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Diabetic Drugs (SGLT - 2 inhibitors (Examples (Canaglifozin, Dapaglifozin,…
Diabetic Drugs
Biguanides
Mechanism
Inhibits glyconeolysis
Increases muscle insulin sensitivity
Delays intestinal uptake
Inhibits gluconeogenesis
Side Effects :warning:
GI Side Effects
Can use MR
Lactic acidosis
Background
Ideal for overweight patients
First line in all patients
Sulfonylureas
Background
reduces blood glucose
stimulating insulin secretion
For patients with no insulin resistance
Examples
Gliclazide
Glibenclamide
Glimeperide
Side Effects :warning:
Hypoglycaemia
Weight gain
Reduce dose in renal impairment
DPP-4 Inhibitors
Examples
Linagliptin
Sitagliptin
Saxagliptin
Side effects :warning:
Pancreatitis
GI distrubance
Mechanism
Lowers stimulation of insulin release
Inhibits glucagon release
SGLT - 2 inhibitors
Examples
Canaglifozin
Dapaglifozin
Empaglifozin
Background
Preferable in hypertensives
Glucose is pee'd out
Mechanism
Reduces reabsorption of glucose
Works in kidneys
Side Effects
Risk of DKA
UTI
Thiazolidinediones
Examples
Pioglitazine
Mechanism
Increases insulin sensitivity in Fat, Liver, Muscle
Decreases hepatic glucose output
Side Effect
HF Risk
GI disturbances
Hepatotoxicty
Fluid retention
Bladder cancer
Bakcground
Suitable for insulin resistancec
South Asians
Glinides
Mechanism
stimulates insulin release
Background
Short half life
Take with meals
Works within 30 mins
No need for dose adjustment
Examples
Repaglinid
gLP-1 Mimetics
Examples
Exanatide
Side Effects
Pancretitis
Injection site fat hypertropy
Mechanism
delays gastic emptying
suppreses glucagon secrection
Stimulates insulin secrection
Background
SC injection
Fat hypertrophy injection site
Not for 2nd line
Must have 3% weight loss
And 1% reduction in HBA1c
Insulin
Types
Long acting
Levemir
Tresima
Rapid Acting
Novorapid
Mixture
Humalog
Novomix
Background
Never event
Patients becoming more insulin resistant