MANUAL 2026
◉ Dipeptidyl Peptidase-4 Inhibitors (Gliptins) Contraindications.
Answer: Use cautiously with patients with hx of pancreatitis
◉ Sodium-Glucose Cotransporter 2 Inhibitors Prototype/MOA.
Answer: -Canagliflozin (Prototype Drug)
-Reduces the reabsorption of glucose, increasing urinary excretion of
glucose
◉ Sodium-Glucose Cotransporter 2 Inhibitors Contraindications.
Answer: Use with caution in patients prone to vulvovaginal and
urinary tract infections.
◉ Sodium-Glucose Cotransporter 2 Inhibitors Main AE. Answer:
Educate patients on signs and symptoms of hypoglycemia. These
drugs also cause a diuretic effect; therefore patients should stay
hydrated and monitor for signs and symptoms of urinary tract or
vulvovaginal infections.
◉ α-Glucosidase Inhibitors MOA/Prototype. Answer: -Acarbose
(Prototype Drug)
,-delays absorption of dietary carbohydrates and thereby reduces the
rise in blood glucose after a meal
◉ α-Glucosidase Inhibitors main AE. Answer: flatulence, cramps,
abdominal distention, borborygmus (rumbling bowel sounds), and
diarrhea.
◉ Glucagon Like Peptide-1 Receptor Antagonists (GLP-1). Answer: -
Non Insulin Injectable
-Exenatide (Byetta) (Prototype Drug);
Liraglutide (Victoza)
Dulaglutide (Trulicity)
Lixisenatide (Adlyxin)
-Activates receptors for GLP-1- slowing gastric emptying, inhibits
glucagon, suppresses appetite, and stimulates glucose-dependent
release of insulin
◉ Glucagon-like Peptide-1 Receptor Antagonists Contraindication.
Answer: should be used with caution in pregnancy; benefits should
clearly outweigh risks. Avoid use in patients with renal dysfunction
or patients that have undergone renal transplant. Use with caution
in patients with a history of pancreatitis.
◉ Glucagon-like Peptide-1 Receptor Antagonists Main AE. Answer:
Educate patients on the signs and symptoms of hypoglycemia. These
,drugs also delay gastric emptying, so may delay the absorption of
other drugs if taken simultaneously.
◉ Drugs More Likely To Cause Hypoglycemia. Answer: insulin
sulfonylureas = (Glyburide)
meglitinides = (Glinides==>Repaglinide)
amylin analogues
◉ Drugs Less Likely To Cause Hypoglycemia. Answer: incretin
mimetics = (GLP-1) Receptor Agonists
metformin
thiazolidnediones = (Glitazone)
DDP-4 inhibitors = (Gliptins)
◉ The first-line treatment for all patients with diabetes. Answer:
Metformin and lifestyle changes
◉ Know what type of insulin and how much is needed according to
carbohydrate intake.. Answer: The mealtime carbohydrate-to-insulin
dose is calculated using the 450 rule for regular insulin and the 500
rule for rapid-acting insulin; thus insulin dose (regular or rapid
acting) is divided by the TDD insulin; The carbohydrate-to-insulin
ratio is 1:(regular or rapid acting insulin/TDD)
, ◉ Insulin Mixing Guidelines. Answer: NPH insulin is appropriate for
mixing with short-acting insulins
◉ Insulin. Answer: -rapid-acting insulin only covers one meal at a
time
-regular insulin provides coverage from meal to meal or the time
between meals
-NPH insulin lasts all day or from breakfast to dinner
-Lantus is a once-daily dosing option
◉ Short Duration: Rapid Acting Insulin. Answer: Insulin lispro
(Humalog)
Insulin aspart (Novolog)
Insulin glulisine (Apidra)
◉ Short Duration: Short Acting Insulin. Answer: Regular insulin
(Humulin R, Novolin R)
◉ Intermediate Duration Insulin. Answer: NPH insulin (Humulin N,
Novolin N)
◉ Long Duration Insulin. Answer: Insulin glargine (U-100) (Lantus);
Insulin Detemir (Levemir)