Diabetes Flashcards
(22 cards)
How does type 2 diabetes often present?
Polyuria
Thirst
Tiredness
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.
What diet should be advised for type 2 diabetes?
Low in sugar
High in starchy carbohydrate
High in fibre
Low in fat
What else should be advised with a good diet?
Exercise
What type of drug is metformin?
Biguanide
What is the first-line pharmacological treatment for type 2 diabetes?
Metformin
How does metformin work?
Reduces rate of gluconeogenesis
Increases insulin sensitivity
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
What are the major side effects of metformin?
GI disturbances
Name some sulphonylureas.
Gliclazide
Glimepiride
Tolbutamide
Glipizide
How do sulphonylureas work?
Act on beta-cells to promote insulin secretion
What are the side effects of sulphonylureas?
Hypoglycaemia
Weight gain
Which sulphonylurea is used in the elderly and why?
Tolbutamide
Has a short half-life
What type of drug is pioglitazone?
Thiazolidinediones (or glitazones)
How does pioglitazone work?
Potentiates effect of endogenous and injected insulin
What are the side effects of glitazones?
Weight gain Fluid retention Increased risk of heart failure Anaemia Osteoporosis
Name the two meglitinides.
Repaglinide
Nateglinide
How do meglitinides work?
Are insulin secretagogues
How to meglitinides act?
Act via closure of the K+-ATP channel in beta-cells
Does IV or oral glucose initiate a greater insulin response? And why?
Oral glucose
Due to the incretin effect
What is the incretin effect?
Release of two peptide hormones (GLP-1 and GIP) from L cells in the intestine
What incretin therapies are there?
Exenatide
Liraglutide
