Diabetes

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Criteria for the diagnosis of diabetes
- Signs and symptoms of diabetes and a random plasma glucose of > 200 mg/dL
- FPG > 126 mg/dL
- 2-hr plasma glucose of > 200 mg/dL during a 75 g oral glucose tolerance test
- HbA1C > 6.5%
ADA Goal HbA1C

< 7%
ADA Blood Glucose goals
- Preprandial: 70-130 mg/dL
- Postprandial: < 180 mg/dL
Treatment goals for labs
- LDL: < 100 mg/dL without overt CVD ( < 70 mg/dL)
- Trig: < 150 mg/dL
- HDL: > 40 mg/dL M; > 50 mg/dL W
- BP: < 130/80 mmHg
Initial therapy for Type II diabetes

Metformin 500mg QD-BID (titrate to 2g daily)
Metformin MOA
- Decrease glucose output
- Decrease intestinal absorption of glucose
- Improves insulin sensitivity
Metformin BBW

Lactic acidosis
Sulfonylureas MOA

Stimulate insulin secretion
Meglinitide MOA

Stimulate insulin secretion
Meglitinides
- Repaglinide (Prandin)
- Nateglinide (Starlix)
Thiazolidinediones (TZDs) MOA

PPAR gamma agonists cause increased peripheral insulin sensitivity
Alpha-glucosidase inhibitors
- Acarbose (Precose)
- Miglitol (Glyset)
Alpha-glucosidase inhibitors MOA
- Delayed glucose absorption
- Inhibit metabolism of sucrose to glucose and fructose
Used to decrease postprandial glucose
- Meglitinides
- Alpha-Glucosidase inhibitors
DPP4-Inhibitors
- Sitagliptan (Januvia)
- Saxagliptan (Onglyza)
- Linagliptan (Tradjenta)
DPP4-Inhibitors MOA
- Increase insulin secretion
- Decrease glucagon secretion from pancreatic alpha cells
Side effect: Nasopharyngitis, URIs

DPP4-Inhibitors
GLP-1 Agonists
- Exenatide (Byetta)
- Liraglutide (Victoza)
Primary SE: Nausea
- Exenatide
- Liraglutide
Cause weight gain
- Sulfonylureas
- TZDs
- Insulin
Weight neutral
- Metformin
- Meglitinides
- Alpha-glucosidase inhibitors
- DPP4-Inhibitors
Cause weight loss
- GLP-1 Agonists
- Pramlintide
Rapid-acting insulins
- Lispro (Humalog)
- Aspart (Novolog)
- Glulisine (Apidra)

Author

adguvetis

161827

Card Set

Diabetes

Description

Diabetes

Updated

2012-07-10T01:19:59Z

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