Clinical Gems

Richard S. Beaser, MD Medications that Increase Insulin Secretion: SULFONYLUREAS CLASS SUMMARY: Action: Insulin secretagogues. Initial effects are to increase insulin secretory capacity. With establishment of long-term glucose control, this increase may not persist and other extrapancreatic effects, either direct or indirect, may also occur. Required for efficacy: Some remaining …

Richard S. Beaser, MD This week’s excerpt covers the following topics: What drugs block glucose absorption How to titrate this class of drugs Learn the contraindications and precautions for the glucose blocking drugs Discover which other drugs can cause serious side effects when used with drugs that block glucose absorption   …

Richard S. Beaser, MD This week’s excerpt covers the following topics: Drug interactions with potential for clinical significance for metformin Contraindications and precautions for metformin Class contraindications and precautions for TZD’s Which TZD interactions are serious and how it is metabolized  

Richard S. Beaser, MD This week’s excerpt covers the following topics: The disadvantages of triple therapy Which abnormality of the metabolic syndrome to treat first When to start triple therapy Why we need to be more aggressive in treating type 2 diabetes Achieving a Proper Balance When initiating and titrating …

Richard S. Beaser, MD This week’s excerpt cover the following topics: Why a patient should start with multiple medications How much treatment is needed When to use combination therapy

Richard S. Beaser, MD This week’s excerpt addresses the following topics: What is the "Incretin Effect"? The seven actions of GLP-1 Efficacy of DPP-IV inhibitors Where do the bile acid sequestrants fit in?

Richard S. Beaser, MD This week’s excerpt covers the following topics: Which medications slow glucose absorption? Which medications increase insulin secretion? What is first phase insulin response? Who are the patient candidates for the different drug classes? Nateglinide vs. Repaglinide  

Richard S. Beaser, MD This week’s excerpt covers the following topics: Which medications reduce insulin resistance The action of biguanides How thiazolidinediones work The risks of thiazolidinediones Liver toxicity with medications

Richard S. Beaser, MD This week’s excerpt covers the following topics: The mechanism of action for antidiabetes medications Which medications improve insulin action Which meds slow gastric absorption Which meds increase insulin secretion Which meds increase the effect of incretins How to compare diabetes meds  

Lipid abnormalities The two main lipid molecules in the plasma are triglycerides and cholesterol To make these lipid particles water-soluble, they are bound to phospholipids and lipoproteins in plasma Lipid measurements are best performed on a fasting sample. The following measurements can be done: Total cholesterol (TC) high levels are …