Metformin 1

Question 1

What is the therapeutic class and indication for metformin respectively?

Answer 1

Biguanide and antidiabetic (type 2 Diabetes)

Question 2

Differentiate between Type 1 and Type 2 Diabetes

Answer 2

T1D- reduce amounts of insulin to convert glucose to energy whereas T2D- reduced ability of insulin to convert glucose to energy

Question 3

State the complications of Type 2 Diabetes

Answer 3

Stroke, retinopathy, Cardiovascular disease, nephropathy, resistance to infection, neuropathy,

Question 4

How is Type 1 Diabetes managed?

Answer 4

Insulin injections

Question 5

How is Type 2 Diabetes managed?

Answer 5

Diet and exercise
Oral meds
Insulin Injections

Question 6

What type of medication is usually the first line of attack in T2D if exercise and diet alone is not sufficient

Answer 6

Metformin

Question 7

Mechanism of action of Metformin

Answer 7

1. Reduces Intestinal absorption of glucose: Hence taken with food
Upregulates SGLT1 (sodium-glucose transporter 1; for glucose absorption in small intestines) & GLUT2 (glucose movement across membranes) reducing  blood-glucose (bg)

2.Reduces hepatic gluconeogenesis: Enters hepatocyte via OCT1 (organic cation transporter 1 enzyme) activates AMPK, inhibits expression of PEPCK & G6Pases: 2 enzymes in the gluconeogenesis pathway (pyruvate glucose via 11 enzymes which reduces BG

3. increases insulin sensitivity in peripheral tissues
   upregulates insulin receptors
   gets insulin into the cells and hence reduces glucose in the blood

Question 8

Name the other Mechanism of action of Metformin

Answer 8

Inhibits Complex I in the electron transport chain of mitochondria
Decreases LDL
Increases fatty acid oxidation
Can cause weight loss