Type 2 diabetes Flashcards

1
Q

What causes type II diabetes?

A

A mixture of genetic, environmental and epigenetic factors

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2
Q

When does T2DM usually occur?

A

In middle or old age

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3
Q

What are some environmental factors that can cause T2DM?

A
  • Obesity
  • Age
  • Pregnancy
  • Calorie-dense diet
  • Sedentary lifestyle
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4
Q

If someone has 1 parent with T2DM, what is their lifetime risk?

A

40%

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5
Q

If someone has 2 parents with T2DM, what is their lifetime risk?

A

80%

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6
Q

Describe the pathophysiology of T2DM in obesity

A
  1. Obesity increases adiposity
  2. Exceeds the fat store threshold, increasing FFA and adipokines
  3. Causes insulin resistance in liver and muscle
  4. Genetics causes vulnerable ß-cells
  5. ß-cells try to keep up with demand, increasing insulin levels
  6. ß-cells fail and stop producing insulin
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7
Q

How is T2DM a spectrum of disease?

A

It can range from predominant ß-cell deficiency to predominant insulin resistance

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8
Q

Why are those of Asian descent more at risk of T2DM?

A

Those of Asian descent have a lower threshold for fat storage

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9
Q

How does T2DM cause symptoms?

A

Through hyperglycaemia

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10
Q

What are some symptoms of T2DM?

A
  • Polyuria
  • Enuresis in children (Bedwetting)
  • Thirst
  • Polydipsia (Drinking lots of water)
  • Blurred vision (High blood glucose causes lense shrinking)
  • Genital thrush
  • Fatigue
  • Weight loss
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11
Q

What are the stages of T2DM management?

A
  1. Diagnosis
  2. Therapeutic lifestyle change
  3. Mono-therapy
  4. Combination therapy
  5. Insulin + Combination therapy
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12
Q

What are the aims of treatment in T2DM?

A

Treat symptoms
Prevent complications

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13
Q

What is some dietary advice given to those with diabetes?

A
  • Normal intake of unrefined carbohydrate foods
  • Reduced refined sugar intake
  • Reduce fat intake
  • Increase fruit and vegetable intake
  • Reduce salt intake
  • Safe and sensible alcohol consumption
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14
Q

What is the HbA1c target for T2DM management?

A

<53mmol/mol (7%)

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15
Q

What are the 3 categories of pharmacological diabetes management?

A

Insulin secretagogues
Insulin sensitisers
Others

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16
Q

What are some examples of insulin secretagogues used in T2DM management?

A
  • Sulphonylureas
  • DPP4 inhibitors
  • GLP-1 receptor agonists
17
Q

What are some examples of insulin sensitisers used in T2DM management?

A
  • Thiazolidinediones
  • Metformin
18
Q

What are some examples of other drugs used in T2DM management?

A
  • Insulin
  • SGLT-2 inhibitors
19
Q

What is meant by remission?

A

Remission is a period of time in which an illnesses symptoms and signs are less severe

20
Q

What level of weight loss is thought to increase chance of T2DM remission?

A

10-15kg

21
Q

What management trial has shown to be effective in inducing T2DM remission?

A
  1. Complete diet replacement (12-20 weeks)
  2. Stepped food reintroduction + exercise programme (2-8 weeks)
  3. Weight loss maintenance (up to 1 year)
  4. Relapse management
22
Q
A