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Flashcards in Diabetes Deck (22):
1

How does type 2 diabetes often present?

Polyuria
Thirst
Tiredness

2

What are the WHO criteria for the diagnosis of diabetes?

Fasting plasma glucose > 7.0mmol/l
Random plasma glucose >11.1mmol/l
-One abnormally result diagnostic for symptomatic individuals and two values needed in asymptomatic people.

3

What diet should be advised for type 2 diabetes?

Low in sugar
High in starchy carbohydrate
High in fibre
Low in fat

4

What else should be advised with a good diet?

Exercise

5

What type of drug is metformin?

Biguanide

6

What is the first-line pharmacological treatment for type 2 diabetes?

Metformin

7

How does metformin work?

Reduces rate of gluconeogenesis
Increases insulin sensitivity

8

Why is metformin particularly useful in treating type 2 diabetes in overweight people?

Does not induce hypoglycaemia and so does not predispose to weight gain

9

What are the major side effects of metformin?

GI disturbances

10

Name some sulphonylureas.

Gliclazide
Glimepiride
Tolbutamide
Glipizide

11

How do sulphonylureas work?

Act on beta-cells to promote insulin secretion

12

What are the side effects of sulphonylureas?

Hypoglycaemia
Weight gain

13

Which sulphonylurea is used in the elderly and why?

Tolbutamide
Has a short half-life

14

What type of drug is pioglitazone?

Thiazolidinediones (or glitazones)

15

How does pioglitazone work?

Potentiates effect of endogenous and injected insulin

16

What are the side effects of glitazones?

Weight gain
Fluid retention
Increased risk of heart failure
Anaemia
Osteoporosis

17

Name the two meglitinides.

Repaglinide
Nateglinide

18

How do meglitinides work?

Are insulin secretagogues

19

How to meglitinides act?

Act via closure of the K+-ATP channel in beta-cells

20

Does IV or oral glucose initiate a greater insulin response? And why?

Oral glucose
Due to the incretin effect

21

What is the incretin effect?

Release of two peptide hormones (GLP-1 and GIP) from L cells in the intestine

22

What incretin therapies are there?

Exenatide
Liraglutide