• Professor question:Why are statins recommended in the evening instead of morning? (pg 561)After starting John on insulin, he calls the office saying he feels bad. He said when he checked his blood sugar before calling it was 52 mg/dl. What instructions should he be given?
• Professor quest...
Please give all credit to these responses to my classmates in Professor Halls
class!!! Hope this helps in reviewing for our midterm!! Sorry for the late
submission! Good luck everyone
Week 1
Professor question: Why are statins recommended in the evening instead of
morning? (pg 561)
After starting John on insulin, he calls the office saying he feels bad. He said when he
checked his blood sugar before calling it was 52 mg/dl. What instructions should he be
given?
Answer from classmate: Statins are recommended to be taken in the evening.
Cholesterol synthesis is highest through the night and first thing in the morning. The
biosyntheses of cholesterol follows a normal circadian rhythm. Administration at night
allows for the medication to be at peak levels in the body during the time of high
cholesterol synthesis (Korani et al., 2019).
A blood glucose level <70mg/dL is considered to be hypoglycemia. John called the
office with a sugar of 52mg/dL. He would be given instructions that follow "the rule of
15". This means that when symptoms occur, he should consume 15 g of a fast-acting
carbohydrate. After 15 minutes, he should recheck his blood glucose. John should also
be educated on the best options of carbohydrates to consume. Examples would be 4
oz of juice, four-five hard candies, honey, or half a can of regular soft drink. Another
education point is that John needs to have a meal within a few hours after the low blood
glucose. He may also need to see his doctor for adjustments to be made on insulin
dosage as well as meal patterns to help prevent another low blood glucose episode
from occurring (Woo & Robinson, 2016).
Professor question: What diabetic medications would be contraindicated in patients
with heart failure?
Which diabetic drug(s) may have beneficial effects in heart failure?
(text has info on this but ADA 2020 guidelines has even more up to date info on this
topic, so here is the page. See Recommendation 9.9 and 9.10)
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