Mechanism of action
This is the primary mechanism of action of metformin
What is :
Suppresses gluconeogensis
Improves insulin sensitity
Decreases GI absorption of glucose
Sulfonylureas, thiazolidinediones, and insulin have this side effect in common
What is weight gain
This glucose lowering class are associated with reducing the progression of nephropathy
SGLT2 inhibitors
Metformin is contraindicated at this eGFR
What is < 30 ml/min/1.73m2
A patient with type 2 diabetes is managed with metformin 1000 mg twice daily. The patient's eGFR reduced from 60 to 38 ml/min. How would you modify the metformin dose
Reduce metformin to 1000 mg /day
This glucose lowering class of blocks renal tubular reabsorption of glucose
What are SGLT2 inhibitors
This side effect of metformin is associated with mortality
Lactic acidosis
This glucose lowering class is associated with reducing heart failure hospitalizations
SGLT2 inhibitors
These are risk factors for SGLT2 associated acute renal insufficiency
What are :
Hypovolemia
Hypotension
This sulfonylurea has an active metabolite that is really eliminated and should not be used in the presence of impaired renal function.
What is glyburide
These glucose lowering agents stimulate the pancreas to release insulin
What are
Sulfonlyureas
Meglitinides
These glucose lowering class of medications are associated with higher risk of hypoglycemia
Sulfonlyureas
Insulin
These glucose lowering classes are associated with secondary prevention of ASCVD
What are :
SGLT2 inhibitors
GLP1 agonists
This glucose lowering class is associated with B12 deficiency
What are biguanides (metformin)
This glucose lowering class should be consider if the patient is symptomatic and A1c is =>10%
What is insulin
This class of glucose lowering class promotes the transportation of glucose into cells, tissues, muscles, and suppresses gluconeogenesis
What is insulin
This glucose lowering class is associated with fluid retention and worsening heart failure
What is Thiazolidinediones
This glucose lowering class is associated with primary prevention of diabetes related cardiovascular disease
Biguanides (metformin)
These glucose lowering classes are associated with lower risk of hypoglycemia
What are:
Biguanides (metformin)
Thiazolidindiones
SGLT2 inhibitors
GLP1 agonists
These glucose lowering classes may require renal dose adjustments
Metformin
Insulin
SGLT1 inhitiors
Sulfonylurea
DDP4 inhibitors
This glucose lowering class is an agonist for peroxisome proliferator activated receptor gamma (PPAR gamma) resulting in improved response to insulin (an insulin sensitizer)
What are thiazolidinediones
This glucose lowering class is associated with genital mycotic infections and urinary tract infections
What is SGLT2 inhibitors
This glucose lowering class is associated with secondary prevention of stroke or myocardial infarction
What are thiazolidindiones
This glucose lowering class is associated with euglycemic ketoacidosis
What are SGLT2 inhibitors
This is order of insulin by risk of hypoglycemia
What is:
Rapid analog insulin
Regular insulin
NPH or Mixed NPH insulin
Glargine or basal insulins