Podcast
Questions and Answers
What is the primary mechanism of action of metformin?
What is the primary mechanism of action of metformin?
What is a common side effect of metformin?
What is a common side effect of metformin?
Which of the following is true regarding the use of sulfonylureas?
Which of the following is true regarding the use of sulfonylureas?
Which class of diabetes medication is known for being shorter acting than sulfonylureas?
Which class of diabetes medication is known for being shorter acting than sulfonylureas?
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What is the main risk associated with the use of metformin in patients with renal impairment?
What is the main risk associated with the use of metformin in patients with renal impairment?
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What is the primary action of Thiazolidinediones (TZDs) in type 2 diabetes management?
What is the primary action of Thiazolidinediones (TZDs) in type 2 diabetes management?
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Which of the following adverse effects is associated with Pioglitazone?
Which of the following adverse effects is associated with Pioglitazone?
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What should be monitored periodically when a patient is using Thiazolidinediones?
What should be monitored periodically when a patient is using Thiazolidinediones?
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What are a-Glucosidase Inhibitors primarily indicated for?
What are a-Glucosidase Inhibitors primarily indicated for?
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What is the main benefit of Dipeptidyl Peptidase-4 (DPP-4) inhibitors?
What is the main benefit of Dipeptidyl Peptidase-4 (DPP-4) inhibitors?
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How do Sodium-glucose cotransporter 2 (SGLT-2) inhibitors assist in diabetes management?
How do Sodium-glucose cotransporter 2 (SGLT-2) inhibitors assist in diabetes management?
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Which of the following is a potential risk of using Thiazolidinediones?
Which of the following is a potential risk of using Thiazolidinediones?
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What adverse effect is most commonly associated with the use of Exenatide?
What adverse effect is most commonly associated with the use of Exenatide?
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What happens when Dipeptidyl Peptidase-4 inhibitors are combined with a sulfonylurea?
What happens when Dipeptidyl Peptidase-4 inhibitors are combined with a sulfonylurea?
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Which of the following treatment strategies involves combining SGLT-2 inhibitors with other medications?
Which of the following treatment strategies involves combining SGLT-2 inhibitors with other medications?
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Study Notes
Non-Insulin Medications for Diabetes Treatment
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Biguanides (Metformin):
- First-line treatment for type 2 diabetes.
- Lowers glucose production in the liver and improves tissue response to insulin.
- Excreted unchanged by the kidneys, use with caution in renal impairment.
- Common side effects: decreased appetite, nausea, diarrhea, potential weight loss.
- Black box warning: severe metabolic acidosis can occur in patients with significant renal impairment.
- Therapeutic uses: glycemic control and type 2 diabetes prevention.
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Sulfonylureas:
- Two generations; second-generation (e.g., glipizide) is more potent with fewer drug interactions.
- Stimulate insulin release from the pancreas
- Primarily used for type 2 diabetes, typically with lifestyle changes.
- Potentially cause hypoglycemia, especially in patients with renal or liver dysfunction.
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Meglitinides (Glinides, e.g., Repaglinide):
- Stimulate insulin release, but shorter acting than sulfonylureas.
- Taken with each meal.
- Used for type 2 diabetes; less effective if sulfonylureas are ineffective.
- Monotherapy or combined with metformin or glitazones.
- Side effect: hypoglycemia; eat within 30 minutes of taking.
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Thiazolidinediones (Glitazones, e.g., Pioglitazone):
- Primarily reduce insulin resistance.
- Primarily used for type 2 diabetes, often given in addition to metformin.
- Side effects: upper respiratory infections, headache, sinusitis, myalgia.
- Black box warning: associated with heart failure due to fluid retention.
- May cause ovulation and increase risk of unintended pregnancy in premenopausal women.
- Possible increased risk for bladder cancer, fractures in women, and hepatic failure (monitor LFTs).
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α-Glucosidase Inhibitors:
- Delay carbohydrate absorption, slowing blood glucose rise after meals.
- Used for type 2 diabetes in conjunction with lifestyle changes.
- Used alone or with insulin, metformin, or sulfonylureas.
- Common side effects: flatulence, cramps, abdominal distension, diarrhea, potential iron malabsorption.
- Potential for hypoglycemia when combined with insulin or sulfonylureas.
- Long-term, high-dose therapy may cause liver dysfunction.
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Dipeptidyl Peptidase-4 Inhibitors (Gliptins, e.g., Sitagliptin):
- Enhance incretin hormone action (stimulate insulin release, suppress glucagon).
- Second-line treatment often added to metformin.
- Side effects: upper respiratory infections, headache, nasal/throat inflammation, potential pancreatitis.
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Sodium-glucose co-transporter 2 (SGLT-2) Inhibitors (e.g., Canagliflozin):
- Block glucose reabsorption in the kidneys, increasing glucose excretion.
- Side effects: female genital infections, urinary tract infections, increased urination, potential dehydration and hypotension in older adults, especially with diuretics.
- Drug interactions with certain medications (e.g., rifampin, phenytoin).
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Glucagon-like peptide-1 (GLP-1) Receptor Agonists (e.g., Exenatide):
- Mimic GLP-1, slowing gastric emptying, stimulating insulin release, suppressing glucagon, and reducing appetite.
- Often used as add-on therapy for type 2 diabetes.
- Potential for dose-related hypoglycemia, especially with sulfonylureas.
- Common side effects: gastrointestinal issues (nausea, vomiting, diarrhea), pancreatitis, and renal impairment limits use.
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Description
This quiz covers the various non-insulin medications used in the treatment of diabetes, including Biguanides, Sulfonylureas, and Meglitinides. Explore the mechanisms, uses, side effects, and precautions associated with these important medications. Test your knowledge and enhance your understanding of diabetes management.
