Increase endogenous insulin secretion 2 . Have a significant risk for hypoglycemia 3 . Address the insulin resistance found in type 2 diabetics 4 . Improve insulin binding to receptors 12. Dipeptidyl peptidase-4 inhibitors (gliptins) act on the incretin system to improve glycemic control. Advantages of these drugs include: 1 . Better reduction in glucose levels than other classes 2 . Less weight gain than sulfonylureas 3 . Low risk for hypoglycemia 4 . Can be given twice daily 13. Control targets for patients with diabetes include: 1 . HbA1C between 7 & 8 2 . Fasting blood glucose levels between 100 & 120 mg/dl 3 . Blood pressure less than 130/80 mm Hg 4 . LDL lipids less than 130 mg/dl 14. Establishing glycemic targets is the first step in treatment of both types of diabetes. For type 1 diabetes: 1 . Tight control/intensive therapy can be given to adults who are willing to test their blood glucose at least twice daily. 2 . Tight control is acceptable for older adults if they are without complications. 3 . Plasma glucose levels are the same for children as adults. 4 . Conventional therapy has a fasting plasma glucose target between 120 & 150 mg/dl. 15. Treatment with insulin for type 1 diabetics: 1 . Starts with a total daily dose of 0.2 to 0.4 units per kg of body weight 2 . Divides the total doses into three injections based on meal size ADV Pharm | TextBook | StudyGuide 85
3 . Uses a total daily dose of insulin glargine given once daily with no other insulin required 4 . Is based on the level of blood glucose 16. When the total daily insulin dose is split & given twice daily, which of the following rules may be followed? 1 . Give two-thirds of the total dose in the morning & one-third in the evening. 2 . Give 0.3 units per kg of premixed 70/30 insulin with one-third in the morning & two-thirds in the evening. 3 . Give 50% of an insulin glargine dose in the morning & 50% in the evening. 4 . Give long-acting insulin in the morning & short-acting insulin at bedtime. 17. Studies have shown that control targets that reduce the HbA1C to less than 7% are associated with fewer long-term complications of diabetes. Patients who should have such a target include: 1 . Those with long-st&ing diabetes 2 . Older adults 3 . Those with no significant cardiovascular disease 4 . Young children who are early in their disease 18. Prevention of conversion from prediabetes to diabetes in young children must take highest priority & should focus on: 1. Aggressive dietary manipulation to prevent obesity 2. Fostering LDL levels less than 100 mg/dl & total cholesterol less than 170 mg/dl to prevent cardiovascular disease 3. Maintaining a blood pressure that is less than 80% based on weight & height to prevent hypertension 4. All of the above 19. The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are: 1 .
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