TBL - management of diabetes

Question 1

HHS is caused by what type of insulin deficiency?

Answer 1

Relative insulin deficiency

Question 2

Which medications have weight loss potential?

Answer 2

Metformin (Biguanides) + GLP1 analogues

Question 3

How does GLP1 cause weight loss?

Answer 3

Satiety signals to the brain reduce appetite through delayed gastric emptying. This causes nausea and abdominal discomfort.
They can also increase metabolic rate by increasing the heart rate.

Question 4

Which diabetic medication can cause lactic acidosis?

Answer 4

Metformin

Question 5

How can metformin cause lactic acidosis?

Answer 5

It inhibits pyruvate carbohydrate leading to increased pyruvate.
Inhibition of electron transport chains which increase NADH levels, increasing acetate dehydrogenase and increased lactate.

Question 6

Which medication inhibits lipogenic enzymes via GLUT4 activation?

Answer 6

Metformin

Question 7

Which medication delays gastric emptying?

Answer 7

GLP1

Question 8

Which medication inhibits alpha-glucosidase enzymes?

Answer 8

Acarbose

Question 9

Which medication blocks the K+ ATP channels within beta cells and therefore stimulates insulin secretion?

Answer 9

Gliclazide

Question 10

Which pancreatic tumour can cause an excess of insulin?

Answer 10

Insulinoma

Question 11

Does an OGTT consistent with glucose intolerance mean an absolute or relative insulin deficiency?

Answer 11

Relative