Diabetes

Question 1

Metformin

Answer 1

Diabetes

MOA:
- lower intestinal glucose absorption
- decreased gluconeogenesis 
- higher capacity of GLUT
antihyperglycaemic (no effect on insulin production)
\+ pleiotropic effects

ADR:
- dyseusia, loss of appetite, unspecific GI ADR
→ lead to lower body weight
- Vit B12 deficiency (Check ups!)
- lactic acidosis (avoid alcohol, vor OP absetzen)

Question 2

Gliflozines

Answer 2

Diabetes

= SGLT-2-Inhibitor (SGLT-2 is für 90% der Reabsorption von Glucose in renalem Tubulus verantwortlich)
Bsp: Empagliflozine

MOA: inhibition of SGLT2 on renal epithelial cells
empagliflozine
→ glucosuria
→ lower blood glucose level
→ lower body weight
= mimics a low sugar diet = very attractive for patients

ADR:

• severe hypoglycaemia
• diabetic ketoacidosis
• genital infections/UTI
• risk for toe amputation

CI: efficacy depends on renal function (ineffective if GFR < 60 ml/min)

Question 3

GLP-1 receptor agonists

Answer 3

Diabetes
- injected daily!
Bsp: Liraglutide, Dulaglutide, Exenatide

Inkretin Mimetik = Effekt wie das Hormon GLP-1 = Inkretin
MOA: GLP-1 agonistic effect (incretin mimetic) auf beta-Zelle
→ meal-related (?) insulin secretion (in theory only!)
→ insulin secretion decreases as glucose conc decrease
+ delaying gastric emptying
+ suppressing postprandial glucagon secretion

ADR:

• hypoglycaemia
• persistent diarrhoea, abdominal pain
• nausea (due to delayed gastric emptying) → lower body weight
• pancreatitis, thyroid cancer
• suicidal thoughts