NR 565 VERIFIED EXAM QUESTIONS AND ANSWERS
Glycemic Goal
A1c < 7.0%; Premeal glucose 70-130 mg/dL.
Diabetic Nephropathy Prevention
Use ACEi or ARBs to slow nephropathy progression.
1st Generation Sulfonylureas
Include tolbutamide, tolazamide, chlorpropamide.
2nd Generation Sulfonylureas
Include Glucotrol IR, Glucotrol XL.
Sulfonylureas Mechanism
Stimulate insulin release from pancreatic islets.
Metformin
Biguanide; first-line therapy for Type 2 DM.
Metformin Mechanism
Inhibits liver glucose production, increases insulin sensitivity.
Metformin Side Effects
Commonly causes GI disturbances, nausea, diarrhea.
Metformin Weight Effect
Weight-neutral; may cause weight loss or maintenance.
Lactic Acidosis Risk
Rare but fatal; early signs include hyperventilation.
Sulfonylureas Side Effects
Risk of hypoglycemia and weight gain.
Sulfonylureas Contraindications
Not for T1DM, pregnancy, or breastfeeding.
ACEi
Angiotensin-converting enzyme inhibitors for hypertension.
ARBs
Angiotensin II receptor blockers for hypertension.
Diabetic Hypertension Goal
Maintain blood pressure < 140/90 mmHg.
, Hypoglycemia
Low blood sugar; can be severe or fatal.
Insulin Sensitization
Sulfonylureas may increase sensitivity over time.
Renal Insufficiency
Contraindication for metformin use.
Pregnancy and Metformin
May be acceptable alternative to insulin.
Pregnancy and Sulfonylureas
Contraindicated due to neonatal hypoglycemia risk.
Glucose Absorption
Metformin slightly reduces glucose absorption in gut.
Peripheral Neuropathy
Possible from B12 deficiency due to metformin.
Folic Acid Deficiency
Metformin decreases absorption; risk for fetal defects.
Black Box Warning
Metformin has high risk of metabolic acidosis.
Weight Gain with Sulfonylureas
Common side effect; contrasts with metformin.
Drug-Drug Interactions
1st generation sulfonylureas have more significant interactions.
Potency Comparison
2nd generation sulfonylureas are more potent.
Dextrose Treatment
IV dextrose may be needed for severe hypoglycemia.
Comprehensive Treatment Plan
Includes lifestyle changes and medication for DM.
Meglitinides
Short-acting insulin secretagogues taken with meals.
Sulfonylureas
Glycemic Goal
A1c < 7.0%; Premeal glucose 70-130 mg/dL.
Diabetic Nephropathy Prevention
Use ACEi or ARBs to slow nephropathy progression.
1st Generation Sulfonylureas
Include tolbutamide, tolazamide, chlorpropamide.
2nd Generation Sulfonylureas
Include Glucotrol IR, Glucotrol XL.
Sulfonylureas Mechanism
Stimulate insulin release from pancreatic islets.
Metformin
Biguanide; first-line therapy for Type 2 DM.
Metformin Mechanism
Inhibits liver glucose production, increases insulin sensitivity.
Metformin Side Effects
Commonly causes GI disturbances, nausea, diarrhea.
Metformin Weight Effect
Weight-neutral; may cause weight loss or maintenance.
Lactic Acidosis Risk
Rare but fatal; early signs include hyperventilation.
Sulfonylureas Side Effects
Risk of hypoglycemia and weight gain.
Sulfonylureas Contraindications
Not for T1DM, pregnancy, or breastfeeding.
ACEi
Angiotensin-converting enzyme inhibitors for hypertension.
ARBs
Angiotensin II receptor blockers for hypertension.
Diabetic Hypertension Goal
Maintain blood pressure < 140/90 mmHg.
, Hypoglycemia
Low blood sugar; can be severe or fatal.
Insulin Sensitization
Sulfonylureas may increase sensitivity over time.
Renal Insufficiency
Contraindication for metformin use.
Pregnancy and Metformin
May be acceptable alternative to insulin.
Pregnancy and Sulfonylureas
Contraindicated due to neonatal hypoglycemia risk.
Glucose Absorption
Metformin slightly reduces glucose absorption in gut.
Peripheral Neuropathy
Possible from B12 deficiency due to metformin.
Folic Acid Deficiency
Metformin decreases absorption; risk for fetal defects.
Black Box Warning
Metformin has high risk of metabolic acidosis.
Weight Gain with Sulfonylureas
Common side effect; contrasts with metformin.
Drug-Drug Interactions
1st generation sulfonylureas have more significant interactions.
Potency Comparison
2nd generation sulfonylureas are more potent.
Dextrose Treatment
IV dextrose may be needed for severe hypoglycemia.
Comprehensive Treatment Plan
Includes lifestyle changes and medication for DM.
Meglitinides
Short-acting insulin secretagogues taken with meals.
Sulfonylureas
