Type 2

Question 1

Type 2 definition

Answer 1

Insulin resistance

Question 2

1st line treatment

Answer 2

Metformin

Question 3

ASCVD or at high risk, CKD&albuminuria

Answer 3

SGLT2i, GLP1RA

*if A1C is still above target, consider adding on with the other

Question 4

HF (HFrEF <45%)

Answer 4

SGLT2i

Question 5

Decrease hypoglycemia

Answer 5

GLP1RA, SGLT2i, DPP4i, TZD

Question 6

Increase weight loss or decrease gaining weight

Answer 6

GLP1RA- good efficacy for weight loss

SGLT2i

Question 7

Decrease cost

Answer 7

SU, TZD

Question 8

Biguanide

Answer 8

Metformin
Decreases hepatic glucose production, decreases intestinal absorption of glucose, increases insulin sensitivity

Max : 2000mg/day
SE: lactic acidosis

Question 9

SGLT2i

Answer 9

-flozin
Empagliflozin, canagliflozin, dapagliflozin
Inhibits SGLT2 in the proximal renal tubules; increases urinary excretion of glucose, decreasing plasma glucose concentrations

SE: diuretic(taking in AM), DKA risk, hypotension, volume depletion risk
Canagliflozin- bone fracture risk, lower limb

Question 10

GLP1RA

Answer 10

G- slows down food leaving your stomach
L- helps reduce the amount of sugar release from your liver
P- when BS is high, increases the amount of insulin released from your pancreas

-tides
Semaglutide, dulaglutide, liraglutide

DO NOT USE WITH DPP4i
BOX WARNING: risk of thyroid C-cell tumors

Question 11

DPP-4i

Answer 11

Inhibits DPP-4 enzyme, prolonging active incretin levels

-gliptin
Saxagliptan

DO NOT USE WITH GLP1RA
AVOID w/ pancreatitis

Question 12

TZD

Answer 12

Agonist for PPARgamma
Improves target cell response to insulin, w/o increasing pancreatic insulin secretion

-glitazone
Pioglitazone

BOX warning: CHF
pio: bladder cancer
Rosiglitazone: increase LDL, BOX WARNING: MI

Question 13

SU

Answer 13

Stimulates insulin release from pancreatic B cells; decrease glucose output from liver

Glipizide

AVOID W/INSULIN
Glimepuride & glyburide: increase risk of severe prolonged hypoglycemia in elderly