management of diabetes Flashcards
name 7 people making up the MDT for a patient with diabetes?
dietician podiatrist pharmacist diabetes doctor GP psychologist specialist nurses
name 8 things a diabetic patient should expect from their care?
BG levels checked BP checked blood lipids checked eyes screened feet checked kidney function weight smoking cessation support
4 reasons why patients have an interest in treatment?
relief of 1y symptoms
prevention of complications
preservation of quality of life
damage minimilisation
5 stages to the 5-step framework for choosing a GLC lowering drug?
1 - set target HbA1c
2 - treat other risk factors
3 - optimise current treatments
4 - GLC lowering options
5 - set review date and target HbA1c with patient
why is metformin normally first choice?
improves outcome
well tolerated
cheap
class of drug - metformin?
biguanides
role of metformin?
improves insulin sensitivity
decreases fatty acid synthesis
inhibits gluconeogenic pathways
improves receptor function
half life of metformin?
6 hrs
benefits of taking metformin in overweight patients?
reduces MI risk and other macrovascular complications
microvascular risks also decrease
name 4 advantages of metformin?
well tolerated
no weight gain
cheap
used in pregnancy
name 4 disadvantages of metformin?
vitamin B12 malabsorption
lactic acid uptake by liver is inhibited - leads to hypoxia, hepatic failure etc.
GI side effects in 20-30% cases
name 3 Sulphonylureas?
Glimepiride
Gliclazide
Glipizide
how are Sulphonylureas named?
Gli___ide
action of Sulphonylureas?
bind to SUR-1 receptor
- > K+ cancels close
- > decreased K+ influx depolarisation
- > Ca2+ channels open
- > exocytosis of secretory granules of insulin to cell surface
action of Sulphonylureas?
bind to SUR-1 receptor
- > K+ cancels close
- > decreased K+ influx depolarisation
- > Ca2+ channels open
- > exocytosis of secretory granules of insulin to cell surface
