Diabetes Managment Flashcards Preview

Nurs 5229 Clinical Pharmacotherapeutics > Diabetes Managment > Flashcards

Flashcards in Diabetes Managment Deck (31)
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1
Q

Diabetes dx Acute symptoms of diabetes plus casual* plasma glucose concentration greater
than or equal to

A

200

2
Q

fasting dx criteria

A

Fasting* plasma glucose greater than or equal to 126 mg/dL.

*Fasting is defined as no caloric intake for at least 8 hours.

3
Q

2 hour load dx critiera

A

2 hour post-load plasma glucose in an oral glucose tolerance test greater than or
equal to 200 mg/dL. The test uses a glucose load containing the equivalent of 75
g anhydrous glucose dissolved in water.

4
Q

Hb A1C dx criteria

A

Hemoglobin A1C (HbA1C) greater than or equal to 6.5%

5
Q

pre diabetes dx

A

Plasma glucose 140 to 199 mg/dL (IGT) 2 hours post-ingestion of standard
glucose load (75 g) or
A1c 5.7% to 6.4%

6
Q

Type one options

A
  • Rapid Acting
  • Short Acting
  • Regular Acting
  • Intermediate Acting
  • Long Acting
  • Fixed Combination
7
Q

two two options

A
Biguanides (Glucophage/Metformin)
Sulfonylureas
Alphaglucosidase Inhibitors
Thiazolidinediones
Meglitinides
Selective Sodium-Glucose Cotransporter (SGLT-2)
Incretin Therapy
• Glucagon-like peptide (GLP-1 agonists)
• Dipeptidyl Dipeptidase 4 Inhibitors (DPP-4 inhibitors)
Amylin Mimetics
8
Q

Goals of Treatment for diabetes

A
  • Near normalization of blood glucose
  • Individualized goals for children, pregnant women, and older adults
  • Prevention of acute complications
  • Prevention of chronic complications
  • Appropriate individualized self-management
9
Q

Calculating Glycemic Targets

A
  • Consider age
  • Consider whether episodes of hypoglycemia
  • Pregnancy status
  • Presence/absence of comorbidities
  • Medical
  • Chronic illness(es)
  • End-stage diseases
  • Cognitive/Functional
  • ADL impairments and severity
  • Cognitive impairments and severity
10
Q

Key concepts in setting goals:

A
  • Individualize goals
  • Special considerations for children, pregnant women, and older adults
  • Less intensive glycemic goals for patients with severe or frequent hypoglycemia
  • More intensive glycemic goals may further reduce microvascular complications at the risk of increasing hypoglycemia
  • Postprandial glucose may be targeted if HbA1c goals are not met despite reaching preprandial glucose goals
  • Lipid goals should follow ATP IV guideline based on risks; initial evaluation at age 40 years
11
Q

Children and
adolescents
- A1C

A

<7.5% or <8% if hypoglycemic

episodes

12
Q

Nonpregnant adulcts A1C

A
<7%
Maybe <6.5% if:
• short-term duration of DM
• long life expectancy
• Those treated: lifestyle,
metformin
• no significant CVD
13
Q

Pregnanct adults A1C

A

<6-7%

14
Q
Older adults
(healthy)
Older adults
(with
comorbidities,
hypoglycemia) A1C
A

< 7-7.5%
<8-8.5%%
10% higher glycemic targets

15
Q

Children and

adolescents - fasting bgl

A

Individualize!

90-250mg/dL prior to exercise

16
Q

Nonpregnant

adults - fasting bgl

A

90-130mg/dL

17
Q

Pregnant adults - fasting bgl

A

70-95mg/dL (<140mg/dL) and
either 1-h postprandial glucose 110-
140 mg/dL or 2-h postprandial
glucose 100-120 mg/dL

18
Q
Older adults
(healthy)
Older adults
(with
comorbidities,
hypoglycemia) - fasting bgl
A

90-150mg/dL

100-180mg/dL

19
Q

Children and

adolescents - bedtime bgl

A

Individualize

20
Q

Nonpregnant

adults - bedtime bgl

A

80-180mg/dL

21
Q

Pregnant adults - bedtime bgl

A

Individualize

22
Q
Older adults
(healthy)
Older adults
(with
comorbidities,
hypoglycemia) - bedtieme bgl
A

100-180mg/dL
110-200mg/dL
Diabetes Care 2021

23
Q

Children - facts

A
  • Managed by specialty team
  • Modify glycemic targets for planned activity and growth.
  • Insulin for type 1 DM
  • Type 2 DM treatment
  • Metformin and/or insulin and/or liraglutide if >10 years
  • Lifestyle changes
24
Q

Older Adults Facts

A
  • 10% higher glycemic targets

* Avoid first-generation sulfonylureas, TZDs.

25
Q

Metformin:

A

weight loss, low risk of hypoglycemia.

26
Q

Sulfonylurea

A

weight gain and hypoglycemia

27
Q

TZDs

A

weight gain, edema, heart failure (HF)

28
Q

• DPP-4:

A

weight neutral, nausea

29
Q

GLP

A

receptor agonists: weight loss, low risk of hypoglycemia

30
Q

Sodium–glucose transport protein-2 (SGLT-2) Inhibitors

A

genital yeast

infections, potential weight loss

31
Q

Insulin

A

weight gain, hypoglycemia