t2 diabetes

Answer 1

Question: Can you tell me about Metformin?
Answer:

Class: Biguanide

Mechanism: Increases insulin sensitivity in peripheral tissues, ↓ hepatic gluconeogenesis, ↓ appetite

Use: First-line treatment for Type 2 Diabetes (DM2)

Side Effects: GI disturbance, weight loss, lactic acidosis, ↓ B12 absorption

Contraindications: eGFR < 45 ml/min, severe cardiac or pulmonary disease

Monitoring: Renal function

Answer 2

Question: Can you tell me about Gliclazide, Glimepiride, Glipizide, Tolbutamide, and Glibenclamide?
Answer:

Class: Sulfonylureas

Mechanism: Stimulate insulin secretion from pancreatic β-cells

Use: DM2

Side Effects: Weight gain, hypoglycaemia, nausea, diarrhoea; rare: haemolytic anaemia

Monitoring: Blood glucose levels

Answer 3

Question: Can you tell me about Canagliflozin, Dapagliflozin, Empagliflozin, and Ertugliflozin?
Answer:

Class: SGLT-2 Inhibitors

Mechanism: Block glucose reabsorption in kidneys → ↑ glucose excretion in urine

Use: DM2 (often added to metformin, especially with heart failure or ASCVD)

Side Effects: Dyslipidaemia, genital infections, polyuria, DKA (rare), hypoglycaemia (if combined with insulin or sulfonylurea)

Answer 4

Question: Can you tell me about Repaglinide and Nateglinide?
Answer:

Class: Meglitinides

Mechanism: Stimulate rapid insulin release → fast onset and short duration

Use: DM2 (meal-time control)

Side Effects: Same as sulfonylureas (hypoglycaemia, weight gain)

Answer 5

Question: Can you tell me about Pioglitazone?
Answer:

Class: Thiazolidinediones (TZDs)

Mechanism: PPARγ agonist → improves insulin sensitivity via gene regulation in adipocytes

Use: DM2

Side Effects: Weight gain (due to fluid retention), bone fractures; uncommon: bladder cancer

Contraindications: Heart failure history

Caution: Monitor for oedema and cardiac status

Answer 6

Question: Can you tell me about Sitagliptin, Vildagliptin, Saxagliptin, Alogliptin, and Linagliptin?
Answer:

Class: DPP-4 Inhibitors (Gliptins)

Mechanism: Inhibit DPP-4 enzyme → ↑ endogenous GLP-1 & GIP → ↑ insulin secretion, ↓ glucagon

Use: DM2

Side Effects: Abdominal pain, flatulence, nasopharyngitis, headache

Answer 7

Question: Can you tell me about Exenatide, Lixisenatide, Dulaglutide, Liraglutide, Semaglutide, and Tirzepatide?
Answer:

Class: Incretin Mimetics (GLP-1 receptor agonists)

Mechanism: Mimic GLP-1 hormone → ↑ insulin release, ↓ glucagon, ↓ appetite

Use: DM2

Side Effects: Nausea, vomiting, diarrhoea

Note: Tirzepatide is also a dual GIP/GLP-1 agonist

Answer 8

Question: Can you tell me about Acarbose?
Answer:

Class: Alpha-glucosidase inhibitor

Mechanism: Inhibits enzymes that digest carbs → slows starch/sugar absorption

Use: DM2; gaining attention due to cardioprotective effects

Side Effects: Diarrhoea, flatulence, vomiting; rare: liver disorders