Diabetes

Question 1

Roughly what percent of the population has diabetes?

Answer 1

9%

Question 2

Which class of drugs are non-insulins injectibles?

Answer 2

GLP-1 Agonists

Question 3

MOA of metformin?

Answer 3

Increases the body’s sensitivity to insulin

Question 4

What is gluconeogenesis?

Answer 4

process that transforms non-carbohydrate substrates (such as lactate, amino acids, and glycerol) into glucose

Question 5

What is the first line therapy for Type II DM?

Answer 5

Metformin

Question 6

Metformin decreases A1C by how much?

Answer 6

1.5-2%

Question 7

Which drug has the lowest risk of hypoglycemia?

Answer 7

Metformin

Question 8

In what conditions would you not use metformin?

Answer 8

CKD, Cirrhosis, CHF

Question 9

ADRs from metformin?

Answer 9

Weight loss, GI upset, Vitamin B12 deficiency (after long-term use), lactic acidosis

Question 10

What time periods does an A1C look at? And which time frame is the most accurate?

Answer 10

Looks at the past 3 months; most accurate within a month

Question 11

What metformin ADR would caution use in CKD, CHF, cirrhosis?

Answer 11

Lactic acidosis

Question 12

MOA for sulfonylureas?

Answer 12

increases insulin secretion from the beta cells of the pancreas

Question 13

Sulfonylureas decrease A1C by how much?

Answer 13

1.5-2%

Question 14

Which drugs are sulfonylureas?

Answer 14

Glipizide, glyburide, glimepiride

Question 15

Whcih sulfonylurea drug is the longest acting?

Answer 15

Glyburide

Question 16

Which is the safest sulfonylurea drug to use if you’re worried about hypoglycemia?

Answer 16

Glipizide

Question 17

Of all the non-insulin medications, which drugs have the highest risk of hypoglycemia?

Answer 17

Sulfonylureas

Question 18

ADRs of sulfonylureas?

Answer 18

Weight gain, hypoglycemia, rash (due to sulfas)

Question 19

What kind of drug MOA can cause weight gain?

Answer 19

Any that stimulate insulin release

Question 20

What drugs fall under the thiazolidinediones (TZD)?

Answer 20

pioglitazone (Actos)

Question 21

MOA of TZD?

Answer 21

Stimulates PPAR receptor (which controls lipid and glucose metabolism in liver and muscle), which increases insulin sensitivity

Question 22

TZDs decrease A1C by how much?

Answer 22

1-1.5%

Question 23

By itself what is the risk of hypoglycemia from TZD?

Answer 23

Low

Question 24

CI of TZD?

Answer 24

HF

Question 25

ADRs for TZD?

Answer 25

Edema, weight gain, possibly bladder cancer

Question 26

Caution of TZD in what condition?

Answer 26

Liver disease (and HF)

Question 27

Why would HF be a CI for TZDs?

Answer 27

Because they cause edema, weight gain

Question 28

Alpha glucosidase inhibitors MOA?

Answer 28

Inhibits As which prevents glucose formation from carbohydrate metabolism

Question 29

Alpha glucosidase inhibitors ADRs

Answer 29

GI upset, flatulence, Diarrhea

Question 30

Caution for Alpha glucosidase inhibitors?

Answer 30

Malabsorption and GI issues

Question 31

Hypoglycemic risk with alpha glucosidase inhibitors?

Answer 31

moderate

Question 32

Alpha glucosidase inhibitors decrease A1C by how much?

Answer 32

0.5-1%

Question 33

MOA of DPPV-IV

Answer 33

increases incretin levels by inhibiting DPPV-IV, which helps promote insulin release and inhibits glucagon, which makes you feel fuller

Question 34

ADRs of DPPV-IV

Answer 34

HA, N/V, pancreatitis, HF (saxagliptin)

Question 35

WHich DPPV-IV has been shown to increase HF?

Answer 35

Saxagliptin

Question 36

DPPV-IV decreases A1C by how much?

Answer 36

0.5-0.8%

Question 37

Hypoglycemic risk with DPPV-IV?

Answer 37

low

Question 38

Weight loss profile with DPPV-IV?

Answer 38

neutral (doesn't really do either)

Question 39

SGLT-2 Inhibitors MOA?

Answer 39

promote urinary excretion of glucose by inhibiting reabsorption of glucose in the kidneys

Question 40

SGLT-2 inhibitors decrease A1C by how much?

Answer 40

0.8-1%

Question 41

hypoglycemic risk for SGLT-2 inhibitors?

Answer 41

low

Question 42

Weight profile for SGLT-2 inhibitors?

Answer 42

minimal weight loss

Question 43

ADRs with SGLT-2 Inhibitors?

Answer 43

H/A, drowsiness, hypotension, UTIs

Question 44

Rare risks of what are connected with SGLT-2 inhibitors?

Answer 44

Euglycemic DKA, Fournier's gangrene

Question 45

Why would SGLT-2 inhibitors have the rare risk associated with Fournier's gangrene?

Answer 45

Because of their UTI risk: there's more sugar excreted through the kidneys, and that sugar attracts bacteria