BCACP - DM EXAM QUESTIONS AND ANSWERS 2024.

incidence of MI 7 year DM/prior MI DM no prior MI 18.8%; DM no prior ME 20.2%; no DM no prior MI 3.5; DM and prior MI 45% Drugs that increase/decrease blood sugar decrease: alcohol; increase steroids, atypical antipsych (those are the maor ones) 4 ways to dx diabetes fasting 126; 2 hour post prand 200; A1c =6.5, casual and DM symptoms =200 3 ways for prediabetes fasting 100-125; 2 hour post prand 140-199; A1c 5.7-6.4% ADA recommendations for dealing with prediabets weight loss and increased physical activity - metformin if high risk (A1c 6, BMI 35, Age 60) what is incretin? What happens to it in DM? Stimulates beta cells to release more insulin; decreased effect What effect on BS do SU have? Morning fasting and post prandial What effect does metformin have on BS? only fasting What are the meglitinides? Repaglinide and nateglinide Brand name of repaglinide and nateglinide Prandin and Starlix What BS do the meglitinides cover? PP Advantages of meglitinides? disadvantages? less hypo and weight gain than SU; more frequent dosing (at meals) What is the alpha glucosidase inh? Acarbose (precose) and miglitol (glyset) What BS does acarbose cover? PP What BS does TZD cover? PP and fasting Major disadvantage to TZD? long lag time until effect (weeks) What hormone released in gut after food in GI tract? incretins which use DPP-IV enzyme for GLP (associated with satiety, glucagon suppression, insulin secretion) DPP-IV inhibitors to increase GLP; what are they? Sitagliptin saxagliptin linagliptin alogliptin Brand names of DPP-IV inh? Sitagliptin (januvia) saxagliptin (onglyza) linagliptin (Tradjenta) alogliptin (Alogliptin) What BS does DPP-IV inh target? PP What is the rare side effect of DPP-IV inh? pancreatitis (very well tolerated) What BS does colesevelam affect? Fasting How much glucose does the kidneys resorb daily? how much in pateints with DM? 180 g; 240g What meds reduce renal resorption down to ~100g? SGLT2 inh What are the SGLT2 meds? Canagliflozin (invokana) and Dapagliflozin (Farxiga) What BS do SGLT2 meds target? Fasting and PP (no hypo for monotherapy) What is the amylin analog? Pramlintide (Symlin) (satiety, inh glucagon, reduce gastric eptylin) What BS doe pramlintide target? PP What are the GLP1 analogs (not DPP-4 inh) Exenatide (Byetta), Liraglutide (Victoza) Exenatid LAR (Bydureon) Containdication of GLP1 analog? pancretitis (similar to risk with DPP4 inh (sitagliptan saxagliptan) A1C% 6.0 corresponds to what BG? 10%? 8%? 126, 183, 240 Only 3 DM meds cuase weight gain, which? insulin, SU, TZD Only 2 DM meds with hypo risk SU and insulin Starting insulin dose/kg for adding insulin DM2 0.1-0.2u/kg How much insulin to change based on FBG 100-120, , 180 2-8 Learn rule of 500 and rule of 1800? yes U/kg start for DM1 ... When to start insulin as initial therapy at what A1c? 9% T1DM starting insulin dose? 0.5 U / kg/day (50% as basal, 50% as bolus split into three) Sick day rules for T1DM, stop mealtime insulin if patinet is not eating, never stop the basal yes