The Arthur E. Schwarting Symposium is an educational conference focused on pharmacy practice for pharmacists in many settings.
This year's sympoisum had an overall topic of Drug Induced Disease from a Patient Safety perspective. This presentation deals with drug induced diabetes complications.
Learning Objectives
| · List major causative medications leading to hyperglycemia and diabetes mellitus and their putative mechanisms |
| · Describe clinical manifestations of medication-induced hyperglycemia |
| · Identify preventive and management strategies for medication-induced hyperglycemia |
Session Offered
Released: May 13, 2021
Expires: May 13, 2024
Course Fee
$15 Pharmacist
ACPE UAN Codes
0009-0000-21-009-H05-P
Session Code
21RW09-VTP69
Accreditation Hours
1.0 hours of CE
Accreditation Statement
| The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. |  |
Pharmacists and Pharmacy Technicians are eligible to participate in this application-based activity and will receive 1.0 CE Hour for completing the activity (ACPE UAN 0009-0000-21-009-H05-P), passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor online system and your participation will be recorded with CPE Monitor within 72 hours of submission.
Grant Funding
There is no grant funding for this activity.
Faculty
Devra Dang, PharmD., BCPS, CDE, FNAP
Associate Clinical Professor
University of Connecticut School of Pharmacy
Storrs, CT
Faculty Disclosure
Dr. Dang has no financial relationships with any ineligible company associated with these presentations.
Disclaimer
The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.
Content
Handouts
Post Test Pharmacist
1. Which of the following is the MAIN mechanism of glucocorticoid-induced hyperglycemia?
a. Appetite suppression
b. Increased insulin resistance
c. Increased insulin sensitivity
2. AA is a 60-year-old male who has just been prescribed prednisone 10 mg every morning for rheumatoid arthritis. He also has type 2 diabetes that was diagnosed last year and has been taking metformin since diagnosis. Recognizing that glucocorticoids can lead to drug-induced hyperglycemia, the prescriber ask for your recommendation regarding monitoring of the patient’s blood glucose. When should AA perform finger sticks to detect any blood glucose elevation due to the prednisone prescription?
a. Obtain a fasting fingerstick daily
b. Obtain a bedtime fingerstick daily
c. Obtain a pre-dinner fingerstick daily
3. Why is insulin therapy often a better option in the management of glucocorticoid-induced hyperglycemia compared to oral diabetes treatments such as metformin or GLP-1 receptor agonists?
a. Insulin has a faster onset of glucose-lowering effect
b. Insulin is less expensive than oral medications
c. Insulin is easier to self-administer by patients than oral medications
4. Which of the following is a guideline recommendation for monitoring of hyperglycemia and diabetes caused by second-generation antipsychotics?
a. Obtain a family history of diabetes at baseline, at 12 weeks after start of therapy, and at least once a year thereafter
b. Obtain a fasting blood glucose at baseline, at 12 weeks after start of therapy, and at least once a year thereafter
c. Measure weight at baseline, at 12 weeks after start of therapy, and at least once a year thereafter
5. What did the JUPITER RCT find when the researchers analyzed the risk of diabetes in the rosuvastatin 20 mg group compared to the placebo group?
a. A relative risk of a 28% increase in diabetes but an absolute risk difference of only 0.3%
b. A relative risk of a 28% reduction in developing diabetes in the rosuvastatin arm compared to the placebo arm
c. There was no difference in the risk of developing diabetes with rosuvastatin compared to placebo
6. Patients prescribed protease inhibitors may present with hyperglycemia. What additional clinical manifestation is also likely?
a. Lipodystrophy
b. Weight gain
c. Hyperpigmentation of the skin
7. EF is a 70-year-old male with a history of myocardial infarction 2 years ago, hypertension, dyslipidemia, and COPD. He reluctantly admits to not taking his atorvastatin for the last six months due to concern of developing diabetes – he read about this on a post on social media. Which of the following education points should you discuss with EF?
a. Data from large randomized, controlled trials have shown that a very small increase in diabetes risk in patients without pre-existing diabetes but a large reduction in major cardiovascular events and cardiovascular death.
b. The risk of developing diabetes has only been shown with rosuvastatin, so he can ask his physician to prescribe one of the other statins instead.
c. The risk of developing diabetes has only been shown in postmenopausal women.
8. Pentamidine can cause initial hypoglycemia followed by hyperglycemia via what mechanism?
a. Destruction of pancreatic beta cells
b. Destruction of pancreatic alpha cells
c. Weight gain
9. When drug-induced hyperglycemia occurs, what is a good management strategy?
a. Discontinue medication or reduce the dose if possible
b. Increase the dose of the suspected medication
c. Recommend an exercise regimen in patients prescribed glucocorticoids
10. Which of the following are symptoms of hyperglycemia and diabetes?
a. Headaches and dizziness
b. Peripheral edema and shortness of breath
c. Polyuria, excessive thirst, and polydipsia