DM

Question 1

which 2 classes of DM meds increase insulin sensitivity

Answer 1

metformin (biguanide)
TZD

Question 2

which class (1) of DM meds increase insulin secretion

Answer 2

SU, bind to sulfonylurea receptor on pancreatic b cells

Question 3

which class (1) of DM meds delay glucose absorption

Answer 3

alpha glucosidase inhibitors

Question 4

which class (1) of DM meds increase glucose excretion

Answer 4

sglt2i

Question 5

pt has UC/CD, what DM meds to avoid

Answer 5

alpha glucosidase

Question 6

pt has heart failure, what DM meds to avoid

Answer 6

tzd

Question 7

pt has hx of pancreatitis, what dm meds to avoid

Answer 7

glp1 / gliptins

Question 8

cut off egfr for empa and dapa

Answer 8

empa 20
dapa 25

Question 9

why impaired insulin secretion in t2dm

Answer 9

beta cell mass and function reduced

Question 10

why does reduced incretin effect occur

Answer 10

decreased concentrations of / resistance to effects of incretin hormones

Question 11

why increased insulin resistance

Answer 11

excessive hepatic glucose production

Question 12

why excess glucagon secretion

Answer 12

glp1 and insulin resistance / deficiency, suppressing glucagon

Question 13

toujeo can keep in room temperature for

Answer 13

6 weeks

Question 14

lantus can keep in room temperature for

Answer 14

4 weeks

Question 15

actrapid flexpen can keep in room temperature for

Answer 15

6 weeks

Question 16

do longer acting products have a higher or lower risk of nocturnal hypoglycemia

Answer 16

lower risk

Question 17

during acute ilness or ketosis, do you need higher or lower insulin doses

Answer 17

higher

Question 18

what does metformin do to the liver

Answer 18

decrease hepatic glucose production

Question 19

why does metformin have low hypoglycemic risk

Answer 19

does not directly increase pancreatic insulin secretion

Question 20

does metformin affect cholesterol

Answer 20

decreases tg levels and ldlc
increases hdl

Question 21

metformin can cause deficiency of

Answer 21

vb12 cyanocobalamin

Question 22

which grp of pts are more susceptible to lactic acidosis when it comes to metformin

Answer 22

renal insufficiency, heart failure, hepatic impairment, alcoholism

Question 23

alpha glucosidase cut off in renal pts

Answer 23

crcl <25

Question 24

how does pioglitazone (tzd) affect tg

Answer 24

decrease tg

Question 25

why does fluid retention occur in tzd

Answer 25

peripheral vasodilation and improved insulin sensitisation in kidney -> increased sodium and water retention

Question 26

which glp1 can reduce the most a1c

Answer 26

dulaglutide, liraglutide

Question 27

how do dpp4i work

Answer 27

prolongs half life of endogenously produced glp1/gip

Question 28

difference between dpp4i and glp1 in terms of gastric emptying

Answer 28

glp1 slows gastric emptying, increase satiety

dpp4i does not affect gastric emptying

Question 29

which class of DM meds cause flu

Answer 29

dpp4i / tzd

Question 30

which class of dm meds have black box warning on risk of severe joint pain

Answer 30

dpp4i

Question 31

which class of DM meds delay carbohydrate absorption

Answer 31

alpha glucosidase

Question 32

side effects of alpha glucosidase

Answer 32

flatulence, abdominal pain, diarrhoea

Question 33

what is premlinitide

Answer 33

amylin analog, reduces glucagon secretion, slows gastric emptying, increases satiety

similar to glp1

Question 34

5 symptoms of hypoglycemia

Answer 34

tachycardia
palpitations
sweating
tremors
hunger

Question 35

hhs/dka: which one has ketonuria

Answer 35

dka

Question 36

what is cilostazol used for

Answer 36

help the symptoms of intermittent claudication in peripheral vascular disease