CDCES exam already passed
1 cup milk - =12 CHO gm
1/3 cup of rice - =15grams
1/2 cup pasta - =15 grams
1/2 cup oatmeal - =15grams
1/3 cup beans - =15 grams
Small potato - =15grams
1/2 bagel (1oz) - =15 grams
1/2 English muffin - =15 grams
1/2 cup of non starchy vegetables - =5 grams
1 apple - =15 grams
1/2 banana - =15 grams
1 orange - =15 grams
1 cup milk - =12 CHO gm
Biguanides - =Decrease hepatic glucose output
,No hypo or weight gain
Do not take with dye studies
Do not start if grr less than 45
Metformin (Glucophage) - =Biguanides
500-2500mg
approved for peds
Side effect - Nausea, B12 deficency
Do not use if GFR <30
If already on Metformin and GFR 60-45, okay to continue
Dye studies - Hold metformin and restart 48 hours after
Decreases hepatic glucose output
Metabolized in kidneys
Sulfonylureas - =Stimulates sustained insulin release
Glyburide, Glipizide, Glimepiride
Side effects - hypoglycemia and weight gain
Negative CV benefit due to fluid retention
Kidneys clear
Okay with decreased GFR
Tells pancreas to squirt all day long
Glyburide (Diabeta) - =Sulfonylureas
1.25-20mg
Low cost
Most likely to cause hypoglycemia out of Sulfonylurea family
SE - hypoglycemia and weight gaim
Negative CV benefits
,Glipizide (Glucotrol) - =Sulfonylureas
2.5-40
XR - 2.5-20
SE - Hypoglycemia and weight gain
Negative CV benefits due to fluid retention
SGLT2 inhibitors - =Glucoretics - Decreases glucose reabsorption in kidneys
Resents BG threshold
"-flo" medications - Canaglifozin, Dapaglifloxin, Empaglifloxin, Ertugliflozin
SE - Hypotension, UTI's, increased urination, genital infections, ketoacidosis
Empagliflozin, Dapaglifolzin, and canagliflozin - reduce the risk of CV death, heart failure, and
preserve long-term kidney function
No hypo or weight gain
Recommended for patient with GFR >25 and UACR of 300 or more
Monitor BP due to decrease fluid can lead to decrease BP
DKA risk due to decrease insulin needs
First line therapy for heart failure
Canagliflozin (Invokana) - =SGLT2
100-300mg 1x daily
Do not start if GFR <45
SE - Hypotension, UTI, increased urination, genital infections, and ketoacidosis
Reduces risk of CV death, heart failure, and preserve long-term kidney function
No weight gain or hypos
Dapagliflozin (Farxiga) - =SGLT2
5-10mg 1x daily
Do not start if GFR <45
, SE - Hypotension, UTI, increased urination, genital infections, and ketoacidosis
Reduces risk of CV death, heart failure, and preserve long-term kidney function
No weight gain or hypos
Empagliflozin (Jardiance) - =SGLT2
10-25mg daily
Do not start if GFR <45
SE - Hypotension, UTI, increased urination, genital infections, and ketoacidosis
Reduces risk of CV death, heart failure, and preserve long-term kidney function
No weight gain or hypos
Indicated for HF
Ertugliflozin (Steglatro) - =SGLT2
5-15mg 1x daily
Do not start if GFR <60
SE - Hypotension, UTI, increased urination, genital infections, and ketoacidosis
No weight gain or hypos
DPP-4 Inhibitors - =Incretin Enhancers
Prolongs action of gut hormones
Increases insulin secretion with meals
Delays Gastric emptying
"-liptin" Sitagliptin, Saxagliption, Linagliptin, Alogliptin
SE - Headache, flu-like symptoms
Can cause severe joint pain
Report signs of pancreatitis
No wt gain or hypos
Decrease inflammation
1 cup milk - =12 CHO gm
1/3 cup of rice - =15grams
1/2 cup pasta - =15 grams
1/2 cup oatmeal - =15grams
1/3 cup beans - =15 grams
Small potato - =15grams
1/2 bagel (1oz) - =15 grams
1/2 English muffin - =15 grams
1/2 cup of non starchy vegetables - =5 grams
1 apple - =15 grams
1/2 banana - =15 grams
1 orange - =15 grams
1 cup milk - =12 CHO gm
Biguanides - =Decrease hepatic glucose output
,No hypo or weight gain
Do not take with dye studies
Do not start if grr less than 45
Metformin (Glucophage) - =Biguanides
500-2500mg
approved for peds
Side effect - Nausea, B12 deficency
Do not use if GFR <30
If already on Metformin and GFR 60-45, okay to continue
Dye studies - Hold metformin and restart 48 hours after
Decreases hepatic glucose output
Metabolized in kidneys
Sulfonylureas - =Stimulates sustained insulin release
Glyburide, Glipizide, Glimepiride
Side effects - hypoglycemia and weight gain
Negative CV benefit due to fluid retention
Kidneys clear
Okay with decreased GFR
Tells pancreas to squirt all day long
Glyburide (Diabeta) - =Sulfonylureas
1.25-20mg
Low cost
Most likely to cause hypoglycemia out of Sulfonylurea family
SE - hypoglycemia and weight gaim
Negative CV benefits
,Glipizide (Glucotrol) - =Sulfonylureas
2.5-40
XR - 2.5-20
SE - Hypoglycemia and weight gain
Negative CV benefits due to fluid retention
SGLT2 inhibitors - =Glucoretics - Decreases glucose reabsorption in kidneys
Resents BG threshold
"-flo" medications - Canaglifozin, Dapaglifloxin, Empaglifloxin, Ertugliflozin
SE - Hypotension, UTI's, increased urination, genital infections, ketoacidosis
Empagliflozin, Dapaglifolzin, and canagliflozin - reduce the risk of CV death, heart failure, and
preserve long-term kidney function
No hypo or weight gain
Recommended for patient with GFR >25 and UACR of 300 or more
Monitor BP due to decrease fluid can lead to decrease BP
DKA risk due to decrease insulin needs
First line therapy for heart failure
Canagliflozin (Invokana) - =SGLT2
100-300mg 1x daily
Do not start if GFR <45
SE - Hypotension, UTI, increased urination, genital infections, and ketoacidosis
Reduces risk of CV death, heart failure, and preserve long-term kidney function
No weight gain or hypos
Dapagliflozin (Farxiga) - =SGLT2
5-10mg 1x daily
Do not start if GFR <45
, SE - Hypotension, UTI, increased urination, genital infections, and ketoacidosis
Reduces risk of CV death, heart failure, and preserve long-term kidney function
No weight gain or hypos
Empagliflozin (Jardiance) - =SGLT2
10-25mg daily
Do not start if GFR <45
SE - Hypotension, UTI, increased urination, genital infections, and ketoacidosis
Reduces risk of CV death, heart failure, and preserve long-term kidney function
No weight gain or hypos
Indicated for HF
Ertugliflozin (Steglatro) - =SGLT2
5-15mg 1x daily
Do not start if GFR <60
SE - Hypotension, UTI, increased urination, genital infections, and ketoacidosis
No weight gain or hypos
DPP-4 Inhibitors - =Incretin Enhancers
Prolongs action of gut hormones
Increases insulin secretion with meals
Delays Gastric emptying
"-liptin" Sitagliptin, Saxagliption, Linagliptin, Alogliptin
SE - Headache, flu-like symptoms
Can cause severe joint pain
Report signs of pancreatitis
No wt gain or hypos
Decrease inflammation
