Minnie Hiker has now been a diabetic for 3 years. One morning while listening to
ID: 81521 • Letter: M
Question
Minnie Hiker has now been a diabetic for 3 years. One morning while listening to the news as she was getting ready for the day, she heard an advertisement for a relatively new drug called InvoKana. The drug claimed to stop glucose reabsorption and decrease A1C numbers. Minnie was thrilled at this development because diet and exercise alone had not been sufficient to control her numbers and the doctor was talking about starting her on a different medication. There were side effects to the drug which included: dehydration, hyperkalemia, ketoacidosis, and kidney problems. Additionally, the advertisement warned not to take Invokana with a diuretic. Minnie comes to you as her health care provider to ask you why these side effects occur with this drug. She is taking Furosimide for high blood pressure. See if you can answer the following questions. Minnie's Questions: 1) How does Invokana stop glucose reabsorption and decrease A 1C numbers? How does this alter normal physiology for glucose processing? 2) Why does Invokana cause dehydration and hyperkalemia? (For this answer, I want an explanation at the chemical and cellular level.) 3) Why would a drug that lowers blood glucose increase my risk for ketoacidosis? 4) Why can't you take this drug with a diuretic? Can I continue to take the Furosimide? 5) Do I still have to watch my diet, since this drug is going to stop glucose reabsorption? 6) Just for your teacher's sanity, do you know what the word Diabetes means??Explanation / Answer
1. Invokana might be stopping glucose reabsorption by affecting the glucose transporters in the body and blocking them. The A1C number is the glycated hemoglobin as the transport of glucose will be reduced by the drug the glycated hemoglobin levels will go down. The unabsorbed glucose will accumulate in the blood and cause the side effect symptoms