Diabetes Medication

Question 1

Sulphonylureas

Answer 1

Increase insulin output from the liver/ potenitiate effects

Increase insulin production by the pancreas
Side effects- hypoglycaemic, may cause weight gain, can cause nausea, diarrhoea and headaches

Glibetniclamide, gliclazide, glimepiride, glipizide

Question 2

Biguanides

Answer 2

Metformin

Lower blood glucose levels by inhibiting glycogenolysis, slowing the absorption of glucose from the intestine and increasing insulin sensitivity

Does not cause hypos by itself

Diabex, diaformin

Question 3

Alpha glucosidase inhibitors

Answer 3

Slow digestion and absorption of carbohydrates- don’t cause hypos on own

Glucobay

Question 4

Thiazolidinediones (glitazones)

Answer 4

Lower BGL by increasing effect of your own insulin and improve insulin resistance

Work well with other diabetes tablets
Don’t cause hypos on own

Proglitazone, rosligitazone,

Question 5

GLP-1 analogues - incretin mimetics

Answer 5

Given by injection under the skin

Not a sub for insulin.
Byetta used with metformin and a sulfonylurea og in combination with long activing insulin and metformin

Victoza is for use with metformin or a sulfonylurea

Question 6

DPP-4 inhibitors

Answer 6

Inhibit DPP-4. Enhance levels of active incretin hormones which act to lower BGL by increasing insulin secretion and decreasing glucagon secretion

Unlikely to cause a hypo

Alogliptin, linagliptin

Question 7

SGLT2 inhibitors

Answer 7

New class of drug 
SGLT inhibitors block the SGLT2 protein involved in most of glucose reabsorption in proximal tubule 

May also increase insulin sensitivity, decrease gluconeogenesis and improve insulin release from pancreatic beta cells
High susceptibility to UTI