Diabetes Flashcards
1
Q
Metformin is first line treatment
What can be added?
A
DPP-4 inhibitor e.g. alogliptin
Pioglitazone
Gliclazide
SGLT-2 inhibitor e.g. empaglifozin
2
Q
Mode of action of metformin
A
Only works if functioning beta cells left
Decreases gluconeogenesis
Increases peripheral utilisation of glucose
3
Q
How to use metformin
ADRs
Affects weight?
Withhold if…..
A
GI side effects - increase slowly Can help with weight loss Do not use if eGFR <30 ml/min Low risk of hypos Avoid if hepatic insufficiency Can cause lactic acidosis stop if occurs Do not use if metabolic acidosis Caution if chronic heart disease
4
Q
Gliclazide ADRs Weight? Renal? Hepatic? C/I?
A
Hypos common Weight gain common Metab in liver Excr in kidney avoid if mild/mod, avoid in severe Caution in elderly
5
Q
Pioglitazone
Activates PPAR gamma
Like metformin
Reduces insulin resistance
Insulin dependent
A
Can use if crcl > 4 ml/min C/I if hepatic imp or heart failure or bladder cancer Low risk of hypos Weight gain common Avoid in elderly
