glucose homeostasis (diabetes) Flashcards
What blood glucose level would diabetes be unlikely?
a) < 5.5 mmol/L
b) 5.5-6.9 mmol/L
c) >7 mmol/L
< 5.5 mmol/L
What is the target HbA1c to aim for in most patients?
<6%
HbA1c represents an integrated measure of approximately ______ months worth of glucose exposure
3 months
what is metformin contraindicated in?
renal failure
what is the MOA of metformin?
increase tissue sensitivity to insulin (MOA not fully understood)
what drug can be given for patients allergic to suphonylureas?
glitinides
what is gliclazide and its MOA?
suphonylureas
block ATP-sensitive K+ channels –> depolarisation and influx of Ca2+ –> excocytosis of insulin from pancreas
what antidiabetic drugs are indicated for patients with atherosclerotic CVD, HF or CKD?
GLP-1 receptor agonist (Dulaglutide)
SGLT2 inhibitor (Dapagliflozin)
what is dulaglutide and its MOA?
GLP-1 receptor agonist (incretin mimetic)
synthetic analogues of incretin hormones –> promote insulin release
what drug is sitagliptin and its MOA?
incretin enhancer (DPP-4 inhibitor)
inhibit breakdown of incretin hormones –> increase release of insulin
which antidiabetic drug causes UTI?
SGLT2 inhibitors (dapagliflozin)
what is pioglitazone and its MOA?
thiazolidinedione TZD (insulin sensitiser)
increase tissue sensitivity to insulin and increase glucose transporters
what is acarbose and its MOA?
a-glucosidase inhibitor
slows metabolism and breakdown of complex carbohydrates into glucose
what are signs/symptoms of DKA?
Symptoms:
1. Polyuria, polydipsia, polyphagia
2. Nausea, vomiting, abdominal pain
3. Lethargy, drowsiness, confusion
4. Dyspnoea
Signs
1. Dehydration, tachy/bradycardia, hypotension
2. Ketotic breath
3. Hyperventilation, Kussmaul breathing
4. Impaired mental state, comatose
what is the deficiency in diabetes insipidus?
ADH deficiency
central: failure to produce ADH
nephrogenic: failure of kidneys to respond to ADH
Which symptoms may indicate hypoglycemia?
a) polyuria
b) polydipsia
c) sweating
d) dry skin
sweating
body perceives low blood sugar levels as threat/stressor –> trigger SNS which release adrenaline –> stimulate sweat glands (sweating to regulate body temperature, cool body down)
which antidiabetic drug causes weight gain?
sulphonylureas
which antidiabetic drug is associated with weight loss?
metformin
what is the first thing to prescribe to a patient with diabetic ketoacidosis?
IV hydration
Metformin is conjugated by the liver before it is excreted by the kidney - true or false?
False. Metformin is excreted by kidneys unchanged
how is GLP-1 receptor agonist (incretin mimetics) administered?
injection
what drugs are insulin secretion enhancers? (stimulate release of insulin from pancreas)
GLP-1 receptor agonist, DPP-4 inhibitor, sulfanylureas and glitinides
what drugs are insulin sensitisers?
Metformin and glitazones/thiazolidinediones
untreated hyperglycaemia may lead to all of the following complications except:
a. anorexia (loss of appetite)
b. coma
c. DKA
d. end stage renal disease
e. hyperosmolar syndrome
anorexia (loss of appetite)
