Management of type 2 diabetes

Question 1

most common complaicon of diabes

Answer 1

1st diabetic retionpay
2nd nephrophaty
3rd neruopaty
4th microalmumiuira

Question 2

where is metaform orgin from

Answer 2

french lilac or goats rue plant

Question 3

effect of metaformin

Answer 3

imporve insulin senvity in the liver and muslce tissue

Question 4

half life of metformin

Answer 4

6 hour

Question 5

advantages of metformin

Answer 5

improves cvd outcomes
decrease fasting bg by 22%
not associated iwth weiht gain
reduion in hbac
cheap

Question 6

disadvanctes of metrformin

Answer 6

gi side effects in 20 - 30% of paitents
risk of lactic acidosis by inhibiting lactic uptake by the liver, b12 deficency

Question 7

signs of latic aciddossi

Answer 7

hypox, renal failrue, hepatic flure , alchol abuse

Question 8

first line drug for t2d and gestestion diabtes

Answer 8

metformin

Question 9

what is sulphonylureas examples

Answer 9

glimepiride, gliclazide, glipizide

Question 10

effect of sulphonyureas

Answer 10

increas insulin relesae by binding to sulonylurea recptos of pancreic beta cell
this closes the atp sensitive potassium channels
this decreas the potaum depolation of the cell membrne
this resuls in an influx of calcium and caues exoctoos of the secretory granules and realse of insuin

Question 11

where are sulphonly ureas metabolised

Answer 11

liver

Question 12

what are the advantages of sulphonyurea

Answer 12

cheap, lead to a rapid inmprovement in control
rapid titration
well tolerated

Question 13

down side of sulpholyrea

Answer 13

riskof hypoglycema
weight gain
cause renal and hepatic disae
ci in breast feeding and pregnacy
se of hypersentivy and phosentitivity
blood disorder

Question 14

sglt2 inhibitor types

Answer 14

canglifozin, dapaglifozin, empagliflozin

Question 15

where is sglt2 inhibtor maily sued

Answer 15

in cases of chronic hert fialrue and cvd risk

Question 16

how do sglt2 inhiorr work

Answer 16

help to remove glucose by blocking the sglt3 enzyme which cuase glucose to be retinated in the blood at the kindyes, his cuase glucose to be excreted in urine

Question 17

effect of slg2 inhibtor on sodu

Answer 17

removes itthus lower bp

Question 18

benifit of sglt2 inhiot

Answer 18

weight loss
no hypoglycmeia
good glycmic contorl
cvd risk reduction
can add to insulin regimes

Question 19

downside of sglt2 inhibtor

Answer 19

there expensive
can cuase side effects including uti, fungal infeciton, osmoic sympoms, fourneir gnacre
risk of dka
ci in preany and breast feeding
less glycemic efec in renl impairent

Question 20

what are examples of dppiv inbitpors

Answer 20

sitagliptin, aloglipitns, saxaglipitin

Question 21

how do dpp1v inhibitors work

Answer 21

delay the break down of increptin which are hormones from food relased during ddiestin, this then incres the levle of increptin which then stimulers the acre more to increase the ammount of insulin realsd and reduce glucaon relases

Question 22

advancteages of ddpiv inhibotrs

Answer 22

well tolerated
can be used in renal imparet
no risk of hypoglcema
weigth neuraol

Question 23

down sides of dppiv inhobrs

Answer 23

small effect on glycmeic conrol
ci in pregnacy and breast feeding
nausesa

Question 24

what are exampels of glp 1 agonsits

Answer 24

liraglutide, semaglutide, exenatide

Question 25

mode of action of glp1 agonists

Answer 25

they mimic the effect of glp1 hormone and thus cuase the pancreas to relase more insulin and less glucogaon

Question 26

sdie effect of glp1 agons

Answer 26

nause

Question 27

who is elegpoe for glp 1 agons acoring to nice

Answer 27

bmi over 35
and only on for 6 or 12 monts unless no large effec

Question 28

advances of glp analgoes

Answer 28

weight loss
no risk of hypogleymia
3rd line
can be used with basal insulin

Question 29

disadvances of glp analgones

Answer 29

exspensive, ci in pregnacy, nausea and vommiting

Question 30

what are exampels of thiazolidinediones

Answer 30

pioglitazone

Question 31

where do thiazoliodones work

Answer 31

on adipose tisue
liver and muscle glucose absoption

Question 32

effect of thiazoline

Answer 32

it stiumaltes the nuclear recprot peroxisome prolifator activted recor called gamma
it modultes the trancopin of the inulin sentive gens involed in teh control of glucose and lipid metabnolsm in mucle, adipose tissue and liver
redcues the insulin liver and peripharl tissues
increase the exspence of insulin depent glucose
decreases withdrawl of glucose from the liver
reducs quanti of glucose , insulin and glycertaed hameoglin

Question 33

benifits of thiazoldines

Answer 33

good for insulin resitance
cheap
cvd saftey

Question 34

down sides of thiazolidinediones

Answer 34

incrase the risk of bladder cancer
fluid retention
weigh gain
fractures increase in femalses due to recued bone density

Question 35

what is isophane nsul

Answer 35

long acting insulin that only need injected dialy at bedtime