Flashcards in Type 2 diabetes lifestyle management and therapeutics Deck (46):
what are the key physiological changes in type 2 diabetes?
Beta cell destruction
what does this describe?
the receptor is not responsive to the insulin molecule and therefore less glucose enters the cell. this results in a build up of glucose in the blood
what causes insulin resistance?
increased inflammatory mediators
ectopic fact accumulation
name some things associated with insulin resistance?
as beta cell function declines....what increased?
blood glucose levels increase
what can cause a decline in beta cell function
insulin resistance leading to hyperglycaemia (glucosetoxicity) and lipotoxicity (elevated FFA, TG)
who has a higher risk of diabetes-apples or pears?
name some complications of diabetes?
what is the therapy staircase for type 2 diabetes?
diet and exercise
injection (inuslin) and oral therapy
how can diabetic improve their lifestyle?
name the biguanide used in type 2 diabetes?
what does metaformin do?
improve sensitivity to insulin
what does of metaformin do you normally start on?
500mg 2x day
does metformin cause hypos?
no-not when used as a monotehrapy
can you lose weight when on metaformin?
yes-it suppresses appetite
can metaformin prevent macro and microvascular complications
is metaformin safe in pregnancy?
can metformin make your periods more regular and improve fertility?
name some adverse side effects of metformin
anorexia, nausea, vomiting, diarrhoea, abdo pain, taste disturbance
when do you not want to use metformin?
if advanced cirrhosis or liver failure
if serum creatinine >150
first line treatment for type 2 diabetes
what type of drugs are these?
these 2 are the most common
does the sulphonylureas prevent macro and microvascular disease?
only microvascular disease
adverse side effects of sulphonylureas?
when should you avoid taking sulphonylureas?
in severe renal or liver failure
when do sulphonylureas get used?
or in those who cant tolerate metaformin
what is pioglitazone
why can TZDs cause heart failure?
they cause fluid retention
doe TZDs prevent macro/micro vascular diease?
mainly macrovascular but they do improve microalbuminuria
what is dapaglifozin?
work on the incretin pathway
what type of drugs are these?
benefits of GLP-1 agonist
promote insulin secretion from pancreas without hypoglycaemia
decrease gastric emptying
adverse side effects of GLP-1 agonists
what are type of drugs are these?
benefits of DDP-4 inhibitors?
not so good about DDP-4 inhibitors?
not that potent
same some SGLT2 inhibitors?
how do SGLT2 inhibitors work?
decrease uptake of sugar in the kidney by making you pee it out!
what is the downside to SGLT2 inhibitors?
sugar in urine means more thrush and UTIs
when is insulin used in type 2 diabetes?
usually when oral agents arent working
less use of basal-bolus
more use of basal insulin
what does alpha glucosidase do?
its an enzyme which breaks down starch and other big sugars to glucose
what do alpha glucosidase innibitors do?
delay absorption of glucose so there is a decrease in post prandial increase in blood glucose
what type of drug is acarbose?
is there a hypo risk with alpha glucosidase innibitors?