Session 3

Question 1

What can lead to poor adherence to therapy in patients treated for T2DM?

Answer 1

Perceived risk of hypoglycaemia and weight gain

Question 2

What is the target HbA1c for T2DM?

Answer 2

6.5-7.5%

Question 3

Where is the majority of glucose reabsorbed in the tubule?

Answer 3

SGLT2 channels in the proximal tubule

Question 4

What are the main categories of insulin available?

Answer 4

Ultrafast acting, short acting, rapid acting, intermediate acting, long acting, very long acting insulins

Question 5

Give an example and list the characteristics of a rapid acting insulin

Answer 5

Insulin aspart. Onset within 15 mins. Peaks at 1 hour and lasts 4 hours.

Question 6

Give an example and list the characteristics of a short acting insulin

Answer 6

Actrapid. Onset within 30 mins. Peaks at 1-2 hours and lasts 8 hours.

Question 7

Give an example and list the characteristics of an intermediate acting insulin

Answer 7

Humulin 1, insulatard. Onset within 1 hour. Peaks at 4-8 hours and lasts 12-20 hours.

Question 8

Give an example and list the characteristics of a long acting insulin

Answer 8

Glargine, detemir. Onset within 2 hour. Flat profile and lasts up to 24 hours.

Question 9

Outline the steps for manaement of T2DM

Answer 9

Lifestyle
Metformin or sulphonylurea (giclazide)if not tolerated
Add sulphonylurea/SGLT2 inhibitor(dapaglifozin)/DPP4 inhibitor(gliptins)/pioglitazone
Add additional oral agent
Add injectable agent - GLP1 agonist if obese or basal insulin