Which two things are required for type 2 diabetes to occur in an individual?
- Genetic predisposition
- Environmental factors
T2DM is synonymous with insulin resistance
True or false?
There must also be impaired glucose tolerance
How do pancreatic beta cell respond to initial insulin resistance?
What occurs later in T2DM as beta cell hyperplasia begins to fail at maintaining normoglycaemia?
Beta cell failure
This causes impaired glucose tolerance and diabetes
In T2DM insulin secretion is _________
In T2DM insulin secretion is reduced
Glucose uptake in skeleatal muscle and adipose tissue is __________ in T2DM
Glucose uptake in skeleatal muscle and adipose tissue is decreased in T2DM
How are both glucagon secretion and hepatic glucose production impacted in T2DM?
In the kidneys there is a ___________ rate of glucose resorption compared with normal
In the kidneys there is a higher rate of glucose resorption compared with normal
How is lipolysis impacted in T2DM?
The incretin effect is __________ in T2DM
The incretin effect is decreased in T2DM
Presentation of T2DM is accelerated by what?
How does beta cell dysfunction affect blood sugar levels?
They increase causes hyperglycaemia
Chronic hyperglycaemia has a bigger effect on which of the following, microvascular or macrovascular complications?
Insulin resistance has a bigger effect on which of the following, microvascular or macrovascular complications?
How can CV risk best be treated in T2DM patients?
What is the most effective treatment for T2DM?
(exercise and diet)
By how much does metformin typically affect HbA1c?
What are the main therapeutic effects of metformin?
- Reduce hepatic gluconeogenesis
- Increase (peripheral) glucose uptake and utilisation by skeletal muscle
- Reduce CHO absorption
- Increase fatty acid oxidation
High blood pressure in a T2DM patient will be treated preferentially by which drug class?
(age is irrelevant in this instance)
(calcium channel blockers and thiazide diuretics can be used too)
What are the 3 main benefits of lowering HbA1c?
- Reduce incidence of diabetes end points
- CV risk decrease
- Microvascular complications decrease
What is the:
a) HbA1c aim
b) Ideal HbA1c level in T2DM?
Females are _______ likely to reach their HbA1c target than males
Females are less likely to reach their HbA1c target than males
Sulphonylureas can cause abnormal LFTs
True or false
Thiazolidinediones (TZDs) should not be used in people with CV risk, but why?
They cause fluid retention
Everyone with T2DM and CV risk should definitely be on which 3 drugs?
- SGLT2 inhibitor
GLP-1 agonists are useful in people who are _________
GLP-1 agonists are useful in people who are obese