PHCY 529 - Diabetes
Diagnostic Threshold Values for DM:
A1c
Fasting plasma glucose
2-hour glucose during OGTT
Random glucose with hyperglycemia sx
A1c: >= 6.5%
FBG: >= 126 mg/dL
2 hr OGTT: >=200 mg/dL
Random: >= 200 mg/dL
Based on ADA recommendations, DM patients should have a goal A1c of < ____&, FBG _____-_____
mg/dL, and PPBG <______ mg/dL
A1c: <7%
FBG: 80-130
PPBG: <180
What patients may have a more strict A1c goal than a typical DM patient?
Pregnant women.
May have goal even lower than 7%
What patients may have a more lenient A1c goal than a typical DM patient?
Older adults with coexisting chronic illesses
2+ instrumental ADL impairments
Mild-moderate cognitive impairment
,Which medications used to treat T2DM have high or high-very high efficacy?
Metformin
GLP-1 RA
GIP/GLP-1 RA
TZDs
Sulfonylureas
Insulin
Which medications used to treat T2DM have intermediate or intermediate-high efficacy?
DPP-4 inhibitors
SGLT2 inhibitors
Which medications to treat T2DM are associated with a risk for hypoglycemia?
sulfonylureas
insulin
Which medications to treat T2DM are known to cause weight loss?
SGLT2 inhibitors
GLP-1 RA
GIP/GLP-1 RA
Which medications to treat T2DM have a neutral effect on weight loss?
Metformin (potential for moderate weight loss)
DPP-4 inhibitors
, Which medications to treat T2DM are known to cause weight gain?
Insulin
TZDs
Sulfonylureas
Which T2DM medications have beneficial effects on MACE (CV effect)?
Metformin (potential)
SGLT2 inhibitor
GLP-1 RA (benefit or neutral)
TZDs (potential)
Which T2DM medications have beneficial effects on HF?
SGLT2 inhibitors only
(metformin and GLP-1 RAs are both neutral to HF)
Which T2DM medications have the potential to worsen HF?
TZDs
Metformin is contraindicated in patients with a GFR < _____ mL/min/1.73m^2
30
Diagnostic Threshold Values for DM:
A1c
Fasting plasma glucose
2-hour glucose during OGTT
Random glucose with hyperglycemia sx
A1c: >= 6.5%
FBG: >= 126 mg/dL
2 hr OGTT: >=200 mg/dL
Random: >= 200 mg/dL
Based on ADA recommendations, DM patients should have a goal A1c of < ____&, FBG _____-_____
mg/dL, and PPBG <______ mg/dL
A1c: <7%
FBG: 80-130
PPBG: <180
What patients may have a more strict A1c goal than a typical DM patient?
Pregnant women.
May have goal even lower than 7%
What patients may have a more lenient A1c goal than a typical DM patient?
Older adults with coexisting chronic illesses
2+ instrumental ADL impairments
Mild-moderate cognitive impairment
,Which medications used to treat T2DM have high or high-very high efficacy?
Metformin
GLP-1 RA
GIP/GLP-1 RA
TZDs
Sulfonylureas
Insulin
Which medications used to treat T2DM have intermediate or intermediate-high efficacy?
DPP-4 inhibitors
SGLT2 inhibitors
Which medications to treat T2DM are associated with a risk for hypoglycemia?
sulfonylureas
insulin
Which medications to treat T2DM are known to cause weight loss?
SGLT2 inhibitors
GLP-1 RA
GIP/GLP-1 RA
Which medications to treat T2DM have a neutral effect on weight loss?
Metformin (potential for moderate weight loss)
DPP-4 inhibitors
, Which medications to treat T2DM are known to cause weight gain?
Insulin
TZDs
Sulfonylureas
Which T2DM medications have beneficial effects on MACE (CV effect)?
Metformin (potential)
SGLT2 inhibitor
GLP-1 RA (benefit or neutral)
TZDs (potential)
Which T2DM medications have beneficial effects on HF?
SGLT2 inhibitors only
(metformin and GLP-1 RAs are both neutral to HF)
Which T2DM medications have the potential to worsen HF?
TZDs
Metformin is contraindicated in patients with a GFR < _____ mL/min/1.73m^2
30
