Management of Diabetes D - Type 2 Diabetes Mellitus - Part 2

Question 1

what are the advantages of DPPIV inhibitors?

Answer 1

Usually well tolerated
Can be used as 2nd or 3rd line agent
Can be used in renal impairment
No risk of hypoglycaemia
Weight neutral

Question 2

what are the disadvantages of DPPIV?

Answer 2

Trial data shows relatively small effects on glycemic control
CI in pregnancy and breastfeeding.
Possible increased risk of pancreatitis and pancreatic cancer
SE:
nausea

Question 3

what are the GLP1 analogues advantages?

Answer 3

Weight loss
No risk of hypoglycaemia
3rd line agent
Can be used with basal insulin

Question 4

what are the disadvantages of GLP-1 analogues?

Answer 4

Injection
Very expensive
Possible increased risk of pancreatitis and pancreatic cancer
CI in pregnancy and breastfeeding.
SE:
Nausea, vomiting

Question 5

what are the SGLT2 inhibitor effects?

Answer 5

GETS RID OF GLUCOSE / MORE GLYCOSURIA
LOWERS HbA1C          
GETS RID OF WATER / OSMOTIC DIURESIS
(POSTURAL) HYPOTENSION, DEHYDRATION
GETS RID OF CALORIES / WASTES GLUCOSE
LOSE WEIGHT WITH SAME INTAKE
GETS RID OF SODIUM /LESS REUPTAKE
LOWERS SYSTOLIC BLOOD PRESSURE
GREATER RISK OF UROGENITAL INFECTION
CYSTITIS and CANDIDIASIS

Question 6

what are the advantages of SGLT2 inhibitors?

Answer 6

Weight loss
No risk of hypoglycaemia
Good effects on glycemic control
May have beneficial effect on cardiovascular morbidity & mortality
2nd or 3rd line agent
Can add to insulin regimens in T2DM

Question 7

what are the disadvantage of SGLT2 inhibitors?

Answer 7

Expensive
SE:
UTI, fungal infections, osmotic symptoms
Risk of digital amputation
Risk of DKA
CI in pregnancy and breastfeeding.
Cannot use in renal impairment