Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

endocrine > Management of type 2 diabetes > Flashcards

Management of type 2 diabetes Flashcards

1
Q

Which gender is diabetes more common in (Type 1 + 2)

A

Men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What increases risk of diabetetes

A

Being obese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What drugs cause increase in insulin release

A

Sulphonylureas
Metiglinides
Incretin mimetics
DPPIV inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What drugs cause increased excretion of glucose

A

SGLT2 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What drugs improve the insulin action

A

Biguanides
Thiazolidines
Weight reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What non-pharmaceutical method improves insulin activity

A

Physical activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the first choice diabetic medication and why

A

Metformin - improves outcome and is cheap and well tolerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of drug is metformin

A

A Bigunaide - imprroves the action of insulin - increasing insulin sensitivity in tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the target tissues of metformin

A

Liver and muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the negatives of metformin

A

Can cause GI discomfort
Can cause lactic acidosis by inhibiting lactic acid uptake by the liver
Can cause Vit b12 malabsorption
Cannot be used in eGFR <30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When are sulphonylureas used

A

When there is a rapid improvement required in blood glucose control e.g rapidly increasing HbA1c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the function of sulphonylureas

A

Increase insulin release from the pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do sulphonylureas work

A

They bind to their receptors on beta cells and close the ATP sensitive potassium linked channels - this decreases influx of potassium and therefore depolarisation - this causes voltage gated calcium channels to open and influx calcium - causes translocation and exocytosis of secretory granules of insulin to the cell surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are examples of sulfonylureas

A

Glimepride daily
Gliclazide 2x daily
Glipizide 2x daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the disadvantages of sulfonylureas

A

Can cause hypoglycaemia
Weight gain
can be nephrotoxic and hepatotoxic
Contraindicated in PREGNANCY!
side effects of hypersensitivity and photosensitivity with blood disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the function of thiazolidinedones

A

Improve insulin action - sensitivity of tissues - reduces resistance to insulin in the luver and peripheral tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What tissues do thiazolidinedones target

A

Liver, muscles and adipose tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the main thiazolidinedones

A

Piaglitazone

19
Q

What are the main side effects of pioglitazone

A

Increased risk of bladder cancer
Fluid retention - congestive cardiac failure
weight gain
fractures in females

20
Q

what is the function of SGLT2

A

Sodium, glucose linked transporter - majority of glucose is absorbed by SGLT2 at the proximal tubule

21
Q

What is another name for SGLT2 inhibitors

A

Gliflozins

22
Q

What is the effect of SGLT2 inhibitors

A

Excretes more glucose, water, calories and sodium

Causes weight loss

Lowes blood pressure due to less sodium

Greater risk of urogenital infection

23
Q

What is the effect of gliflozins in renal disease

A

Reduces morbidity and mortality

24
Q

When is canagliflozin contraindicated

A

eGFR<30

25
Q

When is empagliflozin contraindicated

A

eGFR <60 - do not start

Stop if eGFR is drops below 45

If they have CV disease avoid empagliflozin if eGFR <30

26
Q

When is dapagliflozin contraindicated

A

If eGFR is below 15

27
Q

What is the first line treatment for diabetes type 2 when there is high CV risk and metformin is not tolerated

A

SGLT-2 inhibitors - e.g canagliflozin

28
Q

What is the SECOND line treatment for diabetes type 2 when there is high CV risk - metformin first line is tolerable

A

SGLT-2- inhibitor

29
Q

What are the disadvantages of SGLT-2inhibitors

A

UTI, fungal infection, osmotic symptoms
Digital amputations
DKA
Contraindicated in PREGNANCY and breast feeding !
Cannot use in renal impairment

30
Q

What are GLP1 and DPPIV

A

Incretin mimetics

31
Q

What is the incretin effect

A

The difference between taking oral glucose and IV glucose

32
Q

What is the function of DPP-4

A

Causes the breakdown of incretin

33
Q

What is the function of Gliptins

A

DPP-4 inhibitors so incretin is not broken down

34
Q

What are examples of DPPIV inhibitors

A

…Gliptins

35
Q

What has to be done to DPPIV when there is CKD

A

Make adjustments to dosage

36
Q

When are DPPIV inhibitors contraindicated

A

Pregnancy and breast feeding

37
Q

What are GLP1 analogues

A

Resistant to degradation

38
Q

When should GLP-1 analogues be started

A

BMI>35

39
Q

When shoukld GLP-1 analogues be stopped

A

6 months later unless it is proven effective (HbA1c decrease more than 1 % or decrease in weight over 3%)§

40
Q

When should GLP-1 analogues be avoided

A

eGFR<30

41
Q

What are examples of GLP-1 analogues

A

…tide - exenatide

42
Q

What are the negatives of GLP-1 analogues

A

Injection
expensive
Contraindicated in PREGNANCY and breast feeding!
Causes nausea and vomiting

43
Q

What is the first, second and third line for diabetes

A

1st line - metformin - biguanide

2nd line - sulphonylurea - glimapride or glicazide

2nd line with CVD risk - SGLT2 inhibitor - canagliflozin

2nd line with need for weight loss - GLP-1 analogue - .e.g ..tide

endocrine (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions