Type 2 Diabetes Mellitus Flashcards
What is type 2 diabetes?
1 - body cannot produce sufficient insulin
2 - body is not responsive to insulin
3 - body is deaf to effects of insulin
4 - all of the above
4 - all of the above
What is the expected number of people that will have T2DM by 2030?
1 - 100,000
2 - 500,000
3 - 1.5 million
4 - 5.5 million
4 - 5.5 million
- currently 4.9 million
How many patients are predicted to be at risk of developing T2DM?
1 - 13,600
2 - 136,000
3 - 1.36 million
4 - 13.6 million
4 - 13.6 million
How much does T2DM cost the NHS each year aprox?
1 - >£10 billion
2 - >£5 billion
3 - >£100 million
4 - >£5 million
- > £10 billion
- accounts for 10% of the NHS budget
T2DM costs the NHS aprox >£10 billion per year, accounting for 10% of the NHS budget. What is the majority of this money spent on?
1 - mortality of T2DM
2 - complications of T2DM
3 - hospital stays due to T2DM
4 - all of the above
2 - complications of T2DM
- prescriptions
What number of patients that are in hospital have T2DM?
1 - 2-3%
2 - 5-10%
3 - 20-30%
4 - >50%
3 - 20-30%
Is T2DM or T1DM diagnosed at a younger age?
- T1DM
- T2DM is typically older
Which of the following are microvascular complications that can occur in T2DM?
1 - retinopathy (disease of blood vessels of the eye)
2 - nephropathy (disease and deterioration of kidneys)
3 - neuropathy (disease causing nerve damage, mainly peripheries)
4 - all of the above
4 - all of the above
What is the difference between microvascular and macrovascular?
- microvascular = small vessels (capillaries)
- macrovascular = large vessels (arteries and veins)
- macrovascular = large blood vessels
Which of the following are macrovascular complications that can occur in T2DM?
1 - ischaemic heart disease
2 - cardiovascular disease
3 - peripheral vascular disease
4 - all of the above
4 - all of the above
Which of the following are diagnostic of T2DM based on a random glucose measurement?
1 - Glucose >11.1 mmol/l with Symptoms
2 - Glucose = > 11.1 mmol/l on 2 occasions
3 - HbA1c = > 48 mmol/mol ( 6.5% )
4 - all of the above
4 - all of the above
2 - glucose equal to or >11 mmol/L in 2 separate samples
An oral glucose tolerance test (OGTT) (75grams of glucose) can be used to assess if a patient has or is at risk of T2DM. Match cut off values for the following if the patient is fasted:
- without diabetes
- impaired glucose tolerance
- diabetic
- > 7.0 mmol/L
- < 6.0 mmol/L
- 6.0-7.0 mmol/L
- without diabetes = < 6.0 mmol/L
- impaired glucose tolerance = 6.0-7.0 mmol/L
- diabetic = >7.0 mmol/L
An oral glucose tolarence test (OGTT) can be used to assess if a patient has or is at risk of T2DM. Match cut off values for the following after an OGTT:
- without diabetes
- impaired glucose tolerance
- diabetic
- 7.9-11.0 mmol/L
< 7.8 mmol/L - > 11.0 mmol/L
- without diabetes = < 7.8 mmol/L
- impaired glucose tolerance = 7.9-11.0 mmol/L
- diabetic = > 11.0 mmol/L
In patients with T2DM which of the following are pathophysiological aspects we need to be aware of that occur in the pancreas?
1 - increased beta cell apoptosis
2 - reduced beta cell mass
3 - reduced insulin secretion
4 - hyperglucagonemia (excess glucagon secretion as low insulin to inhibits its release)
5 - all of the above
5 - all of the above
In patients with T2DM what is the main pathophysiological aspect we need to be aware of in the GIT?
- impaired incretin effect
- incretin is a factor released by the gut in response to nutrients that facilitates the uptake of glucose by peripheral tissues by stimulating secretion of insulin
In patients with T2DM what are the 2 main pathophysiological aspect we need to be aware of in the liver?
1 - insulin resistance
2 - increased hepatic glucose secretion (gluconeogenesis)
2 - increased hepatic glucose secretion (gluconeogenesis)
In patients with T2DM what is the main pathophysiological aspect we need to be aware of in the muscles?
- insulin resistance
In patients with T2DM what are the 2 main pathophysiological aspect we need to be aware of in adipose tissue?
1 - increased circulating fatty acids
2 - hyperlipidaemia
2 - hyperlipidaemia
Being over what age increases the risk of T2DM?
1 - 16 y/o
2 - 25 y/o
3 - 45 y/o
4 - 65 y/o
3 - 45 years old
- increases risk 6 fold
Other than age which of the following are non-modifiable risk factors for developing T2DM?
1 - genetics
2 - ethnicity (south Asia/African Caribbean)
3 - family history
4 - all of the above
4 - all of the above
What modifiable risk factors for developing T2DM?
1 - obesity
2 - hyperlipidaemia
3 - hypertension
4 - all of the above
4 - all of the above
Which of the following medications may increase the risk of developing T2DM?
1 - glucocorticoids
2 - beta blockers
3 - statins
4 - all of the above
4 - all of the above
- glucocorticoids = cortisol increases blood glucose through gluconeogenesis
- beta blockers = inhibit secretion of insulin
- statins
What are the 3 stages of T2DM development?
1 - normal glucose tolerance
2 - pre-diabetes also known as Impaired glucose tolerance
3 - T2DM
What tissue in the body has been linked with releasing something that has been show to increase insulin resistance in skeletal muscle?
1 - adipocytes
2 - neuronal cells
3 - hepatocytes
4 - renal cells
1 - adipocytes
- adipose tissue
- through the release of free fatty acids