Diabetes

Question 1

first line fluid for DKA

when is 10% glucose started

Answer 1

if bp >90 1L 0.9% saline over 1 hour
if bp <90 0.9% normal saline over 15 mins

when the BM <14mmol/L

Question 2

MOA of
- metformin
- SGLT2
- SU
- DPP4
- Thiazolidinediones
- GLP 1 mimetics

Answer 2

metformin - increase sensitivity to insulin, decrease gluconeogenesis in liver

SGLT2 - reduce reabsorption of glucose in PCT

SU - increase insulin production

Glipitins (DPP4) - prevent breakdown of GLP1

• Thiazo -

_ GLP 1 - increase satiety, increase insulin, decrease glucagon production

Question 3

Main side effects of
- metformin
- sglt2
- SU
- DPP4
- Thiazolidinediones
- GLP 1 mimetics

Answer 3

M - GI upset and lactic acidosis
SGLT2- UTIs, mourners gangrene, DKA, weight loss
SU - hypoglycaemia, weight gain
DPP4 + GLP 1- weight loss, increased risk of pancreatitis, appetite suppression
Glitazones - increase insulin secretion, weight gain. CAN CAUSE BLOOD CANCER (CI if have haematuria)

Question 4

rate of insulin infusion for DKA

Answer 4

0.1 units/kg/hr