Diabetes PPT 4 Flashcards
What are the central components of T2DM treatment?
Diet, exercise
What should you take into account for choosing medications for patients?
- amount and the rapidity of glucose lowering required
- the potential for adverse effects
- the potential for non glycemic benefits
- compliance issues
- cost
What agents are considered first line?
Oral
How long does it take for A1C targets to be reached?
3 months
Where does metformin work?
Liver and skeletal muscles to improve glucose uptake
Where do thiazolidinediones or TZDs work?
liver, skeletal, and adipose tissue
Where do the incretins work?
gut, brain, and pancreas
Where do SGLT-2 inhibitors work?
Renal tubules to decrease glucose reabsorption
What are the two main categories of non injectable medication used for T2DM?
GLP1 or incretin mimetic and amylinomimetics
What is the mechanisms of action for sulfonylureas?
Stimulates insulin release by inhibits K_ATP channels on beta cells
What are the most common sulfonylureas medications?
Glipizide, Glypuride, and Glimepiride
How are they dosed?
In ā10sā of mg
Which sulfonylurea is contraindicated in hepatic and renal disease?
Glyburide
What sulfonylurea has the shortest half life?
Glipizide, less likely to produce serious hypoglycemia when given 30 minutes before a meal
How is Glimepiride dosed?
Once a day, can be given mono or in therapy
What are the two common meglitinide drugs?
Repaglinidie and Nateglinide
What is the mechanism of action of meglinitinide drugs?
Stimulates insulin release by binding to K_ATP channels (glucose dependent)
How should sulfonylureas be dosed, except glipizide?
Take with meals to prevent hypoglycemia and produce maximum effect
