5 - Diabetes Flashcards
What is a SE of sulfonylureas?
Hypos
What is the contraindication for prioglitazone?
Heart failure
Which needs to be tested before starting metformin?
Renal function
What is the definition of diabetes mellitus?
Level of hyperglycaemia sufficient to cause diabetic microvascular complication.
What level of fasting glucose indicates DM?
>11.1 mmmol/L
What random blood glucose indicates DM?
> 13 mmol/L
What value of HBA1C indicates DM?
48 mmol/mol
Can steroids cause DM?
Yes, or at least contribute to increased blood glucose
What risk factors are there for DM?
Male
Obeistiy - viseral
Black and south asian
Age
inactivity
Causes of increased urination
diabetes mellitus
diabetes insipidus
Hypercalcaemia
What regulates Ca serum levels?
Increased: parathyroid hormone and calcitriol
Decreased: calcitonin
Causes for hypercalceamia?
maligangncy
primary hypercalcaemia
Which medication for diabetes mellitus reduces peripheral insulin resistance?
Metformin
Pioglitazone
Which medication for diabetes mellitus increases ß pancreatic cell activity?
Sulphonureas
Meglitinides
Which medication for diabetes mellitus increase GLP-1
DDP4i
incretins
Which medication for diabetes mellitus slow glucose absoption?
acarbose
Which medication for diabetes mellitus enhances glocuse secretion from the kidneys?
SGL2 antagonists
What are the SE of metformin?
GI symptoms and weight loss
What are the SE for Pioglitazone?
osteoperosis
What are the SE for sulphonureas?
weight gain
hypoglyceamia
What are the SE for incretins and DPP4i?
wieght loss
What are the SE for SGL2 antagonists?
wieght loss
increased risk of UTI
Which medication for insulin have and increased risk of hypoglyceamia?
Pioglitazone
Sulphonureas
Insulin
What is the first line therapy for DM?
life style change
What is the 2nd line therapy for DM?
metformin
What is the 3rd line therapy for DM?
Metformin +
DDP4i
Pioglitazone
sulphonureas
SGLT-2
What is the 4th line therapy for DM?
Triple therapy including:
Metformin
DDP4i
Pioglitazone
sulphonureas
SGLT-2
At what threshold would you increase the dose of medication for DM?
increase if HBA1C > 58 mmol/mol
What is metabolic syndrome?
diabetes
dyslipideamia
hypertension
This leads to an increased risk of obeisity and CVD
Symptoms of diabetic ketoacidosis?
Hyperventilation
Vomiting
Dehydration
Hypotention with warm peripheries
Decreased consciousness
What occurs in diabetic ketoacidosis?
Hyperglyceamia
Hyperketonaemia
Acidosis
Diffentiation between HSS and DKA?
DKA has hypernetonaemia which isn’t present in HSS
What occurs during presentation of DKA?
hypernaturaemia
hyperkalaemia
hyperglycaemia
metabolic acidosis
How to treat HHS or DKA?
IV fluids
K+ replacment
insulin
LMWH
Where are GLUT 2 transporters?
ß pancreatic cells
What is the target BP of diabetics?
<140/80 mmHg
What should the Total cholesterol/ HDL in diabetics?
< 3
What can acanthiosis nigracans indicate?
diabetes (not limited too)
What are the symptoms of a severe hypoglyceamia?
Adreniergic symptoms - sweating symptoms, trembling, hunger
Neuroglycopenia - confusion, blurred vision, paraesthesiae
A patient has hypoglyceamia but is fully conscious. What treatment do you give?
30ml of Lucazade or glucose bollus
A patient has hypoglyceamia and is fitting or unconsious. What treatment do you use?
IM,SC or IV glucagon
Can use 50% glucose IV
