PHRM 211 Lecture Notes - Lecture 13: Pioglitazone, Rosiglitazone, Exenatide
Document Summary
When a1c is above target and patient is on 2-3 max doses of diabetes medications. If pt on rosiglitazone or pioglitazone , then that needs to be discussed. Slow introduction to insulin (one injection vs. several injections daily) Nph or glargine (basal insulin) 5-10 units hs. Usually continue oral agents ( except for rosiglitazone and pioglitazone) Increase by 1 unit each morning if blood glucose > 7 mmol/l. Volume of injection (split into 2 separate injections if above 50 units) Massaging the injection site is not recommended. Glp-1, exenatide (byetta), liraglutide (victoza) are absorbed equally from each of the. Injecting into exercising limb usual injection sites (abdomen, arm, thigh) Most common lipodystrophy found at injection sites. Thickened or rubbery lesions that can feel hard when palpated. Associated with use of non purified insulins, repeated injections into a small area, reuse of needles, failure to inspect the injection sites on a regular basis.
