INSULIN AND HYPOGLYCEMIC AGENTS

TYPE 1 DIABETES- PANCREAS DOES NOT PRODUCE INSULIN AT ALL

NEED INSULIN TREATMENT

TYPE 2 DIABETES PANCREASE DOES NOT CREATE ENOUGH INSULIN AND BODY BECOMES REISTANT

1ST- METFORMIN

2ND- GLP-1 AND SGLT2 INHIB

TYPE 1 TREATMENT

RAPID INSULIN- LISOPOR/ASPART/GLUSINE INSULIN PUMPS- TAKEN WITH MEAL

-ADVERSE: HIGH HYPOGLYCEMIC RISK

SHORT ACTING- REG. INSULIN- TAKEN WITH MEALS

LONG ACTING- GLARAGINE/DEMETIR/DEGLUDAC LOW HYPOGLYCMEIC RISK USED FOR MAINTENCE

INSULIN ADMIN

SQ AT 90 DEGREE ANGLE/ROTATE SITE

HYPOGLYCEMIA ADMIN GLUCAGON

15-15 RULE TEST SUGAR EAT 15G OF SUGAR THEN TEST IN 15 MIN REPEAT UNTIL OVER 70

TYPE 2 TREATMENT

METOFORMIN- ALTERS MITOCHONDIRA TO NOT PRODUCE GLUCOSE

ADVERSE: GI UPSET LACTIC ACIDOSIS

-REDUCE DOSE IN RENAL PTS

DDP4 INHIBITORS

-LIPTINS

LOW EFFECTIVNESS

well tolerated

ADVERSE: UTI AND RESP INFECTIONS

SGLT2 INHIBITORS

-FLOZIN

LOWER EFFECTIVENESS THAN GLPS

low hypoglycemic risk

treats HF

ADVERSE: UTI, monitor renal pts

SULFRONYREUAS

CHEAP, LONG DUA

ADVERSE: HIGH HYPOGLYCEMIC RISK, WEIGHT GAIN

GLIPIZIDE, GLYBURIDE

MEGLTINIDES

NATEGLINIDE, REPAGLINDIE

SHORT DUA, FREQUENT DOSING PRIOR TO MEALS

LOW HYPOGLUCMIC RISK

GLP1 AGONSIT

LIRAGLUTIDE , EXENATIDE, SEMAGLUTIDE

TARGET CNS TO SLOW DIGESSTION AND FEEL FULL LONGER

-B CELL PROLIFERATION

LOWER GLUCAGON RELEASE

INCREASE INSUNLIN RELEASE

ADVERSE: PANCRENTIIS, GI UPSET

BENEFIT FOR CARDIOVASCULAR DISEASE

LOW HYPOGLYCMEIC RISK UNLESS PAIRED WITH OTHER MEDICATIONS

GIP+GLP1

TIRZEPTIDE

INDICATED FOR THE MOST WEIGHT LOSS

GESTATIONAL DIABETES

1ST LINE INSULIN REPLACEMENT SINCE INSULIN CANNOT CROSS PLACENTAL BARRIER

TYPE 2 LATE STAGE TREATMENT

LATE STAGE DIABETES MAY NEED INSULIN DUE TO B CELL DELINE AND LOW INSULIN DECRETION