Diabetes Flashcards
DPP-4 inhibitors = gliptins
Monitoring
LFT +UE
DPP-4 inhibitors = gliptins
Weight change?
Hypoglycaemia
Weight neutral
No hypoglycaemia
DPP-4 inhibitors = gliptins
Mechanism
Reduced glucagon release from pancreas
DPP-4 inhibitors = gliptins
Contraindications? (4)
Ketoacidosis
Liver impairment
Heart failure
Pancreatitis
Pioglitazone
Monitoring
LFT
Pioglitazone
Mechanism
Reduced peripheral insulin resistance
Pioglitazone
Weight change and hypoglycaemia
Increase in weight
No hypoglycaemia
Pioglitazone
Contraindications (3)
Heart failure
Bladder Ca/haematuria
Liver impairment
Pioglitazone
Side effects
Fractures
Peripheral oedema
Sulfonylureas = gliclazide
Mechanism
Increased insulin release from pancreas
Sulfonylureas = gliclazide
Weight and hypoglycaemia
Increased weight
Hypoglycaemia
Sulfonylureas = gliclazide
Weight and hypoglycaemia
Increased weight
Hypoglycaemia
Sulfonylureas = gliclazide
Contraindications
Acute porphyria
Ketoacidosis
Severe renal/liver impairment
Obesity
Sulfonylureas = gliclazide
Side effect
Hypoglycaemia
Cholestasis
Sulfonylureas = gliclazide
Side effect
Hypoglycaemia
Cholestasis
SGLT-2 inhibitors = gliflozin
Mechanism
Increased urinary excretion of glucose
SGLT-2 inhibitors = gliflozin
Weight change and hypoglycaemia
Weight loss
No hypoglycaemia
SGLT-2 inhibitors = gliflozin
Contraindications
Ketoacidosis Renal impairment Severe liver impairment Increased age Active foot disease
SGLT-2 inhibitors = gliflozin
Side effects
Foot problems
Increased UTI/urinary output
GLP-1 receptor antagonists = -tide SUBCUT
Weight change and hypoglycaemia
Weight loss
No hypoglycaemia
GLP-1 receptor antagonists = -tide SUBCUT
Contraindications
Ketoacidosis
Pancreatitis
Renal impairment
Hepatic impairment
GLP-1 receptor antagonists = -tide SUBCUT
When to start and stop
Start = BMI >35 or insulin causes occupational problems or weight loss beneficial for other problems
Only continue if >11mmol drop in HbA1c and weight loss >3%
Diagnostic criteria for DMT2?
Fasting glucose >7
OGTT/random glucose >11
HbA1c >48
Diagnostic criteria:
1) Impaired fasting glucose
2) Impaired glucose tolerance
1) Fasting glucose 6.1-7
2) Fasting glucose < 7 and OGTT 7.8-11.1
