Diabetes

Question 1

Diagnosis of diabetes

Answer 1

1 reading required if symptomatic
2 readings required if asymptomatic

Random BSL >= 11.1
Fasting BSL >= 7.0
OGTT (2 hours post glucose load) >=11.1
HbA1c >6.5% or 48mmol/mol

Question 2

Side effects of thiazoledinidiones

Answer 2

oedema, heart failure, fractures

Question 3

Sulfonylureas - drug name, MoA, side effects

Answer 3

Gliclazide, Glipizide, Glibenclamide
Stimulates pancreas to secrete insulin - not glucose dependent
Hypoglycemia, weight gain, GI upset

Question 4

DPP-4 inhibitor - drug name, MoA, side effects

Answer 4

• sitagliptin, linagliptin, saxagliptin
• Inhibits DPP4 enzyme which enhances levels of incretin hormones (GLP1 and GIP) resulting in stimulation of insulin secretion and inhibition of glucagon release to lower BGL

Question 5

GLP1 agonist - drug name, MoA, side effects

Answer 5

• exanetide, luraglutide - injectables
• incretin analogue. stimulates insulin secretion and inhibits glucagon secretion to lower BGL. Delays gastric emptying. Glucose dependent
• GI upset

Question 6

SGLT-2 inhibitors - drug name, MoA, side effects

Answer 6

• dapagliflozin, empagliflozin
• Inhibits SGLT2 channels in kidney, inhibiting glucose resorption, results in glucosuria
• genitourinary s/e including thrush, UTI

Question 7

When is gestational diabetes screening performed?

Answer 7

24-28 weeks gestation

Question 8

Risk factors for developing gestational diabetes (7)

Answer 8

age >40
obesity
family history of diabetes
ethnicity 
PCOS
multiparity 
previous gestational diabetes

Question 9

What are the risks associated with gestational diabetes (5)

Answer 9

miscarriage
foetal malformation (neural tube, cardiac, renal)
gestational hypertension/pre-eclampsia
other electrolyte disturbance
neonatal hypoglycaemia