Type 2 diabetes Flashcards
1
Q
What is the definition of type 2 diabetes?
A
Chronic high blood glucose levels due to insensitivity and insulin resistance
2
Q
How common is type 2 diabetes?
A
Very common and % rapidly rising
3
Q
What is the pathophysiology of type 2 diabetes?
A
- Insulin resistance – due to free fatty acids and pro-inflammatory cytokines in plasma
- = ↓ glucose transport into muscle cells, ↑ hepatic glucose production and ↑ breakdown of fat
- ↓ insulin secretion by pancreatic beta cells
4
Q
What are the risk factors/aetiology of type 2 diabetes?
A
- Older age
- Obesity
- Ethnicity – Asian, African
- Family history
- Low birth weight
- Non-alcoholic fatty liver disease
- Excessive alcohol
- Previous gestational diabetes
- Hypertension
- Low birth weight
5
Q
What are the signs/symptoms of type 2 diabetes?
A
- Polyuria
- Polydipsia (excessive thirst)
- Unexplained weight loss
- Visual blurring/Diabetic retinopathy
- Arterial disease
- Polyneuropathy – tingling and numbness in the feet
- Genital thrush
- Erectile dysfunction
- Lethargy
- Venous glucose >7mmol/L when fasting or >11mmol/L when random
- Acanthosis nigrcans – severe insulin resistance
6
Q
What investigations are conducted when type 2 diabetes is suspected?
A
- U&Es
- Albumin:creatinine ratio
- TFTs
- Lipid profile
- HbA1c
- Blood glucose finger prink
- Glucose tolerance test
- Diabetic specific autoantibody titres/C-peptide – only if atypical features (e.g. >50), clinical suspicion of monogenic form of diabetes, classification uncertain
- Serological testing for coeliac disease – in order to exclude
7
Q
What should patients with type 2 diabetes be told about their ability to drive?
A
Do not drive and inform DVLA during hypoglycaemic spells
8
Q
What are the surgical treatments for type 2 diabetes?
A
Bariatric surgery
9
Q
What are the pharmacological treatments for type 2 diabetes?
A
- Metformin – 1st line
- Sulfonylruea e.g. gliclazide
- Glitazone
- Sulfonylurea receptor binders e.g. nateglinide
- GLP analogues
- DPP-4 inhibitor: sitagliptin/vilagliptin
- Insulin
- Exanatide
- Orlistat – aid weight loss
- Statin
10
Q
What are the non pharmacological treatments for type 2 diabetes?
A
- Foot care
- Eating a healthy, balanced diet
- Maintaining a healthy weight
- Smoking cessation
- Drinking alcohol in moderation
- Exercising regularly
- Checking glucose levels regularly
