calibration?

A

None of them

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15
Q

How to review CGMs

A

DATAA
D- download data (download AGP and talk to pt about what they have learned)

A- Assess safety( hypoglycemia, identify TBR, possible causes/solutions)

T- TIR- ( identify days/times in range)

A- areas to improve( hyperglycemia, identify TAR

A action plan- develop action plan

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16
Q

freestyle libre 2
Reader?
how long worn?
warming period?
finger stick required?
Interactions?

A

Has smart phone and reader
14 days worn
1 hour warming period
no finger stick calibrations
Vitamin C interactions

17
Q

difference between libre 2 and 3

A

3 only works on smart phones, does not have any reader available

18
Q

which CGMs do not need to be scanned

A

Libre 3, G7 and G6

19
Q

G6 receiver?

A

smartphone and reader
(only one approved for use on abdomen)

20
Q

Dexcom G6 and G7 worn for how long

21
Q

warm up time for G6

22
Q

dexcom G7 warm up time

A

30 mins
other than that it is similar to G6

23
Q

medtronic guardian warm up period?
how long worn?
finger stick calibration

A

2 hour warm up period
7 days worn
need finger stick calibration

24
Q

frequency of testing for A1c

A

If meeting requirements- 6 months
If not meeting requirements-3 months

25
A1c goal for elderly should be <7%
No, should be higher
26
in cases of severe hypoglycemia, what do we use
glucagon injection Baqsimi (dry nasal powder) glucagon hypokit injection
27
types of insulin pumps
Open loop- wearer communicated BG to delivery system hybrid closed loop- BG level sensed by CGM and is communicated to pump and gives insulin
28
Two modes of hybrid closed loop
Manual mode and auto mode
29
difference between manual vs auto mode
Auto- basal is automatically adjusted every 5 mins and a CGM is required Manual- basal rates are pre-programmed by provider and can be used without a CGM
30
What are the different types of basal rates and their uses
Square- delivers bolus over long periods of time, mostly used for snacking Blue (tranditional bolus)- used for normal meals Dual wave- is a combination of these two. delivers initial triangle followed by square
31
what are some pros of insulin pumps
Acts as pancrease lowers hypoglycemia risk and improves hypoglycemic awareness Specificity of goals (different rates/goals)
32
Cons of insulin pump
Cost DKA inj site rxns infusion site falling off
33
Who would be a good candidate for pumps
Ppl who have multiple daily injections financially capable maintain regular appointments/ checks poor bolus/basal control
34