Diabetes

Question 1

Describe use of metformin in type 2 diabetes?

Answer 1

first line drug
it is contraindicated in renal failure

Question 2

Does metformin cause hypos?

Answer 2

no

Question 3

Side effects of metformin?

Answer 3

can cause GI upset, usually improves, if intolerable try MR metformin
rarer but serious side effect of lactic acidosis

Question 4

What class of drug is metformin?

Answer 4

a biguanide

Question 5

2 examples of sulfonylureas?

Answer 5

gliclazide and glipizide

Question 6

Describe use of sulfonylureas in type 2 diabetes?

Answer 6

add on/ 1st line therapy if intolerant to metformin

Question 7

Side effects of sulfonylureas?

Answer 7

weight gain
hypos

Question 8

Describe role of SGLT2-inhibitors in type 2 diabetes?

Answer 8

good add on therapy for those with cardiovascular disease as also improves cardiac outcome

Question 9

Side effects of SGLT2i?

Answer 9

increased risk of infection
thrush
UTIs

Question 10

Do SGLT2i cause hypos?

Answer 10

no
but if combined with sulfonylureas or insulin could get hypo

Question 11

Describe use of pioglitazone in type 2 diabetes?

Answer 11

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

Question 12

Does pioglitazone cause hypos?

Answer 12

no
but if combined with sulfonylureas or insulin could get hypo

Question 13

Examples of DPP4- inhibitors?

Answer 13

saxagliptin or sitagliptin

Question 14

Route of DPP4 inhibitors vs GLP agonists?

Answer 14

DPP4 inhibitors are oral but GLP agonists are by subcut injection

Question 15

Use of DPP4 inhibitors in type 2 diabetes?

Answer 15

add on

Question 16

Examples of GLP agonists?

Answer 16

liraglitide, semaglitide

Question 17

Use of GLP agonists in type 2 diabetes?

Answer 17

add on
good if BMI > 30 as cause decreased appetite and weight loss

Question 18

Important side effect of GLP agonists to warn patients about?

Answer 18

pancreatitis
if get any severe abdo pain etc go to a and e

Question 19

Do GLP agonists and DPP4 inhibitors cause hypos?

Answer 19

no
but if combined with sulfonylureas or insulin could get hypo

Question 20

2 main diabetic drugs that cause hypos?

Answer 20

insulin
sulfonylureas

Question 21

In type 1 diabetes what is standard insulin dosing?

Answer 21

0.5 to 1 units per kg/ day

Question 22

What is biphasic insulin and how could you identify it?

Answer 22

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