Podcast
Questions and Answers
What is the recommended treatment regimen for patients with established or high risk of ASCVD, heart failure, and/or CKD?
What is the recommended treatment regimen for patients with established or high risk of ASCVD, heart failure, and/or CKD?
- GLP-1 receptor agonists + metformin (correct)
- Insulin only
- SGLT-2 inhibitors only
- Combination oral therapy
When should early introduction of insulin be considered in diabetes management?
When should early introduction of insulin be considered in diabetes management?
- When A1c is above 10% (correct)
- When A1c is below 7%
- When blood glucose is less than 200 mg/dL
- When blood glucose is under 150 mg/dL
What type of insulin is typically initiated first in patients with severe hyperglycemia?
What type of insulin is typically initiated first in patients with severe hyperglycemia?
- Basal insulin (correct)
- Intermediate-acting insulin
- Premixed insulin
- Rapid-acting insulin
What is preferred before transitioning to insulin in the treatment of Type 2 diabetes mellitus?
What is preferred before transitioning to insulin in the treatment of Type 2 diabetes mellitus?
Which type of injectable agent should be included in the regimen to achieve and maintain treatment goals in Type 2 diabetes mellitus?
Which type of injectable agent should be included in the regimen to achieve and maintain treatment goals in Type 2 diabetes mellitus?
What adjustment would you recommend to the insulin regimen of a patient continuing with Lantus 75 units nightly at bedtime and Metformin 1000 mg BID, based on the provided blood glucose log?
What adjustment would you recommend to the insulin regimen of a patient continuing with Lantus 75 units nightly at bedtime and Metformin 1000 mg BID, based on the provided blood glucose log?
Which type of insulin is Lantus typically switched to at a 1:1 ratio?
Which type of insulin is Lantus typically switched to at a 1:1 ratio?
What is the recommended adjustment when switching from Degludec to Lantus or Levemir?
What is the recommended adjustment when switching from Degludec to Lantus or Levemir?
In what circumstances might a patient need to split their NPH dose to achieve comparable 24-hour coverage?
In what circumstances might a patient need to split their NPH dose to achieve comparable 24-hour coverage?
Which insulin product is known for providing better post-prandial coverage but is also more expensive?
Which insulin product is known for providing better post-prandial coverage but is also more expensive?
What is the recommended step if a patient experiences a higher burden of depression in managing their diabetes?
What is the recommended step if a patient experiences a higher burden of depression in managing their diabetes?
What is the primary method of insulin replacement in Type 1 diabetes mellitus (T1DM)?
What is the primary method of insulin replacement in Type 1 diabetes mellitus (T1DM)?
What is a characteristic of Type 1 diabetes mellitus (T1DM) that necessitates lifelong insulin use?
What is a characteristic of Type 1 diabetes mellitus (T1DM) that necessitates lifelong insulin use?
Which of the following is NOT part of the general principles of injectable agents for diabetes management?
Which of the following is NOT part of the general principles of injectable agents for diabetes management?
In Type 1 diabetes mellitus (T1DM), what combination is used for insulin replacement therapy?
In Type 1 diabetes mellitus (T1DM), what combination is used for insulin replacement therapy?
What technology can lead to better blood glucose control compared to traditional methods in diabetes management?
What technology can lead to better blood glucose control compared to traditional methods in diabetes management?
What is the primary method of achieving better control in diabetes management using technology?
What is the primary method of achieving better control in diabetes management using technology?
What is the typical initial dosing schedule for NPH insulin?
What is the typical initial dosing schedule for NPH insulin?
Which of the following is a common combination for NPH-like insulin with rapid-acting analogs?
Which of the following is a common combination for NPH-like insulin with rapid-acting analogs?
When converting NPH insulin to twice daily dosing, what is the recommended proportion for the two doses?
When converting NPH insulin to twice daily dosing, what is the recommended proportion for the two doses?
Which type of insulin provides better post-prandial coverage but is also more expensive?
Which type of insulin provides better post-prandial coverage but is also more expensive?
In Type 2 diabetes, which of the following agents is commonly included in regimens to achieve treatment goals?
In Type 2 diabetes, which of the following agents is commonly included in regimens to achieve treatment goals?
When titrating NPH insulin based on fasting blood sugars, by how much should the dose be adjusted every 2 to 3 days?
When titrating NPH insulin based on fasting blood sugars, by how much should the dose be adjusted every 2 to 3 days?
What is the dosing regimen for Novolog Mix 70/30?
What is the dosing regimen for Novolog Mix 70/30?
If switching from Levemir to Lantus, what is the recommended conversion ratio?
If switching from Levemir to Lantus, what is the recommended conversion ratio?
What is the dosing regimen for Humulin/Novolin 70/30?
What is the dosing regimen for Humulin/Novolin 70/30?
If a patient is on NPH (dosed BID) and needs to switch to Lantus or Levemir, what is the recommended action?
If a patient is on NPH (dosed BID) and needs to switch to Lantus or Levemir, what is the recommended action?
How should doses be adjusted when using NPH and Regular combinations like Humulin/Novolin 70/30?
How should doses be adjusted when using NPH and Regular combinations like Humulin/Novolin 70/30?
What medication is recommended to reduce by 20% when switching to Glargine (U-100) or Basaglar from Toujeo (glargine U-300)?
What medication is recommended to reduce by 20% when switching to Glargine (U-100) or Basaglar from Toujeo (glargine U-300)?
Which combination of insulin is most appropriate for Ned, a 56-year-old male with T2DM, to achieve better glycemic control?
Which combination of insulin is most appropriate for Ned, a 56-year-old male with T2DM, to achieve better glycemic control?
When should Ned adjust his pre-lunch prandial insulin based on his pre-dinner blood glucose values?
When should Ned adjust his pre-lunch prandial insulin based on his pre-dinner blood glucose values?
Which insulin combination should be initiated for Ned if he experiences severe hyperglycemia?
Which insulin combination should be initiated for Ned if he experiences severe hyperglycemia?
Ned has been prescribed a consistent daily schedule of injections with NPH + Regular Insulin. At which time should he take his Regular Insulin injection?
Ned has been prescribed a consistent daily schedule of injections with NPH + Regular Insulin. At which time should he take his Regular Insulin injection?
Ned is considering switching from Lantus to another basal insulin. Which insulin product should he consider using at a 1:1 ratio?
Ned is considering switching from Lantus to another basal insulin. Which insulin product should he consider using at a 1:1 ratio?
Ned is struggling to maintain consistent meal times due to work commitments. Which insulin option is most suitable for him to maintain better glycemic control?
Ned is struggling to maintain consistent meal times due to work commitments. Which insulin option is most suitable for him to maintain better glycemic control?
What is an essential consideration when using combination insulins like Novolog Mix 70/30 or Humalog Mix 75/25?
What is an essential consideration when using combination insulins like Novolog Mix 70/30 or Humalog Mix 75/25?
When using NPH and Regular combinations like Humulin/Novolin 70/30, what should the dosing schedule be based around?
When using NPH and Regular combinations like Humulin/Novolin 70/30, what should the dosing schedule be based around?
What is a distinguishing feature between Humulin/Novolin and Humalog/Novolog insulins?
What is a distinguishing feature between Humulin/Novolin and Humalog/Novolog insulins?
What is a common characteristic of U-500 insulin that makes it suitable for certain patients?
What is a common characteristic of U-500 insulin that makes it suitable for certain patients?
When considering combination therapy with GLP-1 RA and long-acting insulin, what benefit does the combination offer in terms of A1c reduction compared to monotherapy?
When considering combination therapy with GLP-1 RA and long-acting insulin, what benefit does the combination offer in terms of A1c reduction compared to monotherapy?
What is a key characteristic of long-acting analog insulins compared to NPH insulin?
What is a key characteristic of long-acting analog insulins compared to NPH insulin?
What is a key consideration when prescribing Afrezza for patients with diabetes?
What is a key consideration when prescribing Afrezza for patients with diabetes?
Which insulin delivery device should be avoided for patients with vision or dexterity issues?
Which insulin delivery device should be avoided for patients with vision or dexterity issues?
When using NPH and Regular combinations like Humulin/Novolin 70/30, how should doses be typically adjusted?
When using NPH and Regular combinations like Humulin/Novolin 70/30, how should doses be typically adjusted?
What is the recommended action if a patient on NPH insulin (dosed BID) needs to switch to Lantus or Levemir?
What is the recommended action if a patient on NPH insulin (dosed BID) needs to switch to Lantus or Levemir?
In which circumstances might a patient need to split their NPH dose to achieve comparable 24-hour coverage?
In which circumstances might a patient need to split their NPH dose to achieve comparable 24-hour coverage?
Which insulin product should Ned consider using at a 1:1 ratio if he is considering switching from Lantus to another basal insulin?
Which insulin product should Ned consider using at a 1:1 ratio if he is considering switching from Lantus to another basal insulin?
What is a key requirement for success in a regimen using combination insulin products?
What is a key requirement for success in a regimen using combination insulin products?
Which insulin combination includes a higher percentage of NPH insulin?
Which insulin combination includes a higher percentage of NPH insulin?
Which insulin combination includes 50% lispro protamine and 50% lispro insulin?
Which insulin combination includes 50% lispro protamine and 50% lispro insulin?
What is the recommended conversion ratio when switching from Levemir to Lantus?
What is the recommended conversion ratio when switching from Levemir to Lantus?
What adjustment might be necessary when switching from Lantus or Levemir to NPH insulin?
What adjustment might be necessary when switching from Lantus or Levemir to NPH insulin?
Which insulin product is typically switched to at a 1:1 ratio when switching from Toujeo (glargine U-300)?
Which insulin product is typically switched to at a 1:1 ratio when switching from Toujeo (glargine U-300)?
Which insulin product combination includes 70% NPH and 30% Regular insulin?
Which insulin product combination includes 70% NPH and 30% Regular insulin?
What is a distinguishing feature between Humulin Mix 70/30 and Humalog Mix 75/25 insulins?
What is a distinguishing feature between Humulin Mix 70/30 and Humalog Mix 75/25 insulins?
When using NPH and Regular combinations, how should doses typically be adjusted?
When using NPH and Regular combinations, how should doses typically be adjusted?
Which insulin product should be considered when switching from Lantus at a 1:1 ratio for basal coverage?
Which insulin product should be considered when switching from Lantus at a 1:1 ratio for basal coverage?
What benefit does combining GLP-1 RA with long-acting insulins offer compared to monotherapy?
What benefit does combining GLP-1 RA with long-acting insulins offer compared to monotherapy?
Which insulin product provides better post-prandial coverage but is also more expensive?
Which insulin product provides better post-prandial coverage but is also more expensive?
Which insulin combination requires a consistent schedule and meals for success?
Which insulin combination requires a consistent schedule and meals for success?
Which insulin combination is an NPH-like + rapid-acting analog?
Which insulin combination is an NPH-like + rapid-acting analog?
When switching from NPH (dosed BID) to Lantus or Levemir, what action is recommended?
When switching from NPH (dosed BID) to Lantus or Levemir, what action is recommended?
Which insulin product is typically switched to at a 1:1 ratio when switching from Toujeo (glargine U-300)?
Which insulin product is typically switched to at a 1:1 ratio when switching from Toujeo (glargine U-300)?
Which insulin combination includes 50% lispro protamine and 50% lispro insulin?
Which insulin combination includes 50% lispro protamine and 50% lispro insulin?
Which insulin combination includes a higher percentage of NPH insulin?
Which insulin combination includes a higher percentage of NPH insulin?
What is the typical initial dosing schedule for NPH insulin?
What is the typical initial dosing schedule for NPH insulin?
What is a key requirement for success in a regimen using combination insulin products?
What is a key requirement for success in a regimen using combination insulin products?
Which combination of insulin is most appropriate for a patient with T2DM to achieve better glycemic control?
Which combination of insulin is most appropriate for a patient with T2DM to achieve better glycemic control?
When converting NPH insulin to twice daily dosing, what is the recommended proportion for the two doses?
When converting NPH insulin to twice daily dosing, what is the recommended proportion for the two doses?
If a patient is on NPH (dosed BID) and needs to switch to Lantus or Levemir, what is the recommended action?
If a patient is on NPH (dosed BID) and needs to switch to Lantus or Levemir, what is the recommended action?
Which insulin combination includes a higher percentage of NPH insulin?
Which insulin combination includes a higher percentage of NPH insulin?
What adjustment would you recommend to the insulin regimen of a patient continuing with Lantus 75 units nightly at bedtime and Metformin 1000 mg BID, based on the provided blood glucose log?
What adjustment would you recommend to the insulin regimen of a patient continuing with Lantus 75 units nightly at bedtime and Metformin 1000 mg BID, based on the provided blood glucose log?
If a patient is currently on Lantus and needs to switch due to insurance formulary changes, which insulin product might be considered?
If a patient is currently on Lantus and needs to switch due to insurance formulary changes, which insulin product might be considered?
When switching from Lantus or Levemir to NPH insulin, what is a potential consideration in dosing?
When switching from Lantus or Levemir to NPH insulin, what is a potential consideration in dosing?
Which insulin product is a combination of 70% NPH and 30% Regular insulin?
Which insulin product is a combination of 70% NPH and 30% Regular insulin?
In a switch from Lantus or Levemir to Degludec, what is the recommended action for adjusting the dose?
In a switch from Lantus or Levemir to Degludec, what is the recommended action for adjusting the dose?
Which type of insulin combination provides better post-prandial coverage but is also more expensive?
Which type of insulin combination provides better post-prandial coverage but is also more expensive?
Which rapid-acting analog insulin has an ultra-rapid onset and can be dosed within 20 minutes of starting a meal per labeling?
Which rapid-acting analog insulin has an ultra-rapid onset and can be dosed within 20 minutes of starting a meal per labeling?
What is the recommended proportion for the two doses when converting NPH insulin to twice daily dosing?
What is the recommended proportion for the two doses when converting NPH insulin to twice daily dosing?
Which insulin combination includes a higher percentage of NPH insulin?
Which insulin combination includes a higher percentage of NPH insulin?
Which type of insulin provides better post-prandial coverage but is also more expensive?
Which type of insulin provides better post-prandial coverage but is also more expensive?
Which insulin combination requires a consistent schedule and meals for success?
Which insulin combination requires a consistent schedule and meals for success?
What is the typical initial dosing schedule for NPH insulin?
What is the typical initial dosing schedule for NPH insulin?
When converting from Lantus to an NPH-like + rapid-acting analog combination, what is the recommended initial dosing schedule?
When converting from Lantus to an NPH-like + rapid-acting analog combination, what is the recommended initial dosing schedule?
For a patient experiencing severe hyperglycemia, which insulin combination should be initiated first?
For a patient experiencing severe hyperglycemia, which insulin combination should be initiated first?
When using NPH and Regular combinations like Humulin/Novolin 70/30, how should doses typically be adjusted?
When using NPH and Regular combinations like Humulin/Novolin 70/30, how should doses typically be adjusted?
When considering combination therapy with GLP-1 RA and long-acting insulin, what benefit does the combination offer in terms of A1c reduction compared to monotherapy?
When considering combination therapy with GLP-1 RA and long-acting insulin, what benefit does the combination offer in terms of A1c reduction compared to monotherapy?
If a patient is on NPH (dosed BID) and needs to switch to Lantus or Levemir, what is the recommended action?
If a patient is on NPH (dosed BID) and needs to switch to Lantus or Levemir, what is the recommended action?
When using NPH and Regular combinations like Humulin/Novolin 70/30, what should the dosing schedule be based around?
When using NPH and Regular combinations like Humulin/Novolin 70/30, what should the dosing schedule be based around?
Combination insulin products are more flexible compared to individual intermediate/long-acting and rapid-acting components.
Combination insulin products are more flexible compared to individual intermediate/long-acting and rapid-acting components.
Novolog Mix 70/30 contains 70% aspart protamine and 30% aspart insulin.
Novolog Mix 70/30 contains 70% aspart protamine and 30% aspart insulin.
Splitting a NPH dose to bid dosing may be necessary when switching from Lantus or Levemir.
Splitting a NPH dose to bid dosing may be necessary when switching from Lantus or Levemir.
When switching from Toujeo (glargine U-300) to Glargine (U-100), the dose should be increased by 20%.
When switching from Toujeo (glargine U-300) to Glargine (U-100), the dose should be increased by 20%.
Adding insulin lispro 7 units before lunch and dinner is recommended for this patient's regimen adjustment.
Adding insulin lispro 7 units before lunch and dinner is recommended for this patient's regimen adjustment.
For patients on NPH (dosed BID) switching to Lantus or Levemir, doses should be reduced by 10%.
For patients on NPH (dosed BID) switching to Lantus or Levemir, doses should be reduced by 10%.
The patient's blood sugar levels have consistently decreased over the 7 days.
The patient's blood sugar levels have consistently decreased over the 7 days.
Metformin should be discontinued when initiating insulin therapy.
Metformin should be discontinued when initiating insulin therapy.
NPH insulin can initially be dosed twice a day at breakfast and dinner.
NPH insulin can initially be dosed twice a day at breakfast and dinner.
Combining SGLT-2 inhibitors with insulin therapy typically increases the amount of insulin needed.
Combining SGLT-2 inhibitors with insulin therapy typically increases the amount of insulin needed.
Thiazolidinediones (TZDs) are commonly associated with weight loss.
Thiazolidinediones (TZDs) are commonly associated with weight loss.
Glinides are recommended for use, especially as insulin therapy progresses to prandial/bolus insulin.
Glinides are recommended for use, especially as insulin therapy progresses to prandial/bolus insulin.
Adjusting NPH insulin breakfast dose usually peaks at dinnertime.
Adjusting NPH insulin breakfast dose usually peaks at dinnertime.
When initiating prandial insulin, it is recommended to start with 4 units before the smallest meal of the day.
When initiating prandial insulin, it is recommended to start with 4 units before the smallest meal of the day.
Ultra-rapid acting insulin analogs such as Insulin aspart (Fiasp) have an onset time of 10 minutes.
Ultra-rapid acting insulin analogs such as Insulin aspart (Fiasp) have an onset time of 10 minutes.
Skipping a meal means skipping the dose of prandial insulin to maintain consistency.
Skipping a meal means skipping the dose of prandial insulin to maintain consistency.
Patients using multiple daily injections (MDI) of basal plus prandial insulin should ideally monitor blood glucose 1 to 2 times per day.
Patients using multiple daily injections (MDI) of basal plus prandial insulin should ideally monitor blood glucose 1 to 2 times per day.
Post-prandial blood glucose values are historically recommended to be measured 1 hour after meals.
Post-prandial blood glucose values are historically recommended to be measured 1 hour after meals.