T6 Reading Flashcards
What is the preferred insulin regimen for most adults with type 1 diabetes?
Continuous subcutaneous insulin infusion or multiple daily doses of prandial and basal insulin.
Why are insulin analogs preferred over injectable human insulins for adults with type 1 diabetes?
To minimize the risk of hypoglycemia.
What is recommended for adults with type 1 diabetes to improve glycemic outcomes?
Early use of continuous glucose monitoring (CGM).
What should be prescribed to all individuals taking insulin or at high risk for hypoglycemia?
Glucagon, with education for family and caregivers on how to administer it.
How often should insulin treatment plans be evaluated for individuals with type 1 diabetes?
Every 3–6 months.
Why is insulin essential for individuals with type 1 diabetes?
Because type 1 diabetes is characterized by absent or near-absent beta-cell function.
What are the components of a typical insulin replacement plan?
Basal insulin, mealtime insulin, and correction insulin.
What is the benefit of basal insulin analogs over NPH insulin?
Longer duration of action with more constant plasma concentrations, leading to less hypoglycemia.
What technology is now considered standard of care for most people with type 1 diabetes?
Continuous glucose monitoring (CGM).
What system can improve both glycemic control and reduce hypoglycemia risk in type 1 diabetes?
Automated insulin delivery (AID) systems.
What should guide the choice of pharmacologic agents for adults with type 2 diabetes?
Person-centered shared decision-making, considering cardiovascular and renal comorbidities, hypoglycemia risk, and other individual factors.
When should early combination therapy be considered in type 2 diabetes?
At treatment initiation to shorten time to individualized treatment goals.
What pharmacologic strategy is recommended for adults with type 2 diabetes and CKD?
Use of SGLT2 inhibitors to minimize CKD progression and reduce cardiovascular events.
When should insulin be considered for adults with type 2 diabetes?
If there is ongoing catabolism, symptoms of hyperglycemia, or very high A1C or blood glucose levels.
What is the preferred pharmacologic agent over insulin for glycemic control in adults with type 2 diabetes?
GLP-1 receptor agonists, including dual GIP and GLP-1 receptor agonists.
What is the recommended approach to blood glucose monitoring in adults with diabetes on insulin therapy?
Use of continuous glucose monitoring (CGM) for all insulin-treated adults.
When should dual therapy be considered in type 2 diabetes management?
If A1C target is not reached within 3 months of monotherapy.
What is the role of SGLT2 inhibitors in the treatment of type 2 diabetes?
To reduce the risk of cardiovascular events and slow CKD progression.
What is the first-line therapy for adults with type 2 diabetes and ASCVD?
SGLT2 inhibitors or GLP-1 receptor agonists with demonstrated cardiovascular benefit.
What should guide insulin dose adjustments?
Fasting glucose levels and patient-specific factors such as weight and activity.
What is the preferred agent for type 2 diabetes patients with heart failure?
SGLT2 inhibitors to reduce the risk of heart failure hospitalization.
Why is early use of combination therapy recommended in type 2 diabetes?
It can help to achieve target A1C more quickly and sustain glycemic control.
What is the benefit of GLP-1 receptor agonists over insulin in certain patients with type 2 diabetes?
Lower risk of hypoglycemia and beneficial effects on weight reduction.
What is the significance of individualized glycemic targets in diabetes management?
They should be based on patient characteristics, comorbidities, and risk factors.
What is the impact of using CGM in patients with type 1 diabetes?
It leads to improved A1C control and reduced hypoglycemia episodes.
What are the indications for initiating insulin therapy in adults with type 2 diabetes?
Ongoing catabolism, weight loss, or significant hyperglycemia (A1C >10% or blood glucose >300 mg/dL).
What are the benefits of using SGLT2 inhibitors in patients with CKD?
Reduced progression to kidney failure and cardiovascular protection.
Why is it important to evaluate renal function when using metformin in type 2 diabetes?
Metformin should be discontinued if eGFR falls below 30 mL/min/1.73 m² to avoid lactic acidosis.
What is the role of combination therapy in patients with type 2 diabetes and cardiovascular disease?
Combining SGLT2 inhibitors and GLP-1 receptor agonists can provide dual protection against CV events and CKD progression.
What is the threshold for diagnosing diabetes using fasting plasma glucose (FPG)?
FPG ≥126 mg/dL (7.0 mmol/L).
What should be included in the comprehensive management of diabetes?
Glycemic control, blood pressure management, lipid management, and lifestyle interventions.
How often should A1C levels be assessed in patients who are not meeting glycemic targets?
Every 3 months until glycemic goals are achieved.
