Diabetes Update: Roles and Benefits of SGLT-2 Inhibitors and GLP-1 Agonists

1. The sodium glucose transporter type two (SGLT-2) inhibitor, Empagloflozin was added to the IHS National Core Formulary (NCF) in November 2019 and is available to all eligible for care at IHS.

a) True
b) False

2. Glucagon like protein type one (GLP-1) receptor agonists available via the IHS National Core Formulary include which of the following:

a) dulaglutide-on NCF
b) exenatide
c) liraglutide-on NCF
d) lixisenatide
e) semaglutide-on NCF
f) All of the above
g) a, c, and e

3. Clinical benefits of SGLT-2 Inhibitors include which of the following:

a) Modest A1C reduction of 0.5-0.8%
b) Reduction of death from CHF and improvement in CHF
c) Reduction in CKD progression
d) Glucosuria promotes weight loss and natiuresis which has modest BP lowering impact as well
e) All of the above

4. Clinical benefits of GLP-1 Agonists include which of the following:

a) A1C reduction of 1.0-1.5%
b) Weight loss (2.2-4.4 kg)
c) Low risk for hypoglycemia
d) Reduction in CVD risk
e) Some reduction in CKD risk
f) All of the above

5. Considerations for use of GLP-1 Agonists include which of the following:

a) GLP-1 can be an effective add on therapy to metformin and/or basal insulin
b) GLP-1 have good A1C lowering ability
c) GLP-1 is excellent for weight loss
d) GLP-1 is best early in disease and keeps people from gaining weight and developing macrovascular complications
e) Use caution in people with previous pancreatitis, and active retinopathy
f) All of the above

6. Considerations for use of SGLT-2 Inhibitors include which of the following:

a) SGLT-2 drugs have CVD and CKD preventing effects
b) SGLT-2 is a strong consideration in any person with T2DM and reduced EF CHF
c) SGLT-2 is effective down to GFR of 30 ml/min
d) Use caution if a person has had prior DKA
e) Warn people of mycotic genital yeast infection
f) All of the above