Diabetes management and treatment t2 Flashcards
ominous octet
- decreaesd insulin secretion
- Neurotransmitter dysfunction
- Increased glucose reabsorption
- Increased glucagon secretion
- Decreased incretin effect
- Increased lipolysis
- Decreased glucose uptake
- Increased hepatic glucose production
metformin MOA
reduces liver production of glucose, reduced intestinal absorption of glucose and enhanced insulin sensitivity
GLP-1RA MOA
Increase insulin and inhibit glucagon
Where do GLP-1RA act ?
Liver, pancreas, stomach
Sulphonylureas MOA
Binds to ATP sensitive K+ channel
Voltage gated ca2+ channels open which triggers insulin release
Side effects sulphonylureas
N/V/D
Constipation, weight gain
Contra-indications of sulphonylureas
hepatic and renal impairment , breast feeding
Biguanides MOA
Not understood
Biguanides target population
Overweight/obese
Side effects biguanides
GI upset, decreased B12 absorption
Contra-indications for biguanides
hepatic and renal impairment, breast feeding
Meglitinides MOA
Same as sulphonylureas
Meglitinides side effects
N/v
hypersensitivity reactions
Alpha-glucosidase MOA
binds to a-glucosidase enzymes
binding is irreversible so absorption of glucose is slower than usual
Side effects a-glucosidase
Flatulence, loose stools, abode pain
Contra-indications a-glucosidase
IBD, hepatic/renal impairment, breast feeding
Thiazolidinediones MOA
Bind to PPAR-y
Causes gene transcription -> insulin signalling
Side effects thiazolidnediones
GI disturbances, headache etc
GLP-1RA MOA
Promotes insulin secreting and slows gastric emptying
SGLT2 inhibitors MOA
Inhibit SGLT2 sodium-glucose co-transporters
in renal PCT = reduced glucose reabsorption
SGLT2 inhibitors contra-indications
renal impairment, ketoacidosis, pregnancy, breast feeding
