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REGUB Medicine: T2DM (ii) (OHAs (metformin (SEs (GI upset, lactic acidosis…

- - - - GI upset
      - lactic acidosis
      - vit B12 deficiency
      - renal failure
      - septic shock
      - acute coronary insufficiency
      - pul oedema
      - acute ischaemic limb
  - - - fluid retention
      - HF
      - weight gain
      - hepatotoxicity
      - eczema
      - osteoporosis (inhibits osteoblasts)
      - bladder cancer (unsure if causal or association)
- - - - reduced in T2DM
      - its therapeutic potential is limited by its rapid activation (T1/2 = 1-2min) by the ubiquitous enzyme (DPP4 - dipeptidyl peptidase 4) - would need continuous infusion (inconvenient Tx)
- - - - dietary intake = 180g
      - production = 70g (glujconeogeneis + glycogenolysis)
    - - brain = 125g
      - rest of body = 125g
  - - - 90% @ SGLT2 (new drug target )
      - 10% @ SGLT1