C - Lipid Control

Question 1

Should HTN be treated very aggressively? Why/not?

Answer 1

YES - halves risk of death

Question 2

What is an option for statin intolerance?

Answer 2

PCSK9i

Question 3

How do PCSK9i work?

Answer 3

PCSK9 binds LDL R and targets for degredation
By blocking PCSK9, lower cholesterol

Question 4

How long does it take for good glucose control to affect clinical course of DM?

Answer 4

15 years

Question 5

What study showed the length of time good glucose control takes to affect clinical course of DM?

Answer 5

UKPDS study

Question 6

Describe UKPDS study findings

Answer 6

25% risk reduction at 25 years in intensive vs control group
10 years after study ended, their glucose was the same in both groups HOWEVER, mortality was better in the previously intensive group –> LEGACY effect

Question 7

What did the Accord / Advance studies show?

Answer 7

tight control of glucose in patients with partially blocked coronary arteries did lower HbA1c but caused arrhytmias, hypoglycaemia and death –> dont just look at HbA1c as a measure in DM patients

Question 8

What did the EMPA REG study show?

Answer 8

SGLT2i decreased BM, weight, waist circumference, cardiac events and death

Question 9

Which DM drug is good for weight loss?

Answer 9

Semaglutide