Treatment algorhythm Flashcards
First Line
Metformin
Second Line
Sulphonylureas
DPP4 inhibitors
SGLT2 inhibitors
Sulphonylureas (examples)
- Gliclazide
- Glipizide
- Glibenclamide
- Glimepiride
Third Line
Sulphonylureas
DPP4 inhibitors
SGLT2 inhibitors
GLP1 receptor agonists/insulin
Metformin Pros
Weight loss
Low risk of hypos
Metformin Risks
GI side effects
Vitamin B12 deficiency
Lactic acidosis
Reduce dose in renal impairement
Sulphonylurea Risks
Weight gain
Hypoglyceamia
Avoid in renal impairement
DPP4 Inhibitor (examples)
Alogliptin Linagliptin Saxagliptin Sitagliptin Vildagliptin
DPP4 Inhibitor Pros
Low risk of hypos
No impact on weight
Improved post-parandial control
DPP4 Inhibitor Risks
Avoid in pancreatitis
MSK pain
Reduce dose in renal impairement
GLP-1 Receptor antagonist (examples)
Dulaglutide
Exenatide
Liraglutide
GLP-1 Receptor antagonist Pros
Low risk of hypos
Weight loss
Post-parandial control
Slows kidney disease
GLP-1 Receptor antagonist Risks
Avoid in pancreatitis/MEN1/Thyroid cancer
GI side effects
Avoid in severe renal impairement
SGLT2 inhibitor examples
Dapagliflozin
Empagliflozin
Ertugliflozin
SGLT2 inhibitor Pros
Low risk of hypos Weight loss Reduces CVD Reduces BP Slows renal disease