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Diabetes Seminar for Health Plan Case Managers March 2012
Diabetes Oral Agents
Category
& Names
Glucophage,
Glucophage
Glucotrol,
Glucotrol XL
Glumetza
Micronase,
Tradjenta
DiaBeta,
Fortamet
Starlix
(nateglinide)
Action(s) ↑insulin release
Common • Weight gain
to take • Exception:
should be taken 30 minutes before meal(s). Starlix should be taken 0-30 minutes before each meal. Hold if not eating Not listed above since rarely used: Alpha glucosidase inhibitors (acarbose [Precose], miglitol [Glyset] or first generation sulfonylureas (tolbutamide [Orinase], tolazimide [Tolinase], chlorpropamide [Diabinese]). XL/XR medications are extended release-- never cut tablet
Combination Pills: Refer to details above for both components

Actoplus met
Avandamet
Avandaryl
Glucovance
rosiglitazone & pioglitazone & metformin& Juvisync
Kombiglyze
Metaglip
PrandiMet
Janumet XR
Diabetes Seminar for Health Plan Case Managers March 2012

Insulin Action Times
Time to take
Duration
Name
Apidra
every day. If taken 2 times a day, space about 12 hours apart. (Source: American Association Diabetes Educators Curriculum) • Novolin 70/30, Humulin 70/30 (70% Regular, 30% NPH) • NovoLog Mix 70/30, Humalog Mix 75/25, Humalog Mix 50/50 (mixtures of NPH and pre-mixed insulins are cloudy; the rest are clear Note: these are general action times and vary among individuals and other factors can affect action times including site, depth, dose, and exercise. There is more variation with human than analog insulins. Cautions: Don’t abbreviate insulin names, as “L” could mean Lantus or Levemir Don’t abbreviate units as “u” which could be read as a zero Clear insulin does not necessarily mean rapid-acting anymore Novolog Mix 70/30 and Novolin 70/30 are similar names but different products Diabetes Seminar for Health Plan Case Managers March 2012
Diabetes Injectable Medicines That Are Not Insulin
GLP- Agonists
Amylin Memetic
Bydureon (exenatide weekly version) Victoza (liraglutide) Acts like GLP-1, which is often too low in type 2 diabetes Amylin is co-secreted with insulin in the beta cel s of the pancreas along with insulin. meals Bydureon: 1 time a week, any time of day Victoza: 1 time a day • Byetta has been approved for use in combination with insulin glargine (Lantus) Diabetes Seminar for Health Plan Case Managers March 2012
Diabetes Resources/References
Professional Diabetes References
American Diabetes Association diabetes.org
professional.diabetes.org/CPR_Search.aspx (published each January) American Dietetic Association aace.com/sites/default/files/DMGuidelinesCCP.pdf Clinical Practice for Developing a Diabetes Mel itus Comprehensive Care Plan Michigan Quality Improvement Consortium (MQIC) Guideline
on Management of Diabetes
Complementary and Alternative nccam.nih.gov
Medicines
Patient Diabetes Self-Management Support Resources

Diabetes Education Programs
• For AADE accredited programs:
diabeteseducator.org/DiabetesEducation/Programs.html • For ADA recognized programs: professional.diabetes.org/ERP_List.aspx • For MDCH certified programs (required for Medicaid): http://www.michigan.gov/mdch/0,1607,7-132-2940_2955_2980_3168-13791--,00.html Diabetes Resources for Visual y Impaired • Education audio t download or order: diabetespartnership.org/visimpaired.asp • Talking meters (Advocate Redi-Code, Prodigy Voice, Embrace) Other Education Programs • PATH classes: mihealthyprograms.org Diabetes Magazines, Cookbooks and TV • Diabetes Forecast (from American Diabetes Association): order online at diabetes.org or cal 1-800-DIABETES (1-800-806-7801) • Diabetes Health: order or read online at DiabetesHealth.com, or cal (415) 883-1990 • Diabetes Self-Management: order at DiabetesSelfManagement.com or cal (800) • Cookbooks: from library or stores • TV: dLife on CNBC Sundays, 7 PM (online at dLife.com) • YMCA or fitness centers • Walk in mal s, schools, parks, neighborhood • Community or school programs, swimming pools or fitness equipment • Workout rooms or fitness classes at work • Workout rooms or pools at hotels when traveling • Exercise videos—at the library or buy • TV programs. Check TV listings. Some include: “Sit and Be Fit” on PBS or • Purchase exercise tools: pedometer, resistance bands or tubes, hand weights, exercise bal , exercise bike, treadmil , el iptical • Make own tools with soup cans, milk jugs with water, socks fil ed with sand • Some pharmacies sel some generic medicines for $4 per month, including Target, Wal-Mart, Family Fare, D&W, Sam’s Club. Metformin is free at Meijer. Metformin (plain and XL) and sulfonylureas are free at Family Fare and D&W. • Ask doctor about samples • Online at needymeds.com • Partnership for Prescription Assistance: 1-888-477-2669 or online at pparx.org • Tobacco Free for Good—free classes in West Michigan. Cal (616) 975-0123 or • Michigan Quit Line—free phone help, 24 hours/day, 7 days/week 1-800-480-QUIT (7848) or 1-800-QUIT-NOW (784-8669) • Health plan case manager • Tel friends and family how they can help • Support groups in the community • Ask doctor if the office has a care manager • Examples of internet support: Internet Resources for Diabetes Patients
Encourage caution with what is read on the internet. A few helpful sites:

Food
Calorie King: nutrition information, recipes My Food Advisor: nutrition information, food tips, recipes tracker.diabetes.org Recipes for lower calories or carbohydrates diabetic-recipes.com equal.com splenda.com sweetnlow.com Free online groups and tools, free food and exercise logs Diabetes Exercise and Sports Association My Fitness Pal: nutrition information, free food and exercise logs Ideas for walking programs, free food and exercise logs Startwalkingnow.org American Diabetes Association: much diabetes Joslin Diabetes Center –diabetes research center Other • Websites for blood sugar meters and diabetes medicine(s) – may have discount coupons and other resources on their product and/or diabetes • “Smart” phone “apps” with nutrition information, blood sugar and exercise logs, etc.

Source: http://www.ihcs.msu.edu/qi/documents/DiabetesSeminarforHealthPlanCaseManagersResourcesandReferences.pdf