diabetes from physiology to clinical practice Flashcards
2 main DM trials and for what
- diabetes complication and control trial (DCCT) - type 1 - also EDIC follow up
- UK prospective diabetes study (UKDPS) - type 2
2 groups in DCCT
- promary prevention (no Sx)
2. secondary prevention (minor Sx)
2 intervention in DCCT
- regular insulin injection
2. intensive injection
finding from DCCT
major improvments in retinopathy, nephropathy, neuropathy
SE of intensive treatment (2)
- frequenct hypoglycemia
2. slight weight gain
2 main findings from EDIC
- intensive intervention reduced macro events
2. slows progression of events, but doesn’t prevent it
question asked by UKDPS
does intensive glucose control help in DM2
UKPDS findings
reduced HBA1C and reduced negative outcomes
3 steps for DM2 treatment
- improve insulin sensitivity - diet, exercise, metformin
- counteract insulin deficiency - secretogogues
- if given up - insulin therapy
what are 2 insulin sensitizers
- biguanide
2. thiazolidiones
what do insulin sensitizers do (2)
- lower glucose production
2. increase muscle uptake
what are 2 secretagagues and what do they do
sulfonyureas and meglinitides - increae insulin secretion
how can renal clearance of glucose be increased
SGLT-2 inhibitors
what do mimetics do (2)
- lower glucose production
2. incr. insulin secretion
main SE of secretagogues
hypoglycemia
