Endocrine System/Treatment of Diabetes & Obesity

Question 1

Blood glucose-reducing hormones

Answer 1

Insulin

MoA:
Stimulation of glucose uptake by cells

Indication:
Type 1 and type 2 diabetes mellitus

Adverse Effects/Interactions:
Hypoglycaemia
Digoxin, beta-blockers

Question 2

Oral Biguanide

Answer 2

Metformin

MoA:
Increases insulin sensitivity, inhibits hepatic gluconeogenesis

Indication:
Type 2 diabetes

Adverse Effects/Interactions:
Nausea and vomiting
Diuretics, digoxin

Question 3

Sulphonylureas

Answer 3

Gliclazide

MoA:
Stimulates pancreatic insulin secretion

Indication:
Type 2 diabetes

Adverse Effects/Interactions:
Hypoglycaemia
Warfarin, NSAIDs

Question 4

Thiazolidinediones

Answer 4

Pioglitazone

MoA:
Increases insulin sensitivity in muscle and adipose tissue

Indication:
Type 2 diabetes

Adverse Effects/Interactions:
Weight gain

Question 5

Glucagon-like peptide-1 receptor (GLP-1) agonist

Answer 5

Exenatide

MoA:
Incretin analogue – improves glucose control

Indication:
Type 2 diabetes

Adverse Effects/Interactions:
Asthenia

Question 6

Dipeptidyl peptidase-4 (DPP-4) Inhibitor

Answer 6

Sitagliptin

MoA:
Reduces inactivation of incretins

Indication:
Type 2 diabetes

Adverse Effects/Interactions:
Headache

Question 7

SGLT-2 Inhibitor

Answer 7

Empagliflozin, Dapagliflozin

MoA:
Blockade of renal Na-glucose transporter – increases urinary excretion of blood glucose

Indication:
Type 2 diabetes

Adverse Effects/Interactions:
Urinary infection

Question 8

Lipase inhibitor

Answer 8

Orlistat

MoA:
Inhibition of GI uptake of dietary fat

Indication:
Obesity, especially in presence of Type-2 diabetes

Adverse Effects/Interactions:
Oily stools, faecal urgency

Question 9

Thyroid hormones

Answer 9

Levothyroxine sodium (T4)
Liothyronine sodium (T3)

MoA:
Synthetic hormones

Indication:
Hypothyroidism

Adverse Effects/Interactions:
Diarrhoea, vomiting
Oral anti-coagulants