PHRM 221 Lecture Notes - Lecture 19: Dipeptidyl Peptidase-4, Sulfonylurea, Repaglinide
Document Summary
Adapting diabetes medication for low carbohydrate management of t2d. Euglycemic ketoacidosis risk if insulin insufficiency and dehydrated. Usually stop, due to no benefit if low starch/sucrose ingestion. Very low carb ketogenic diet vlckd ( 50 g/day ) Basal insulins may need to reduce dose by up to 50% Tcr can have a rapid and dramatic impact on blood glucose and bp. Pharmacists need to be prepared to discuss & safely support those who choose tcr: clinical opportunities. Patients and payers are interested in reducing or eliminating need for medications. Patient awareness of diabetes reversal will drive demand: specialty practice. Referral based community deprescribing and diabetes remission centers. Credibility public openly questioning the motivations of providers. Safety we must prepare health care professionals to prevent predictable medication related problems. Positioning iptn leading global research and training initiatives for therapeutic nutrition. Engagement work underway to raise awareness, refine clinical guidelines and establish training and support requirements for therapeutic nutrition.
