KINE 2475 Lecture Notes - Lecture 54: Adipocyte, Dyslipidemia, Renal Glucose Reabsorption

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Meglitinides: repaglinide promote insulin release, actions are shorter than sus, taken before meals to reduce postprandial glucose elevation. Omitted if meal missed: repaglinide lowers hba1c similar to su, fpg drops after 1 month of use. Sodium-glucose cotransporter 2 inhibitors: canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, prevent glucose reabsorption in kidney, increased excretion of urinary glucose & lower bg. Low risk of hypoglycemia, some weight loss: se: mycotic genital infection, volume depletion-related ae, uti, diabetic ketoacidosis, canagliflozin associated with lower extremity amputation & risk of fracture. Influence gene expression leading to enhanced insulin sensitivity, low bg, increase peripheral glucose uptake, enhanced fat cell sensitivity to inulin, decrease hepatic glucose output. Low risk of hypoglycemia, decrease in hba1c 1-1. 5: se: weight gain, increased subcutaneous fat deposition, fluid retention, edema, macular edema , increase risk of fractures- hip & wrist. Increase heart failure risk: tzd contraindicated in patients with active or previous bladder cancer.

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