Home' Australian Pharmacist : Australian Pharmacist July 2012 Contents 570 Australian Pharmacist July 2012 I ©Pharmaceutical Society of Australia Ltd.
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EVIDENCE IN PATIENT CARE
1. When added to other medications to
treat type 2 diabetes, GLP-1 agonist
therapy is more likely to result in
which ONE of the following?
a) No change in body weight.
b) Reduced body weight, but only when
compared to insulin.
c) Reduced body weight.
d) Increased body weight.
2. Target HbA1C levels are reached in
approximately what proportion of
Australians with type 2 diabetes
based on observational studies?
a) 10 to 30%.
b) 30 to 50%.
c) 50 to 70%.
d) 70 to 90%.
3. Which ONE of the following
medications is likely to result in the
MOST weight loss in a person with
type 2 diabetes?
4. Which ONE of the following
adverse e ects is MOST commonly
associated with exenatide
5. Which ONE of the following
statements regarding new classes
of medication for type 2 diabetes is
a) Linagliptin is an injectable incretin
b) Exenatide is an injectable DPP-4
c) Exenatide is an oral incretin mimetic.
d) Sitagliptin is an oral DPP-4 inhibitor.
A score of 4 out of 5 attracts 1.25 CPD credit.
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dysglycaemia and cardiovascular and renal risk in diabetic and
non-diabetic participants in the HOPE study: a prospective
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vascular complications in veterans with type 2 diabetes. N Engl J
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control and vascular outcomes in patients with type 2 diabetes.
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glucose lowering in type 2 diabetes. N Engl J Med. 2008;
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in HbA1C (%) Bene ts
Side e ects and limitations
Extensive clinical experience,
hypoglycaemia rare, improved lipid
pro le, decreased cardiovascular disease
events, some weight loss in most patients
Gastrointestinal intolerance, lactic acidosis
(rare), vitamin B12 de ciency
Extensive clinical experience
Hypoglycaemia, less durability, weight
Hypoglycaemia rare, more durable e ect
than that of metformin or sulfonylureas,
improved lipid pro le, some evidence
of bene cial e ect on coronary
atherosclerosis (with pioglitazone)
Oedema, heart failure, weight gain,
increased risk of long-bone fractures
and potential risk of bladder cancer and
cardiovascular events (with rosiglitazone)
Decreased level of postprandial glucose,
hypoglycaemia rare, possible decrease in
risk of cardiovascular disease events
Hypoglycaemia rare, infrequent side
Less e cacy than GLP-1--receptor
agonists, angioedema, unknown long-
term safety, risk of pancreatitis
Hypoglycaemia rare, weight loss in
most patients, possible protective
cardiovascular e ects
Nausea and vomiting, risks of pancreatitis,
thyroid C-cell hyperplasia, unknown long-
Subcutaneous insulin Subcutaneous
Large e ect in all patients, extensive
Hypoglycaemia, weight gain
Table 2. Characteristics of currently available blood glucose lowering medications (modi ed from Ismail-Beigi 2012).19
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