Diabetes

Question 1

What is added to protophane to make intermediate acting?

Answer 1

Protamine

Question 2

which class of drugs metformin belong to?

Answer 2

Baguanides

Question 3

Mechanisms of action of metformin.

Answer 3

1. . Reduces hepatic gluconeogenesis and glycogen metabolism (glycogenolysis) – overall reduces glucose production
2. Improves insulin resistance via enhancing insulin-mediated glucose uptake by skeletal muscle via phosphorylation of GLUT4, thereby increasing its sensitivity to insulin.
3. Decrease carbohydrate absorption from GIT
4. Lowers triglyceride and total cholesterol levels, raises HDL
5. Weight neutral or associated with modest weight loss and not associated with hypoglycaemia (No risk of severe hypoglycaemia when used as monotherapy).

Question 4

Adverse effects of metformin.

Answer 4

GIT disturbances
Lactic acidosis
reduce Vit B12 absorption

Question 5

Mechanism of action of Sulphonylureas

Answer 5

Stimulates insulin secretion from pancreatic beta cells,
Requires residual beta cell functioning

Additional actions:
Increases peripheral insulin sensitivity
Reduces glucagon release

Question 6

Name the sulphonylurea that has the lowest risk of Hypoglycaemia.

Answer 6

Glicazide

Question 7

where are sulphynalureas metabolised?

Answer 7

Liver

Question 8

Which sulphalnylureas are contraindicated in CKD?

Answer 8

Glibenclamide and glimepiride

Question 9

Adverse effects of sulphanylureas.

Answer 9

Hypoglycaemia
weight gain

Question 10

Diagnostic Criteria for Diabetes.

Answer 10

A fasting glucose above 7
random and OGGT above 11.1

Question 11

benefits of a basal bolus regimen.

Answer 11

tighter glucose control, better mimics physiological insulin secretion,

Question 12

Where should sulphanylureas be avoided?

Answer 12

Liver disease
pregnancy