Type 2 Diabetes Flashcards

1
Q

what is T2DM

A

Insulin resistance leading to decreased glucose uptake

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2
Q

What are the symptoms of T2DM

A
Polydipsia
Polyuria
Glycosuria
Obesity
Acanthosis Nigracans (Dark skin fold)
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3
Q

What are the diagnosis values for T2DM

A

HbA1c >48mmol/L
Random Plasma Glucose >11.1 mmol/L
Fasting Plasma glucose >7mmol/L

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4
Q

What are some risk factors of T2DM

A
Age
Male
South Asian
Obesity
Socioeconomic 
HTN
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5
Q

What is the first line management for T2DM

A

lifestyle advice

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6
Q

What is the overall management of T2DM

A
  1. Lifestyle Advice
  2. Metformin(Biguanide)
  3. Metformin with Sulfonylurea
  4. Metformin with Sulfnylurea/DPP-4 Inhibitor/Pioglitiazone/SGLT2 Inhibitor
  5. Insulin
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7
Q

What is an example of Sulfonylurea

increase insulin secretion from the Pancreas

A

Gliclazide

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8
Q

What is an example of DPP-4 inhibitor

Blocks DPP-4 which destroys incretin so insulin can’t be produced

A

Sitagliptin

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9
Q

What is an example of a thiazolidinedione

Improves the use of insulin by the body

A

Pioglitiazone

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10
Q

What is an example of SGLT2 inhibitor

They decrease blood sugar in the body by inhibiting kidney reabsorption into the blood

A

Glilozin

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11
Q

What investigations are used for T2DM

A

Urine dipstick = glycosuria
High ACR ratio
Low serum creatinine
Fasting lipid profile = dyslipidemia

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12
Q

What is the Gold standard for T2DM investigation

A

HbA1c >48mmol/L >6.5%

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13
Q

What are some macrovascular complications of T2DM

A

Stroke
PAD
MI

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14
Q

What are some microvascular complications of T2DM

A

CKD
Retinopathy
Neuropathy (Gloves and stocking)
Diabetic foot

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15
Q

What can uncontrolled T2DM cause

A

Hyperosmotic Hyperglycemia

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16
Q

What is the difference between ketoacidosis and hyperosmotic hyperglycemia

A

No KETONES in HO HG

17
Q

How to diagnose HO HG

A

rpg >11.1 mmol/L
Urine dipstick = glycosuria
High plasma osmolality

18
Q

What are the presentations of T2DM

A
Lack consciousness
Dehydrated
Hyperglycemic
Hyperosmotic
NO KETONES
19
Q

How to treat HOHG

A

1st = Insulin and Potassium

  • 0.9% Saline Replacement
  • LMWH (Enoxaparin) to thin blood
20
Q

What causes gastroparesis

A

Poor glycemic control causing autonomic nerve damage

21
Q

What are the two prediabetic states

A

IGT and IGF

22
Q

How is IGT diagnosed

A

FPG = >6

2hr Oral Glucose Tolerance = 7.8-11

23
Q

How is IGF diagnosed

A

FPG = 6.1 - 6.9

2hr Oral Glucose Tolerance = <7.8

24
Q

What is the main function of metformin/Biguanide

A

Increase peripheral sensitivity to Insulin

25
Q

What is HOHS

A

Excessive hepatic gluconeogenesis with no ketones

26
Q

What re the macrovascular complications of Diabetes

A

MI
Stroke
PVD

27
Q

What are the microvascular complications fo Diabtetes

A

Retinopathy
Neuropathy
Nephropathy