Diabetes Flashcards
What are the cholesterol targets in metabolic syndrome?
HDL > 1
LDL and Triglycerides
Total > 4
Why are beta-blockers contra-indicated in diabetes?
They mask the sympathetic response to hypoglycaemia
What is the mechanism of action of DPP-4 inhibitors?
Inhibit depeptidyl peptidase 4 > reduce the break down of incretins > increase glucose mediated insulin secretion and reduce glucagon production
What are names of some GLP1a analogs?
Exenatide
Liraglutide
What is the effect and side effect of GLP1a analogs?
Delay gastric emptying to increase the feeling of satiety
Cause bloating
What type of insulin is in novorapid?
Short acting
Aspart
In which condition are thiazolidinediones contraindicated? Why?
Heart failure
They cause fluid retention
Which diabetic drugs increase the risk of hypo’s?
Sulfonylureas
Insulin
What is the normal treatment regimen for long and short acting insulins?
2/3 Long acting
1/3 Short acting
What is novomix 30?
30% short acting insulin
70% intermediate acting insulin
What is the mechanism of action of thiazolidinediones?
They increase peripheral sensitivity to insulin
What does acarbose do?
Reduced carbohydrate absorption by inhibiting alpha glucosidase to prevent the cleavage of polysaccarides into monosaccarides
What are the names of some sulfonylurea?
Gliclazide, glipizide, glibenclamide, glimepiride
What is dapagliflozin? What side effects does it cause?
A Na-Glu transporter 2 inhibitor
Fluid loss
UTI’s
What are the side effects of metformin?
Nausea, vomiting and diarrhoea that ususally resolves
Weight loss
Lactic acidosis in renal failure patients
What is the name (generic and tradename) of a long acting insulin
Detemir
Levemir
What are some side effects of sulfonylureas?
Weight gain (~3kgs)
Hypo’s
Nausea
What are the cholesterol findings in metabolic syndrome?
High triglycerides
Low HDL
What is lantus?
Glargine
A long acting insulin
What is the name of a DPP-4 inhibitor?
Sitagliptin
Saxagliptin
Valdagliptin
What type of drug is gliclazide?
A sulfonylurea
What the cutoff for fasting glucuse, HbA1c and oral glucose test used to diagnose diabetes?
>7 mmol/L
>6.5%
> 11.1 mmol/L
What adverse events do incretin-based therapies increase the risk of?
Pancreatitis
Nasopharyngitis
What are thiazolidinedione?
An insulin sensitizer
Name a sulfonylurea?
Gliclazide
What is the best therapeutic for lowering triglycerides?
Fibrates
Why have sulfonylureas fallen out of favour?
They cause weight gain and increase the risk of hypoglycaemia
What is the main indication for ACE inhibitors and ARBs in metabolic syndrome?
Prevent hypertensive nephropathy
Due to angiotensin II tonic vasoconstriction of efferent arterioles
What is the initial dose of metformin in a new diagnosis of T2DM?
500mg daily
What is the name (generic and tradename) of a intermediate acting insulin?
Protaphane
What is Byetta?
A GLP-1 analogue
What is the EGR cut off from dose reduction and ceasation of metformin?
<40 dose reduce
<30 cease
How do SGLT2 inhibitors promote glycosuria?
Inhibit glucose reabsorption in the kidneys
When do you get acanthosis in diabetes?
Insulin resistance
