Pathophysiology of Type 2 Diabetes Flashcards Preview

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Flashcards in Pathophysiology of Type 2 Diabetes Deck (26)
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1

Which two things are required for type 2 diabetes to occur in an individual?

  1. Genetic predisposition
  2. Environmental factors

2

T2DM is synonymous with insulin resistance

True or false?

False

There must also be impaired glucose tolerance

3

How do pancreatic beta cell respond to initial insulin resistance?

Hyperplasia

4

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

5

In T2DM insulin secretion is _________

In T2DM insulin secretion is reduced

6

Glucose uptake in skeleatal muscle and adipose tissue is __________ in T2DM

Glucose uptake in skeleatal muscle and adipose tissue is decreased in T2DM

7

How are both glucagon secretion and hepatic glucose production impacted in T2DM?

Increased

8

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

9

How is lipolysis impacted in T2DM?

Increases

10

The incretin effect is __________ in T2DM

The incretin effect is decreased in T2DM

11

Presentation of T2DM is accelerated by what?

Obesity

12

How does beta cell dysfunction affect blood sugar levels?

They increase causes hyperglycaemia

13

Chronic hyperglycaemia has a bigger effect on which of the following, microvascular or macrovascular complications?

Microvascular

14

Insulin resistance has a bigger effect on which of the following, microvascular or macrovascular complications?

Macrovascular

15

How can CV risk best be treated in T2DM patients?

  1. Statins
  2. Anti-hypertensives

16

What is the most effective treatment for T2DM?

Lifestyle changes

(exercise and diet)

17

By how much does metformin typically affect HbA1c?

0.8-2%

18

What are the main therapeutic effects of metformin?

  1. Reduce hepatic gluconeogenesis
  2. Increase (peripheral) glucose uptake and utilisation by skeletal muscle
  3. Reduce CHO absorption
  4. Increase fatty acid oxidation

19

High blood pressure in a T2DM patient will be treated preferentially by which drug class?

ACE inhibitors

(age is irrelevant in this instance)

(calcium channel blockers and thiazide diuretics can be used too)

20

What are the 3 main benefits of lowering HbA1c?

  1. Reduce incidence of diabetes end points
  2. CV risk decrease
  3. Microvascular complications decrease

21

What is the:

a) HbA1c aim

b) Ideal HbA1c level in T2DM?

a) 53mmol/mol

b) 48mmol/mol

22

Females are _______ likely to reach their HbA1c target than males

Females are less likely to reach their HbA1c target than males

23

Sulphonylureas can cause abnormal LFTs

True or false

True

24

 Thiazolidinediones (TZDs) should not be used in people with CV risk, but why?

They cause fluid retention

25

Everyone with T2DM and CV risk should definitely be on which 3 drugs?

  1. Metformin
  2. Statin
  3. SGLT2 inhibitor

26

GLP-1 agonists are useful in people who are _________

GLP-1 agonists are useful in people who are obese