FNP Endocrine QUIZLET FOR ENDOCRINE FNP Endocrine QUIZLET FOR ENDOCRINE
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FNP
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FNP
ADA Diagnostic Criteria for T2DM
1. A1C>6.5 or
2. FPG>126(no caloric intake for atleast 8 hours) OR
3. 2 hours plasma glucose >200mg/dl during an OGTT OR
4. Random BG >200mg/dl witht the symptoms of hyperglycemia. 3 Ps: polyphagia, polydipsia, and polyuria.
Criteria 1-3 should ...
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FNP Endocrine QUIZLET FOR ENDOCRINE
FNP Endocrine QUIZLET FOR
ENDOCRINE
ADA Diagnostic Criteria for T2DM - answer 1. A1C>6.5 or
2. FPG>126(no caloric intake for atleast 8 hours) OR
3. 2 hours plasma glucose >200mg/dl during an OGTT OR
4. Random BG >200mg/dl witht the symptoms of hyperglycemia. 3 Ps: polyphagia,
polydipsia, and polyuria.
Criteria 1-3 should be confirmed by repeating testing unless hyperglycemia is
uneuivocal.
ADA Diagnostic Criteria for IFG (pre-diabetics) - answer Impaired fasting glucose 100-
125mg/dl constitutes to prediabetic (must be confirmed on subsequent day)
2 hours PG on the 75-g OGTT 140-199mg/dl
A1C 5.7-6.4%
Intial Management - answer - Set A1C goal
-Reduce cardiovascular risk factors
-Evaluate use of metformin
-Physical exam and monitoring
What is a reasonable A1C goal for a newly diagnosed patient with diabetes? - answer
A1C <7% for most adults with Type 2 diabetes.
A1C <8% for older patients
A1C <6% for type 1 diabetes and pregnant woman.
Treatment Goals - answer Cardiovascular risk reduction
Aspirin 81mg a day
Metformin
Smoking cessation
serum lipids
Exercise
ADA treatment for IFG or A1C 5.7-6.4% - answer -weight loss 7% body weight
-physical activity 150 min/week of mod activity
When to consider Metformin - answer A1C 5.7-6.4%
Less than 60 years old
BMI >35
Women with history of gestational diabetes
, FNP Endocrine QUIZLET FOR ENDOCRINE
FNP Endocrine QUIZLET FOR
ENDOCRINE
ADA first line treatment Evidence Level A: - answer Metformin is first choice of oral
treatment unless there is a contraindication.
Metformin reduces CV risks.
what is a contraindication for initiating metformin in a newly diagnosed patient with
diabetes> - answer 1. Concurrent liver disease
2. Increase serum creatinine
3. Heart failure
4. Alcohol abuse
a person who binges on metformin? - answer they produces lactic acidosis
Metformin is often chose for - answer 1. effect on glucose
2. absence of weight gain or hypoglycema
3. low incidence of side effects
4. low cost
5. Reduction in all cost mortality
How much metformin expected to decrease A1C% in a patient who take moderate dose
daily? - answer 1-2%
Exercise decreases A1C to - answer 1-2%
Metformin plus what other meds: - answer Sulfonylurea or insulin
Sulfonylurea - answer potential insulin secretions
may cause hypoglycemia, tend to cause weight gain
Reduced A1C 1-2%
use in a combo or monotherapy
DPP4 agents - answer -dipeptidyl peptidase-4 inhibitor
-slows inactivation of the incretin hormone (which lower blood glucose)
-use in combo or monotherapy by not intial
-reduces A1C about 0.7%
Gliptins (januvia, tidjenta, Ognlyza)
TZDs - answer -Thiazolidinedione (Pioglitazone, rosiglitazone)
-Preserve beta cell funtions, improves insulin insesitivity
-high dose associated with bone fractures, osteopenia.
--Contraindication in heart failure
-reduces a1c about 0.7% (actose and avandia)
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