Diabetes

• What is the category of Metformin?

  Biguanides
• What is the primary indication for Metformin?

  Type 2 diabetes
• What is the mechanism of action of Metformin?

  Reduces hepatic glucose output
• What weight benefit does Metformin provide?

  Modest weight loss benefit
• How does Metformin affect skeletal muscle?

  Increases skeletal muscle glucose uptake
• Does Metformin stimulate insulin secretion?

  No, it does not stimulate insulin secretion
• What are common adverse effects of Metformin?

  GI upset (nausea, vomiting, diarrhea)
• What is a rare but serious adverse effect of Metformin?

  Lactic acidosis
• What renal condition requires dose adjustment for Metformin?

  Renal impairment (eGFR <30 mL/min/1.73 m²)
• In what situation should Metformin be avoided?

  Acute illness causing hypoxia or dehydration
• How should Metformin be used in hepatic impairment?

  Use cautiously
• What should be done before IV contrast studies if renal impairment is suspected?

  Withhold Metformin
• What should be monitored when using nephrotoxic drugs with Metformin?

  Monitor renal function regularly
• What medications oppose the effects of Metformin?

  Corticosteroids and diuretics
• What is the typical starting dose of Metformin?

  500 mg daily
• What lifestyle changes should be advised with Metformin?

  Healthy diet and exercise
• How should the dose of Metformin be adjusted?

  Increase weekly as tolerated
• What should be monitored while on Metformin?

  Monitor HbA1c and renal function
• What is the category of SGLT2 Inhibitors?

  SGLT2 Inhibitors
• What are the indications for SGLT2 Inhibitors?

  Type 2 diabetes, chronic heart failure
• What is the mechanism of action of SGLT2 Inhibitors?

  Inhibit SGLT2 in proximal renal tubule
• What effect do SGLT2 Inhibitors have on glucose reabsorption?

  Reduce glucose reabsorption, causing glycosuria
• How do SGLT2 Inhibitors affect blood pressure?

  Reduce blood pressure and preload
• What are common adverse effects of SGLT2 Inhibitors?

  Increased UTI/genital infections
• What is a rare but serious adverse effect of SGLT2 Inhibitors?

  Euglycaemic DKA
• What risks are associated with volume depletion when using SGLT2 Inhibitors?

  Avoid in volume depletion/hypotension risk
• How often should renal function be monitored with SGLT2 Inhibitors?

  Regularly, yearly for most patients
• What should be done when using SGLT2 Inhibitors with diuretics?

  Use with caution
• What is the typical starting dose of dapagliflozin?

  10 mg once daily
• What should patients be counseled about when taking SGLT2 Inhibitors?

  Increased urination and dehydration risk
• How frequently should renal function be monitored in CKD patients on SGLT2 Inhibitors?

  More frequently than yearly
• What is the category of Sulfonylureas?

  Sulfonylureas
• What is the primary indication for Sulfonylureas?

  Type 2 diabetes
• What is the mechanism of action of Sulfonylureas?

  Stimulate insulin secretion by blocking K+ channels
• What is required for Sulfonylureas to be effective?

  Residual pancreatic function
• What is a common adverse effect of Sulfonylureas?

  Risk of hypoglycemia
• What rare adverse effects can occur with Sulfonylureas?

  Hypersensitivity reactions
• In what conditions should Sulfonylureas be used with caution?

  Hepatic and renal impairment
• What factors increase the risk of hypoglycemia with Sulfonylureas?

  Older adults, malnutrition, adrenal insufficiency
• What effect do β-blockers have on hypoglycemia symptoms?

  Mask hypoglycemia symptoms