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SGLT-2 Concerns

What is your top concern when prescribing SGLT-2 inhibitors to patients with diabetes?

- Amputation risk
- Infection risk
- Kidney risk
- Price

Follow the link and see how you compare to your colleagues.

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Avoiding Hypoglycemia with MDI

Which of the following is an important consideration when giving a post-meal insulin bolus with the aid of CGM-based trend arrows dosing in order to avoid hypoglycemia in persons using multiple daily insulin therapy?

A. Always consider using the full dose suggested by calculations based on the correction factor and target glucose.
B. Give ~50% of the calculated insulin dose (using the correction factor and target glucose) to adjust for active insulin (insulin on board).
C. Use ~25% of the calculated insulin dose (using the correction factor and target glucose) to adjust for active insulin (insulin on board).
D. Use 75% of the calculated insulin dose (using the correction factor and target glucose) to adjust for active insulin (insulin on board).
E. Another insulin dose should never be given after eating.

Follow the link for the answer.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #149: Glucose Toxicity Part 5

The effects are consistent with a role for O-GlcNAc in damping acute hormone- and phosphorylation-mediated signals in situations of chronic nutrient excess. Although discovered in the context of diabetes, the aforementioned changes mediated by the HBP can also be viewed as adaptive responses to excess nutrient flux: muscle cells protect themselves from excess glucose fluxes and the excess nutrients are eventually stored as fat. Indeed, if insulin signaling were not dampened and glycogen synthesis were effectively engaged even with overeating, a pound of ingested carbohydrate would result in approximately four pounds of hydrated glycogen in muscle, and it is easy to visualize diets rich in sodas and donuts resulting in the development of glycogen storage diseases.

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