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KEY COUNSELING POINTS

DPP-4 Inhibitors
• Can cause:
● Pancreatitis .
● Renal impairment.
● Severe arthralgia.
● Saxagliptin and alogliptin: heart failure.
Sulfonylureas/Meglitinides
• Take sulfonylureas with breakfast, except glipizide R:I take 30 minutes before breakfast.
• Take meglitinides 51- 03 minutes before meals. Do not take if skipping the meal.
• Can cause:
● Hypoglycemia.
● Weight gain.
Insulins
• Subcutaneous injection (except Afrezza). Rotate injections sites. See Insulin Injection
Counseling section for details.
• Can cause:
● Hypoglycemia.
● Hypokalemia.
• Weight gain.
• Store unopened insulin pens/vials in the refrigerator. Once opened, store at room
temperature and discard after the designated number of days (for that type of insulin).
Pramlintide
• When starting, reduce dose of mealtime insulin by 50%. Inject before meals. Do not mix
with insulin.
• Can cause nausea.
Alpha Glucosidase Inhibitors
• Can cause flatulence and diarrhea.
• Do not cause hypoglycemia. If you get hypoglycemia (from another medication) treat with
glucose tablets or gel.

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