non-insulin anti-diabetic agents - Dr.Kania

Question 1

Metformin MOA

Answer 1

Metformin works in the liver and in the skeletal muscle
Liver: it works in accumulating AMP which activates AMPK to shut off the release of glucose from the liver

Skeletal muscle: it accumulated AMP which activateds AMPK which activates different things that will stimulate the dislocation of Rab from glut 4 which allows glut 4 to move to the membrane and increase the reuptake of glucose into the skeletal muscle

Question 2

Clinical application of metformin
benefits and side effects

Answer 2

It is used in type 2 diabetes
it is extremely effective (reduces A1C by 1.5-2%)
also lowers LDL

SIDE EFFECTS:
Vitamin B12 deficiency so test annually for levels
Dementia
GI effects: diarrhea, flatulence, nausea, and vomiting
- take with larger meals and titrate dose to help reduce these side effects

Question 3

Metformin dosing

Answer 3

MAX DOSE: 2g/day

Start with 500mg by mouth twice daily and titrate dose weekly or bi-weekly and increase by 250/500 mg/day