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Type 2 Diabetes Flashcards

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1
Q

What is Type 2 diabetes characterized by?

A

Insulin deficiency or resistance

Type 2 diabetes is a metabolic disorder that affects how the body processes blood sugar (glucose).

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2
Q

What are some associated conditions with Type 2 diabetes?

A
  • Obesity
  • Physical inactivity
  • Raised blood pressure
  • VTE
  • Increased risk of cardiovascular disease

These conditions can exacerbate the complications associated with Type 2 diabetes.

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3
Q

When does Type 2 diabetes typically develop?

A

Later in life

Age is a significant risk factor for the onset of Type 2 diabetes.

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4
Q

What is the first step in treating Type 2 diabetes?

A

Lifestyle advice for 3 months

Lifestyle changes are crucial for managing Type 2 diabetes effectively.

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5
Q

What is the second step in the treatment of Type 2 diabetes?

A

Anti-diabetic drugs and lifestyle control

This step is taken if lifestyle advice alone is insufficient.

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6
Q

What is the only available biguanide?

A

Metformin

Metformin is widely used for managing Type 2 diabetes.

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7
Q

What is a key benefit of Metformin regarding weight?

A

Leads to no weight gain

This makes Metformin a favorable option for overweight patients.

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8
Q

Is Metformin the first choice for diabetes treatment?

A

Yes, it is the first choice for everyone

Metformin is recommended as the initial medication for Type 2 diabetes.

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9
Q

Does Metformin cause hypoglycemia?

A

No, it does not cause hypo

This is an advantage of using Metformin compared to other diabetes medications.

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10
Q

How should doses of Metformin be increased?

A

Slowly to prevent GI side effects

Gradual dose escalation helps minimize gastrointestinal discomfort.

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11
Q

What is the MR version of Metformin used for?

A

If normal Metformin is not tolerated

The MR (modified release) version can help manage side effects.

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12
Q

What are common side effects of Metformin?

A
  • Gastric problems
  • Lactic acidosis (rare)

Monitoring for these side effects is important during treatment.

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13
Q

What are contraindications for Metformin use?

A
  • Acute metabolic acidosis
  • Ketoacidosis
  • Renal failure
  • General anesthesia
  • EGFR below 30

These conditions can increase the risk of serious complications.

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14
Q

How can Metformin affect renal function?

A

It can cause renal failure, increasing the risk of lactic acidosis

Renal function must be monitored closely.

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15
Q

Can Metformin be used during pregnancy and breastfeeding?

A

Yes, it can be used

Metformin is generally considered safe in these situations.

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16
Q

In what conditions should Metformin be used with caution?

A

Conditions that worsen renal function and risk factors for lactic acidosis

Careful evaluation is necessary to prevent complications.

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17
Q

What should be monitored before starting Metformin treatment?

A

Renal function

Annual monitoring is also recommended following initiation of treatment.

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18
Q

What are signs of lactic acidosis to look out for?

A
  • Dyspnea
  • Muscle cramps
  • Abdominal pain
  • Hypothermia
  • Lack of energy

Early detection of lactic acidosis is crucial for patient safety.

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19
Q

What are sulfonylureas also known as?

A

IDES

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20
Q

What are two potential adverse effects of IDES?

A

Hypoglycemia and weight gain

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21
Q

What are some side effects of IDES?

A

GI upset, hepatic impairment, allergic skin reactions

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22
Q

During what time frame are allergic skin reactions most likely to occur with IDES?

A

In the first six to eight weeks

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23
Q

In which populations should IDES be used with caution?

Study These Flashcards
A

Elderly with G6PD deficiency, acute porphyria, and ketoacidosis

24
Q

What should be done in cases of renal or hepatic impairment when using IDES?

Study These Flashcards
A

Avoid or reduce doses of the IDES

25
What is the primary alpha-glucosidase inhibitor mentioned?
Acarbose ## Footnote Acarbose is a medication used to manage blood sugar levels.
26
How does the anti-hyperglycemic effect of acarbose compare to other medications?
It has a poorer anti-hyperglycemic effect than others. ## Footnote This indicates that acarbose may not be as effective as other diabetes medications.
27
What type of side effects are more common with acarbose?
GI effects ## Footnote GI effects refer to gastrointestinal side effects such as bloating, gas, and diarrhea.
28
What should be given for hypoglycemia when using acarbose?
Glucose ## Footnote Acarbose interferes with sucrose absorption, making glucose the preferred treatment for low blood sugar.
29
Fill in the blank: Acarbose interferes with _______ absorption.
sucrose ## Footnote This interference can lead to complications in managing blood sugar levels.
30
What is the thazolidinedione mentioned in the text?
Pioglitazone ## Footnote Thazolidinediones are a class of medications used to treat type 2 diabetes.
31
What is pioglitazone associated with?
Heart failure (HF) ## Footnote Pioglitazone can exacerbate or lead to heart failure in some patients.
32
What is the risk associated with pioglitazone?
Very high increased risk of bladder cancer ## Footnote Patients taking pioglitazone should be informed of this increased risk.
33
When should treatment with pioglitazone be continued?
If HbA1c decreases by at least 0.5% within 6 months of starting treatment ## Footnote HbA1c is a measure of blood glucose levels over time.
34
What are some side effects of pioglitazone?
Bone fracture, weight gain, visual impairment, increased risk of infections, numbness ## Footnote Patients should be monitored for these side effects during treatment.
35
What should be monitored while a patient is on pioglitazone?
The liver ## Footnote Liver function tests may be necessary to avoid potential liver damage.
36
What are the inhibitors known as gliptins?
Dipeptidylpeptidase-4 inhibitors ## Footnote Gliptins are a class of medications used to treat type 2 diabetes.
37
What is a contraindication of gliptins?
Diabetic ketoacidosis ## Footnote This condition must be managed before initiating gliptins.
38
What are common side effects of gliptins?
GI and skin reactions ## Footnote These side effects can vary in severity among individuals.
39
What should be done if symptoms of acute pancreatitis occur while on gliptins?
Discontinue the gliptins ## Footnote Acute pancreatitis is a serious condition that requires immediate action.
40
Are gliptins associated with weight gain?
No ## Footnote This makes gliptins a favorable option for weight management in diabetic patients.
41
How does the incidence of hypoglycemia with gliptins compare to sulfonylureas?
Less incidence ## Footnote This indicates a lower risk of low blood sugar levels with gliptins.
42
What are SGLT2 inhibitors commonly referred to as?
Flozins ## Footnote SGLT2 inhibitors help in glucose control by promoting glucose excretion.
43
What serious condition can flozins lead to?
Diabetic ketoacidosis ## Footnote Patients should be monitored for this risk when taking flozins.
44
What is a risk associated with canagliflozin?
Increased risk of lower limb amputation ## Footnote This risk necessitates careful patient selection and monitoring.
45
When should dapagliflozin be avoided?
If EGFR is below 15 ## Footnote This is critical to prevent renal complications.
46
What should be done to the doses of insulin and sulfonylureas when administered with flozins?
Reduce doses ## Footnote This helps minimize the risk of hypoglycemia.
47
What are the side effects of flozins?
Weight loss, DKA, increased infection risk, urinary disorders ## Footnote These side effects should be discussed with patients.
48
What are GLP-1 inhibitors also known as?
Tides ## Footnote GLP-1 receptor agonists are used in diabetes management.
49
When are tides recommended?
For combination therapy when other treatment options have failed ## Footnote They are often used in more complex diabetes cases.
50
What action should be taken if acute pancreatitis occurs while on tides?
Discontinue the tides ## Footnote Similar to gliptins, this condition warrants immediate cessation of the medication.
51
What is required for effective contraception in patients using tides?
Effective contraception is required ## Footnote This is important to prevent potential risks during treatment.
52
Overview of diabetic drugs
53
54
Dual and triple therapy
55
Mhra for pioglitasone
HF, bladder cancer, bone fracture = all risks increase
56
MHRA canagliflozin
Lower limb amputation
57
Flozin MHRA
Increased risk of diabetic ketoacidosis

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