Diabetes

Question 1

What is the first line treatment for type 2 diabetes?

Answer 1

Lifestyle change (exercise, diet)
less salt, sugar and fat, more fibre and fruit and veg

Question 2

What is the first line drug for type 2 diabetes? Actions?

Answer 2

Metformin (an insulin sensitiser)

Increases glucose uptake by muscle and adipocytes, decreases hepatic gluconeogenesis

Question 3

SE of metformin

Answer 3

Lactic acidosis (rare apart from in renal disease or alcoholism)
GI upset

Question 4

Name two types of insulin sensitisers

Answer 4

Biguanides (metformin)

Thiazolidinediones (pioglitazone)

Question 5

Name 3 sulphonylureas

Answer 5

Glimepiride
Gilbenclamide
Gilclazide

Question 6

Action of sulphonylureas? SE?

Answer 6

Causes pancreatic ßcells to release insulin via closing K+ channel and opening CA2+ channel
Can lead to weight gain and hypoglycaemia

Question 7

Name an alphaglucosidase inhibitor and action

Answer 7

Acabose, inhibits enzyme in gut needed for carb absorption

Question 8

Actions and side effects of alphaglcosidase inhibs

Answer 8

Inhibits enzyme needed for carb absorption so decreases post-prandial glucose peaks
SE= GI upset due to overgrowth of bacteria

Question 9

What is GLP-1?

Answer 9

A native hormone that increases insulin, decreases glucagon and decreases glucose
Actions are glucose dependent

Question 10

Name 2 DPP-4 inhibitors and action

Answer 10

Sitagliptin, vildagliptin

Decrease breakdown of native GLP-1 by 80% so less hunger, less glucagon, more insulin

Question 11

Name a GLP-1 receptor agonist

Answer 11

Exenatide

Question 12

Name a GLP-1 analogue

Answer 12

Liraglutide

Question 13

Name an SGLT-2 inhibitor and action

Answer 13

Dapagliflozin
Stops reabsorption of glucose in kidney
Weight loss :) But expensive and new :(

Question 14

Name 2 glinides and action

Answer 14

Repaglinide
Nateglinide
Post prandial glucose regulator via stimulating early insulin release from pancreas