Week 12 - Type 2 Diabetes

Question 1

What is the primary purpose of Type 2 antidiabetic agents?

Answer 1

To lower blood sugar levels.

Question 2

Who are the typical candidates for oral antidiabetic agents?

Answer 2

Uncomplicated Type 2 diabetics who do not respond to diet control alone.

Question 3

What age group is usually considered for Type 2 diabetes treatment with these agents?

Answer 3

Usually under 40 years old.

Question 4

What is the maximum insulin requirement for patients suitable for these medications?

Answer 4

Less than 40 IU/day equivalent of insulin.

Question 5

Name one class of oral antidiabetic agents.

Answer 5

Sulfonylureas.

Question 6

List one drug that belongs to the sulfonylureas class.

Answer 6

Gliclazide (Diamicron®).

Question 7

How many chemical subclasses of non-sulfonylureas are there?

Answer 7

Seven.

Question 8

What is the mechanism of action for sulfonylureas?

Answer 8

They stimulate the pancreas to secrete insulin.

Question 9

What is a common adverse effect of sulfonylureas?

Answer 9

Hypoglycemia.

Question 10

What is Metformin classified as?

Answer 10

A biguanide.

Question 11

Why does Metformin not cause hypoglycemia?

Answer 11

It decreases glucose production in the liver and promotes glucose uptake by cells.

Question 12

What is a serious adverse event associated with Metformin?

Answer 12

Lactic acidosis.

Question 13

Name one thiazolidinedione.

Answer 13

Pioglitazone (Actos®).

Question 14

What is the primary action of thiazolidinediones?

Answer 14

To increase sensitivity of insulin receptor sites.

Question 15

What is a potential risk associated with Pioglitazone?

Answer 15

Bladder cancer.

Question 16

What do glinides do?

Answer 16

They stimulate rapid insulin secretion at mealtime.

Question 17

Name one α-glucosidase inhibitor.

Answer 17

Acarbose (Precose®).

Question 18

What is the mechanism of action for α-glucosidase inhibitors?

Answer 18

They inhibit the absorption of sugar in the gastrointestinal tract.

Question 19

What is a common gastrointestinal side effect of α-glucosidase inhibitors?

Answer 19

Gas.

Question 20

What do SGLT2 inhibitors target?

Answer 20

Renal glucose reabsorption.

Question 21

Name one SGLT2 inhibitor.

Answer 21

Dapagliflozin (Farxiga®).

Question 22

What is a common adverse effect of SGLT2 inhibitors?

Answer 22

Yeast infections.

Question 23

What is the mechanism of action for GLP-1 agonists?

Answer 23

They mimic the incretin hormone GLP-1, stimulating insulin secretion and reducing glucagon production.

Question 24

Name one GLP-1 agonist approved in Canada.

Answer 24

Liraglutide (Victoza®).

Question 25

What is a potential adverse effect of GLP-1 agonists?

Answer 25

Nausea.

Question 26

What is the role of DPP-4 inhibitors?

Answer 26

They delay the breakdown of incretin hormones.

Question 27

Name one DPP-4 inhibitor.

Answer 27

Sitagliptin (Januvia®).

Question 28

What is a common side effect of DPP-4 inhibitors?

Answer 28

Gastrointestinal discomfort.

Question 29

What is the primary goal of diabetes medications?

Answer 29

To achieve glycemic control.

Question 30

What is the significance of insulin receptor sensitivity?

Answer 30

Increased sensitivity allows insulin to work more effectively in the body.

Question 31

What is the effect of sulfonylureas on liver glycogenolysis?

Answer 31

They decrease liver glycogenolysis.

Question 32

What is a contraindication for Metformin?

Answer 32

Kidney disease or dysfunction.

Question 33

How do glinides differ from sulfonylureas?

Answer 33

Glinides stimulate insulin secretion rapidly at mealtime, while sulfonylureas have a longer duration of action.

Question 34

What is the primary action of sodium-glucose cotransporter-2 inhibitors?

Answer 34

Inducing glucosuria (excretion of glucose in urine).

Question 35

What is a common adverse event associated with SGLT2 inhibitors?

Answer 35

Ketoacidosis.

Question 36

What is the mechanism of action for biguanides like Metformin?

Answer 36

They decrease glucose production in the liver and increase glucose uptake by cells.

Question 37

What is the effect of thiazolidinediones on bone density?

Answer 37

They may decrease bone density.

Question 38

What is the primary use of GLP-1 agonists in recent marketing?

Answer 38

Weight loss.

Question 39

What is a common gastrointestinal side effect of Metformin?

Answer 39

Nausea.

Question 40

What is the mechanism of action for α-glucosidase inhibitors?

Answer 40

They slow down carbohydrate absorption in the intestines.

Question 41

What is a potential cardiovascular risk associated with sulfonylureas?

Answer 41

Increased risk of cardiovascular disease.

Question 42

What is the role of incretin hormones in diabetes management?

Answer 42

They help regulate insulin secretion and glucose metabolism.

Question 43

What is the effect of DPP-4 inhibitors on incretin levels?

Answer 43

They increase the levels of endogenous incretin hormones.

Question 44

What is a common side effect of thiazolidinediones?

Answer 44

Fluid retention.

Question 45

How do SGLT2 inhibitors affect blood pressure?

Answer 45

They may cause orthostatic hypotension.

Question 46

What is the primary indication for using glinides?

Answer 46

To achieve glycemic control, especially around mealtimes.

Question 47

What is a contraindication for α-glucosidase inhibitors?

Answer 47

Diabetic ketoacidosis.

Question 48

What is the mechanism of action for sulfonylureas in the pancreas?

Answer 48

They stimulate beta-cells to secrete insulin.

Question 49

What is a common adverse effect of GLP-1 agonists related to weight?

Answer 49

Excessive weight loss.

Question 50

What is the importance of monitoring for hypoglycemia in patients taking sulfonylureas?

Answer 50

Because sulfonylureas can cause low blood sugar levels.

Question 51

What is the primary mechanism of action for sodium-glucose cotransporter-2 (SGLT2) inhibitors?

Answer 51

They target renal glucose reabsorption and induce glucosuria.

Question 52

Which class of medications is most commonly used as the first-line treatment for Type 2 diabetes in Canada?

Answer 52

Biguanides, specifically Metformin.

Question 53

What is a significant adverse effect of thiazolidinediones that has led to reduced use?

Answer 53

Increased risk of heart failure due to fluid retention.

Question 54

How do GLP-1 agonists contribute to weight management in Type 2 diabetes patients?

Answer 54

They slow gastric emptying and increase satiety, leading to reduced food intake.

Question 55

What is the role of incretin hormones in the action of DPP-4 inhibitors?

Answer 55

DPP-4 inhibitors delay the breakdown of incretin hormones, increasing their levels and enhancing insulin secretion.