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Title: Medication Instructions for the Sick Diabetic

Category: Pharmacology & Therapeutics

Keywords: insulin, metformin, sulfonylureas, repaglinide (PubMed Search)

Posted: 7/4/2013 by Ellen Lemkin, MD, PharmD

  • Hold metformin if the patient is at risk for dehydration (eg. vomiting, diarrhea) due to the risk of lactic acidosis
  • Medications that stimulate insulin secretion (eg. sulfonylureas, repaglinide, or nateglinide) should be held if the patient is at risk for hypoglycemia
  • Patients usually should continue their basal insulin, but may decrease or hold their bolus dosing.
  • Finger sticks should be checked every 2-4 hours for those on insulin, or 2-4 times per day for type II diabetics not on insulin.

References

Diabetes. Pharmacist's Letter March 2013;29(3):13-4.


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