diabetes 2

Question 1

non metformin regimen if it is CI or not tolerated

Answer 1

if chronic HF or established atherosclerotic CVD, give an SGLT2 with proven CV benefit

for all other pt, consider DDP4 inhibitor, pioglitazone, or SU as 1st line. SGLT2 is an alt to DDP4 if SU and pioglitazone can’t be taken

if dual therapy can’t provide adequate control, consider insulin

Question 2

if insulin is started in T2D what happens to other drugs

Answer 2

continue metformin unless CI or not tolerated

review and stop other ADs if necessary

Question 3

recommended insulin treatment regimens for T2D

Answer 3

○ Human isophane insulin injected OD or BD, according to requirements

	○ Human isophase insulin in combination with a SA insulin, administered either separately or as a pre mixed (biphasic) human insulin preparation (this may be particularly appropriate if HbA1c is 75mmol/mol (9.0%) or higher

• Insulin detemir or insulin glargine as an alternative to human isophase insulin

Question 4

SADMAN sick day rules re start 1-2 days after normal

Answer 4

SGLT2i
ACE
Diuretics
Metformin
ARB
NSAID

Question 5

pre diabetes HbA1c range

Answer 5

42-47

Question 6

if someone has hypo on SU which is a well known SE do you need to report to Yellow Card

Answer 6

YES always if it was a severe event even if its a common SE