Diabetes Treat Flashcards
(12 cards)
First line treatment
Lifestyle treatment
Can reduce HBA1C by 1%
2nd line treatment if HBA1C is still >7%
Start metformin
MR if have GI issues
Reduce HBA1C by 3%
Inhibits hepatic gluconeogenesis = decrease glucose
Not for the really impaired as causes lactic acidosis
Diarrhoea is common and is self resolving
3rd line treatment if HBA1C is still >7%
Add in a 2nd drug
- sulfonylurea (gliclazide)
- glitazone (pioglitazone)
- SGLT-2 inhibitor (dapaglaflozin)
- DPP-4 inhibitor (stigaliptin)
sulfonylurea (gliclazide)
Increase insulin secretion
There is a high chance of hypoglycaemia
Glitazone (pioglitazone)
Increase insulin sensitivity
Can cause weight gain
SGLT-2 inhibitor (dapaglaflozin)
Inhibit glucose absorption
Can cause UTI
4th line treatment if HBA1C is still >7%
Triple drug therapy from the drugs listed previously
5th line treatment if HBA1C is still >7%
Start insulin
Reduce HBA1C by 7%
If HbA1c is >9% , then start insulin straight away, no oral drugs
Steps for insulin
- Start on long acting insulin 0.1 unit/kg
(Check morning sugar and adjust dose accordingly)
If sugar is still not controlled
- Add another insulin
(Pick the biggest meal of the day and add a rapid acting insulin before the meal or start on a regimen)
Regimen:
– basal bolus
– Mixed 70/30
– Sliding scale
From a graph, how do the peaks look in a diabetic with no insulin?
There is a higher baseline and the peaks overlap between breakfast lunch and dinner
From a graph, how do the peaks look in a basal bolus regime?
It will mimic normal peaks and the baseline is in the middle
There is an injection before each meal
From a graph, how do the peaks look in a mixed in and regime?
There is injection before breakfast and an injection in the evening, it doesn’t mimic normal
There are two low peaks that overlap each other
