T2DM

Question 1

Metformin MOA

Answer 1

• acts by activation of the AMP-activated protein kinase (AMPK)
• increases insulin sensitivity
• decreases hepatic gluconeogenesis
• may also reduce gastrointestinal absorption of carbohydrates

Question 2

Metformin Side Effects

Answer 2

• GI upset
• reduced B12 abs
• lactic acidosis (in severe liver disease or renal failure)

Question 3

Metformin Contraindications

Answer 3

• CKD
• tissue hypoxia (MI, sepsis, AKI, dehydration)
• iodine Xray contrast
• alcohol abuse

Question 4

Gliclazide MOA

Answer 4

(sulfonylurea)

Stimulate pancreatic beta cells to secret insulin (dependent on pt having functioning beta cells)

Question 5

Gliclazide Side Effects

Answer 5

• hypoglycaemia
• weight gain
• hyponatraemia

Question 6

List 5 medications used to treat T2DM

Answer 6

• metformin
• sulphonylureas
• alpha-glucosidase inhibitors
• glitazones
• insulin