Diabetes Flashcards
What are the actions of GLP-1
Enhances glucose-dependent insulin secretion
Slows gastric emptying
Suppresses glucagon secretion
Promotes satiety
Possibly improves insulin sensitivity.
What are the recommendations for treatment of Type 2 Diabetes?
Initiate metformin therapy along with lifestyle interventions at diagnosis.
In newly diagnosed patients with markedly elevated blood glucose levels, consider insulin therapy.
If non-insulin therapy does not achieve A1C target over 3 months, add a second oral agent, a GLP-1 receptor agonist or insulin.
What does metformin do? Why is it first line?
It activates hepatic AMP-kinase, which decreases hepatic glucose production.
It is first line, because it causes no weight gain or hypoglycemia, and reduces cardiovascular events and mortality.
What are the side effects if metformin? What is it contraindicated in?
GI, lactic acidosis and vit B12 deficiency.
Contraindicated in reduced kidney function.
What letter do all the sulfonureas start and end with?”
Start with “G”, end with “-ide”. Just know that.
What do the sulfonureas do? What are the side-effects?
They close the potassium-ATP channels on beta-cell plasma membranes. This results in increased insulin secretion and reduced cardiovascular events/mortality.
Side effects: hypoglycemia and weight gain.
What do the 2 meglitinides end in?
“-glinide.” Don’t worry about anything else.
What do the meglitinides do? When are they used? Side effects?
They close the potassium-ATP channels on beta-cell plasma membranes, resulting in increased insulin secretion. They are used before each meal.
Side effects: hypoglycemia and weight gain.
What do the thiazolidinediones do? What is it used for?
It activates PPAR-alpha, which increases peripheral insulin sensitivity.
It raises HDL and lowers triglycerides, without causing hypoglycemia.
What do the thiazolidinediones end in?
“-glitazone”
What are the alpha-glucosidase inhibitors?
Acarbose and Miglitol.
What do Acarbose and Miglitol do? What are the side-effects?
They inhibit alpha-glucosidase, which inhibits carbohydrate breakdown and delays its GI absorption, while reducing post-prandial glucose.
Side effects: GI
What do the GLP-1 receptor agonists end with?
“-tide”. Preceded by a vowel. NOT PRAMLINTIDE.
What do the GLP-1 receptor agonists do? Side effects?
They activate the GLP-1 receptor which increases insulin secretion and decreases glucagon secretion in a glucose dependent manner, slows gastric emptying and increases satiety.
Leads to weight reduction and may improve beta-cell mass.
Side effects: acute pancreatitis and GI
What do the DPP-4 inhibitors end in?
“-gliptin”
