NURS 5334 MODULE 6-9 REVIEW

Review Module 6 Pharm Diagnostic criteria: fasting glucose 126; casual glucose of 200 or greater or A1c 6.5 and greater Insulin dosing must be coordinated with cho intake BP140/90 or below ACE/ARB Statins Review Dr. Rippergers Pearls on insulin 4 step approach: Step 1-initiate lifestyle plus metformin (at diagnosis) Step 2- Continue lifestyle changes plus metformin, and add a second drug, either a sulfonylurea, a thiazolidinedione, a dipeptidyl peptidase-4 (DPP-4) inhibitor, a sodium-glucose cotransporter 2 (SGLT-2) inhibitor, a glucagon-like peptide-1 (GLP-1) receptor agonist, or basal insulin. The choice of agent is made in light of relative efficacy, hypoglycemia risk, tolerability, weight-related considerations, and cost. Step 3- Progress from step 2 to a three-drug combination (inclusive of metformin). Again, the choice of regimen used is determined based on drug- and patient-specific considerations. Step 4: If three-drug combination therapy that includes basal insulin fails to achieve treatment goals after 3 to 6 months, it is recommended to proceed to a more complex insulin regimen, usually in combination with one or more noninsulin medicines. Insulin is summarized in Dr. Ripperger’s Pearls and also covered in Collaborate There are rapid onset, short duration, intermediate duration and long acting