Correct Answers
A1C goal for DM
less than 7%
preprandial blood glucose goal for DM
80-130 mg/dL
Peak postprandial glucose goal in DM
<180 mg/dL
Drugs that can lower glucose
beta blockers, quinolones, linezolid, lorcaserin, pentamide
*can also raise
Drugs that can raise glucose
beta blockers, thiazides, Loops, immunosuppressants (tacrolimus, cyclosporine), ~~~niacin, PIs~~~,
quinolones, atypical antipsychotics, statins, systemic steroids
If A1C is above _______, may start with dual therapy
8.5%
If A1c is 10% or above consider starting
insulin
If initiating dual therapy and the patient has ASCVD, choose one of the following:
GLP1: liraglutided, semaglutide, exenatide
SGLT2: empagliflozin, canagliflozin
If initiating dual therapy and the patient has HF or CKD, choose one of the following:
empagliflozin or canagliflozin
if those are not tolerated then use GLP1 (lira-, sem-, or exana-)
If initiating dual therapy and the patient has no ASCVD, HF, or CKD consider (three things and their
meds):
1. minimize hypoglycemia: DPP-4, GLP1, SGLT2, or TZD
2. weight loss: GLP or SGLT2
3. cost: SU or TZD
Three drug combinations that are not recommended
insulin with SU or meglitindies
Combo injectable therapy
, basal insulin and either a GLP-1 or mealtime insulin
Drugs that lower hepatic glucose output
metformin
Drugs that raise or replace insulin secretion
insulin, sulfonylureas, meglitinides
Drugs that lower glucagon (which lowers glucose production)
GLP-1, DPP-4, pramlintide
Drugs that slow gastric emptying
GLP-1, pramlintide
Drugs that raise glucose excretion
SGLT 2 inhibitors
Drugs that increase insulin sensitivity
metformin, TZDs
metformin & glipizide
Metaglip
metformin & glyburide
Glucovance
metformin & pioglitazone
Actoplus Met, Actoplus Met XR
metformin/alogliptin
Kazano
metformin/linagliptin
Jentadueto
metformin/sitagliptin
Janumet, Janumet XR
metformin/saxagliptin
Kombiglyze XR
metformin/canagliflozin
Invokamet