DM2 - Side Effects/Contraindications

Question 1

Metformin

Answer 1

SE: N&V, diarrhoea, abdominal pain, lactic acidosis

CI: tissue hypoxia (e.g. MI, sepsis), AKI/CKD, GA

STOP: pre-op (48h), iodine-contrast, renal failure (eGFR <36 or Cr >150)

Question 2

Sulphonylureas

Answer 2

SE: weight gain and HYPOs

CI: overweight

*fails after 2-5 years

Question 3

DPP4 inhibitors (Gliptins)

Answer 3

SE: less effective (max 1-2% drop in HbA1c) and expensive

Question 4

GLP-1 analogues

Answer 4

SE: injections, pancreatitis (small risk)

inadequate response (<1% drop in HbA1c, <3% weight loss)

Question 5

SGLT2 inhibitors (Gliflozins)

Answer 5

SE: normoglycaemic DKA, infection risk (UTI/fungal)

CI: recent infection

Question 6

Glitazones/TZDs

Answer 6

SE: non-responders, FLUID retention, HYPOs, hepatotox, ?cardiac, fractures, ?bladder cancer

CI: past/present heart failure, osteoporosis, DKA, liver impairment, visible haematuria/bladder cancer RF

Question 7

Acarbose

Answer 7

SE: bloating, diarrhoea, flatulence, pain, distension