Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

D&E Pathology > Management of Type 2 DM > Flashcards

Management of Type 2 DM Flashcards

1
Q

Where should diabetics go for advice?

A

Practice nurse/GP
Online
Group education sessions
Dietetic ad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What should you ask in a consultation with a diabetic?

A 
Review data in diabetes
Review blood glucose
Ask patient concerns
Establish whether challenges are approaching
Set goals - care plan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the aims of diabetes treatment?

A

Relief of symptoms
Prevent complications
Preserve QoL
Damage minimalisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which treatments improve insulin action?

A

Biguanides (metformin)
Thiazolidiadiones (Glitazones)
Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which treatments improve insulin release?

A

Sulphonylureas (Gliclazide)
metiglinides
Incretin mimetics
DPPIV inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the effect of beta cell dysfunction?

A

Decreased insulin production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the action of SGLT2 inhibitors?

A

Increase excretion of glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the effect of decreased incretin effect?

A

Decreased insulin production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which factors decrease insulin action?

A 
Insulin resistance (periphery)
Excess glucagon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What factors can be controlled to reduce the potential complications of diabetes?

A 
Lipids
Smoking
HTN
Mood 
Dietary change
Sedentary behaviour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the 5step framework for choosing a glucose lowering drug?

A
  1. Set target HbA1c
  2. Are there other current risk factors needing Rx
  3. Are the current treatments optimised
  4. What Rx options are there
  5. Agree to review date
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What factors must be taken into account in setting a target HbA1c?

A

Age/frailty
Reduced life expectancy
What risk would a hypo have?
Is intense management appropriate?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the first line management for T2D?

A

Metformin

Sulfonylurea if symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

After metformin, what is the second line therapy for T2D?

A

Sulfonylurea
Thiazolidinedione
DPP-IV inhibitor
SGLT-2 inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

After sulfonylurea, what is the second line therapy for T2D?

A

Metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is Thiazolidinedione indicated for second line T2D therapy?

A

If hypos are a concern

If no CCF

17
Q

When are inhibitors

indicated for second line T2D therapy?

A

If hypos are a concern

If weight gain are a concern

18
Q

What are the third line therapies for T2D?

A

Thiazolidinedione
DPP-IV/SGLT-2 inhibitor
GLP-1 agonist
Insulin

19
Q

When is insulin indicated in T2D?

A

Third line

If osmotic symptoms/rising HbA1c

20
Q

When is GLP-1 agonist indicated in T2D?

A

Third line
BMI>30
Desire to lose weight
<10y from Dx

21
Q

What class of drug is metformin?

A

Biguanides

22
Q

Metformin acts on what?

A

Liver

Muscles

23
Q

How does metformin work?

A

Improves Insulin Action
Decreased FA synthesis
Improve receptor function
Inhibits gluconeogenesis

24
Q

What is the half life of metformin?

A

6hrs

25
Q

What are the disadvantages of metformin?

A

Risk of lactic acidosis
GI side effects (20-30%)
Risk of vitamin B12 malabsorption

26
Q

How does metformin cause lactic acidosis?

A

Inhibits lactic acid uptake by the liver

27
Q

Sulphonylureas act on what?

A

Pancreas

28
Q

What is the mechanism of Sulphonylurea action?

A

Bind to Sulphonylurea receptors (SUR-1) on B-cells
Closes ATP K channels
Decreases depolarisation
Ca2+ channels open
Translocation of secretory granules of insulin

29
Q

Which sulphonylurea is indicated in reduced renal function?

A

Gliclazide

30
Q

What are the disadvantages of sulphonylureas?

A

Risk of hypoglycaemia
Weight gain
Caution in renal/hepatic issues
Cant pregnant/breastfeeding

31
Q

What side effects are associated with sulphonylureas?

A

Hypersensitivity
Photosensitivity
Blood disorders

32
Q

What is the action of Thiazolidiones?

A

Improve insulin action
Modulates transcription of insulin-sensitive genes
Reduces insulin resistance

33
Q

Thiazolidiones act on what?

A

Liver
Muscle
Adipose tissue

34
Q

What are the disadvantages of Thiazolidiones?

A

Increased risk blader cancer
Fluid retention (NO USE IN CCF)
Weight gain
Fractures in females

35
Q

When are Thiazolidiones contraindicated?

A

CONGESTIVE CARDIAC FAILURE

Bladder neoplasm

36
Q

What is the main contraindication of metformin?

A

Reduced eGFR

D&E Pathology (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions