Diabetes

• Ketoacidosis
• Type 1 Diabetes
• Renal impairment

• Hypoglycaemia
• weight gain
• Nausea, diarrhoea, metallic taste

• 40-320mg once or twice daily
• Start with 20mg once daily if 12-18y
• Controlled release: 30mg once daily initially

• Take with food to minimise risk of hypos
• Avoid binge drinking since it can lower blood glucose levels.
• Eat when you drink also.
• Make sure you and
• family members know how to treat hypos

1mg once daily initially increase by 1mg every 1-2 weeks, max 4mg daily

• Type 1 diabetes—contraindicated.
• Ketoacidosis—contraindicated.
• Respiratory failure—contraindicated.
• Severe infection or trauma—contraindicated.
• Dehydration—contraindicated.
• Alcohol misuse—contraindicated.

malabsorption of vitamin B12, nausea, vomiting, anorexia, diarrhoea

rash,

cramps, malaise, weightloss, anorexia - lactic acidosis

Iinitially 500 mg 1–3 times daily; may be increased up to 850 mg 2 or 3 times daily according to response. Maximumdaily dose 3 g.

Controlled release tablet, initially 500 mg once daily with the evening meal; may be increased up to 2 g once daily.

60–90 mL/minute, 2 g daily.

30–60 mL/minute, 1 g daily.

Take with meals to reduce stomach upset.

Tell your doctor immediately if you have loss of appetite, nausea, vomiting, abdominal pain, cramps, fatigue, diarrhoea or weight loss.

• Drinking alcohol can affect control of your diabetes. It can also increase the risk of serious side effects. Limit your alcohol intake, avoid binge drinking
• and have something to eat when you drink alcohol.

Lifestyle and monitoring of glucose levels!

• Type 2 diabetes, alone or with metformin and/or a sulfonylurea
• insulin

• osteoporosis
• heart failure - may worsen

peripheral oedema, weight gain, headache, dizziness,

• 15–30 mg once daily; may be increased to a maximum dose of 45 mg once
• daily after 6–8 weeks of treatment if effect is inadequate.

with insulin: start with 15mg daily

Tell your doctor immediately if you have swollen feet or ankles, breathlessness, nausea, vomiting, abdominal pain, fatigue, loss of appetite or dark urine.

Actute t rauma - higher doses may be needed

hypoglycaemia (sweating, hunger, faintness, palpitations, tremor, headache, visual disturbance and altered mood.), weight gain, allergic reactions,

• Drinking alcohol decreases your blood glucose. It can also mask warning symptoms of hypoglycaemia.Avoid binge drinking and have something to eat when you drink alcohol.
• Make sure that you, and your friends and family, know how to recognise and treat hypoglycaemia;
• ask your doctor or diabetes educator if you are unsure.
• Insulin is injected under the skin usually in the
• abdomen, or less commonly in the thigh, upper arm or buttock. Pinch the skin to reduce the chance of injecting into a blood vessel.
• Rotate injection sites in the same general area to avoid swelling of fatty tissue (called lipodystrophy).
• Use short-acting insulin 30 minutes
• before meals.
• Use ultra-short-acting insulin immediately before or soon after meals when necessary.
• Gently rotate vials and cartridges of cloudy insulin in hands before use to ensure resuspension.
• When
• mixing insulins, draw up short-acting insulin into the syringe first to avoid contaminating the vial with long-acting insulin.
• Do not mix insulin glargine with other insulins.

Type 2 diabetes, with metformin and/or a sulfonylurea when these are inadequate

• Severe GI disease, eg gastroparesis, dumping syndrome
• Treatment with a sulfonylurea—increases risk of hypoglycaemia
• History of pancreatitis with exenatide—contraindicated.

nausea and/or vomiting, diarrhoea, dyspepsia, GORD, abdominal pain,

SC initially 5 micrograms twice daily, increase after 1 month to 10 micrgrams

• Inject exenatide in the 60 minutes before breakfast and dinner
• Do not use it after a meal.
• This medicine slows stomach emptying, which occasionally affects the absorption of some
• other medicines; antibiotics should be taken at least one hour before, or 4 hours after, injecting exenatide.
• Tell your doctor immediately if you develop unexplained severe abdominal pain.

Type 2 diabetes, dual therapy with metformin, a sulfonylurea or a thiazolidinedione

• nausea, hypoglycaemia,
• constipation

• 100mg once daily with or without food
• reduce in renal impairment