Diabetes Flashcards
Describe use of metformin in type 2 diabetes?
first line drug
it is contraindicated in renal failure
Does metformin cause hypos?
no
Side effects of metformin?
can cause GI upset, usually improves, if intolerable try MR metformin
rarer but serious side effect of lactic acidosis
What class of drug is metformin?
a biguanide
2 examples of sulfonylureas?
gliclazide and glipizide
Describe use of sulfonylureas in type 2 diabetes?
add on/ 1st line therapy if intolerant to metformin
Side effects of sulfonylureas?
weight gain
hypos
Describe role of SGLT2-inhibitors in type 2 diabetes?
good add on therapy for those with cardiovascular disease as also improves cardiac outcome
Side effects of SGLT2i?
increased risk of infection
thrush
UTIs
Do SGLT2i cause hypos?
no
but if combined with sulfonylureas or insulin could get hypo
Describe use of pioglitazone in type 2 diabetes?
it is an add on therapy, not very popular as has been found to increase risk of bladder cancer and fractures, it is also contraindicated in heart failure as it causes fluid retention
Does pioglitazone cause hypos?
no
but if combined with sulfonylureas or insulin could get hypo
Examples of DPP4- inhibitors?
saxagliptin or sitagliptin
Route of DPP4 inhibitors vs GLP agonists?
DPP4 inhibitors are oral but GLP agonists are by subcut injection
Use of DPP4 inhibitors in type 2 diabetes?
add on
Examples of GLP agonists?
liraglitide, semaglitide
Use of GLP agonists in type 2 diabetes?
add on
good if BMI > 30 as cause decreased appetite and weight loss
Important side effect of GLP agonists to warn patients about?
pancreatitis
if get any severe abdo pain etc go to a and e
Do GLP agonists and DPP4 inhibitors cause hypos?
no
but if combined with sulfonylureas or insulin could get hypo
2 main diabetic drugs that cause hypos?
insulin
sulfonylureas
In type 1 diabetes what is standard insulin dosing?
0.5 to 1 units per kg/ day
What is biphasic insulin and how could you identify it?
it is a mixture where theres a short acting which gives a peak early and long acting background one
can identify cause they all end in mix or have a capital M and then a number
