Non Insulin

Question 1

What are the classes of diabetes medications mentioned?

Answer 1

Biguanides, SGLT2 inhibitors, DPP-4 Inhibitors, GLP-1 Receptor Agonists, Sulfonylureas, Thiazolidinediones

These classes represent different mechanisms and targets for managing diabetes.

Question 2

Name a drug associated with Biguanides.

Answer 2

Metformin

Metformin is the most commonly used medication in this class.

Question 3

What is the mechanism of action (MOA) of Metformin?

Answer 3

Decrease hepatic glucose production, decrease interstitial glucose absorption, sensitizes insulin receptors

This results in increased peripheral glucose uptake and utilization.

Question 4

What is the primary action of SGLT2 inhibitors?

Answer 4

Decrease glucose reabsorption through sodium-glucose cotransporter 2 (SGLT2) in the proximal renal tubule

This promotes glucose excretion in urine.

Question 5

What effects do GLP-1 receptor agonists have on insulin secretion?

Answer 5

Increase glucose dependent insulin secretion, decrease glucagon secretion, slows gastric emptying, decrease food intake

They mimic the incretin hormone GLP-1.

Question 6

What are common adverse drug reactions (ADRs) associated with Metformin?

Answer 6

Diarrhea, N/V, B12 deficiency, AKI, bone fractures, GU infections, hypotension, volume depletion, fatigue, headache

These reactions may vary in severity and duration.

Question 7

True or False: Hypoglycemia is a common ADR of SGLT2 inhibitors.

Answer 7

False

SGLT2 inhibitors are not typically associated with hypoglycemia.

Question 8

What contraindications are noted for SGLT2 inhibitors?

Answer 8

eGFR < 30, metabolic acidosis, iodinated contrast

These conditions can increase the risk of adverse effects.

Question 9

Which medication is associated with a risk of bladder cancer?

Answer 9

DPP-4 Inhibitors

This risk is particularly noted with saxagliptin.

Question 10

Fill in the blank: The efficacy of Metformin is typically between _______.

Answer 10

1-1.5%

This refers to the reduction in A1c levels.

Question 11

What is a unique feature of linagliptin in terms of renal dosing?

Answer 11

Does not require renal dose adjustment

This makes it suitable for patients with renal impairment.

Question 12

Which two classes of medications are noted for their cardiovascular (CV) benefits?

Answer 12

GLP-1 Receptor Agonists, SGLT2 inhibitors

These classes have shown benefits in reducing major adverse cardiovascular events (MACE).

Question 13

What is the primary focus of diabetes management in T1DM according to the notes?

Answer 13

Insulin management

Non-insulin therapies have limited efficacy in T1DM.

Question 14

What is the cost and efficacy of Pralintide as a diabetes therapy?

Answer 14

Cost: $265/month; Efficacy: modest decreases in A1c and weight

Pralintide is an injection given before major meals.

Question 15

What are the effects of SGLT2 inhibitors on body weight and blood pressure?

Answer 15

Modest decrease in A1c, body weight, and BP

However, they are also associated with an increased rate of diabetic ketoacidosis (DKA).