本文へ移動
cccskills
無料GitHub で公開

pdm-glp1ra-discontinuation-timing

Recommends discontinuation of GLP-1RA before conception rather than between start of pregnancy and end of first trimester for individuals with type 2 diabetes who are planning pregnancy. Trigger when clinician considers stopping GLP-1RA therapy in a patient with type 2 diabetes who is planning pregnancy or seeking preconception care.

dromlakhani/MD2SKILL
インストール方法を見る

含まれるファイル（1）

  • SKILL.md2.5 KB

SKILL.md（原文）

インストールする前に、エージェントに与えられる指示の中身を確認できます。

Discontinue GLP-1RA before conception in type 2 diabetes

STEP 1 — Gather Information

Collect pregnancy intention, current GLP-1RA regimen and dosing, contraception method, HbA1c, weight, renal function, and anticipated timing of conception after contraception cessation.

STEP 2 — Rule In / Rule Out

Rule in: patient with type 2 diabetes mellitus currently on a GLP-1RA who is planning pregnancy or seeking preconception care; rule out: patient not planning pregnancy, already pregnant, has type 1 diabetes, or is not on a GLP-1RA.

STEP 3 — Classify or Stratify

Stratify by anticipated conception timing (<1 month, 1–3 months, >3 months) and GLP-1RA half‑life (short‑acting e.g., lixisenatide vs long‑acting e.g., semaglutide) to determine discontinuation window and need for insulin transition.

STEP 4 — Decide

Discontinue GLP-1RA at least 1 month before desired conception for short‑acting agents and 2 months for long‑acting agents; initiate insulin or other pregnancy‑safe antihyperglycemic agent; maintain effective contraception until conception is desired; optimize glycemia to HbA1c <6.5% before conception attempt.

Clinical Guardrails / Mimics / Pitfalls

Do not discontinue GLP-1RA without ensuring effective contraception to avoid hyperglycemia‑related teratogenicity; avoid abrupt cessation leading to weight gain and hyperglycemia; do not delay discontinuation until after pregnancy confirmation; do not neglect active glycemic management after GLP-1RA stop; do not overlook risks of prolonged time off GLP-1RA such as rebound weight gain.

Concrete Clinical Example

A 32‑year‑old woman with type 2 diabetes on semaglutide 1 mg weekly desires pregnancy in the next 3 months and uses condoms. Advise to stop semaglutide now, start basal‑bolus insulin titrated to fasting <95 mg/dL, continue contraception for another month to allow washout, then attempt conception after confirming HbA1c <6.5% and stable weight.

Source: Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline, Endocrine Society, 2025, https://doi.org/10.1210/clinem/dgaf288

レビュー

まだレビューはありません。使ってみた感想をお寄せください。

ログインしてレビューを書く

同じリポジトリのスキル

概要と使いどころ

780g-pump-adjustment

無料

Guide pump setting adjustments for the MiniMed 780G system based on CareLink data, using Medtronic's 3-step follow-up workflow. Use when a clinician has CareLink data for a 780G patient and wants to know what to change — which setting, by how much, and how to program it. Triggers include: "what do I adjust", "how to fix high TIR", "how to reduce hypos", "adjust ICR/ISF/basal", "SmartGuard settings", "780G pump settings review", or any question about optimising 780G therapy after reviewing a download.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

ata-acth-stim-test-interpretation

無料

Performs corticotropin stimulation test to diagnose adrenal insufficiency when morning cortisol is indeterminate (3-15 µg/dL). Triggers include morning cortisol 3-15 µg/dL requiring further AI testing.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

ata-adrenal-crisis-treatment

無料

Administers immediate parenteral injection of 50–100 mg hydrocortisone for suspected adrenal crisis secondary to adrenal insufficiency. Triggers include hypotension, hypoglycemia, or acute illness in a patient with known adrenal insufficiency.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

ata-aed-ai-education

無料

Clinicians educate adrenal insufficiency patients taking nondexamethasone glucocorticoids who initiate enzyme-inducing antiepileptic drugs about early signs of adrenal insufficiency. Trigger when an AI patient on nondexamethasone GC starts an enzyme-inducing AED such as phenytoin, carbamazepine, or oxcarbazepine.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

ata-aed-lt4-monitoring

無料

In central hypothyroidism patients receiving levothyroxine who initiate enzyme‑inducing antiepileptic drugs, the guideline recommends checking free T4 at least 6 weeks after AED start and increasing the levothyroxine dose if free T4 falls below the target range. Triggers include: central hypothyroidism patient on levothyroxine starting antiepileptic drug such as phenytoin, carbamazepine, or oxcarbazepine.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

ata-cortisol-cutoff-ai-diagnosis

無料

Applies serum cortisol cutoffs (<3 μg/dL indicates central adrenal insufficiency; >15 μg/dL likely excludes it) when evaluating morning cortisol for suspected adrenal insufficiency. Triggers include morning cortisol measurement in suspected AI and use when interpreting morning cortisol levels for adrenal insufficiency workup.

日本語の概要は準備中です。原文の説明を表示しています。

dromlakhani/MD2SKILL132026年10月5日 更新

dromlakhani のスキルをすべて見る

このスキルの問題を報告する