Diabetes mellitus Flashcards
If a diabetes drug begins with “Gli-“, what class is it?
Sulfonylurea (eg glibenclamide)
What value for a random plasma glucose is diagnostic of diabetes mellitus?
> 11.1 mmol/L + symptoms
What do all SGLT2 inhibitor drug names start or end with?
End with “-aglifozin”
What is the range for impaired fasting blood glucose?
6.1-6.9 mmol/L
If a diabetes drug ends with “-aglifozin”, what class is it?
SGLT2 inhibitor
If a diabetes drug ends with “-gliptin”, what class is it?
DPP4 inhibitor (inhibits degradation of GLP-1) (eg sitagliptin)
What do all sulfonylurea drugs start or end with?
Start with “Gli-“ (eg glibenclamide)
What is the step-wise drug Mx of T2DM?
Metformin
+ sulfonylurea
+ DPP4 inhibitor OR GLP-1 analogue
What value for a fasting plasma glucose is diagnostic of diabetes mellitus?
> 7 mmol/L
What value for HbA1c is diagnostic of diabetes mellitus?
> 6.5% or 48 mmol/mol
What do all GLP-1 analogues start or end with?
End with “-tide” (eg exenatide)
If a diabetes drug ends with “-tide”, what class is it?
GLP-1 analogue (eg exenatide)
What do all DPP4 inhibitors start or end with?
End with “-gliptin” (eg sitagliptin)
What value for a 2-hour oral glucose test is diagnostic of diabetes mellitus?
> 11.1 mmol/L
In which patients is metformin contraindicated and why?
Renal failure. Can cause lactic acidosis
What is exenatide?
GLP-1 analogue
What is glibenclamide?
Sulfonylurea
what are the guidelines regarding insulin use (in a T1DM) prior to surgery?
take half the dose of long acting insulin on the morning of the surgery only
what are the guidelines regarding metformin use prior to surgery?
Stop 48 hours before
what is the fasting blood glucose target for diabetics for surgery?
5-10mmol/L
what are the guidelines regarding sulfonylureas use prior to surgery?
withhold 12 hours prior to surgery
what are the guidelines regarding DPP4 inhibitors, SGLT2 inhibitors and GLP-1 analogues use prior to surgery?
withhold morning of surgery
what are the guidelines regarding basal bolus insulin use prior to surgery?
give basal insulin (normal or 2/3) and then give bolus with breakfast if afternoon surgery. Also give IV 5% dextrose
What are the side effects of sulphonylureas?
Weight gain and hypoglycaemia
What is the most common precipitating event for diabetic ketoacidosis?
Infection
What is the target blood pressure in DM?
130/80
What is the target HDL in DM?
Greater than 1.0
What is the target LDL in DM?
Less than 2.0
What is the target total cholesterol in DM?
Less than 4.0
