T2DM Flashcards
(33 cards)
insulin deficiency in T2DM
relative
what causes insulin deficiency in T2DM
excess adipose - not enough insulin to go around
symptoms T2DM
overweight, over 30, polydipsia, polyuria
glucose for T2DM
fasting >7 // random or glucose tolerance >11.1 // once if symptomatic, twice if asymptomatic
what is glucose tolerance testing
eat 75g glucose –> test 2 hours later
what is HbA1c
glycosated Hb over past 2-3 months
what does HbA1c give a good measure of
diabetic control over last few months
T2DM diagnosis HbA1c
> 6.5% or 48 // if asymptomatic repeat test
what are the 2 categories of prediabetes
impaired fasting glucose // impaired glucose tolerance
what is impaired fasting glucose in (IFG) pre-diabetes
fasting glucose between 6.1-7
what is impaired glucose tolerance (IGT) in pre-diaebtes
fasting glucose <7 AND glucose tolerance test between 7.8-11.1
what should patients with IGF be offered
oral glucose test // >11.1 = T2DM // 7.8-11.1 = IGT // <7.8 = IFG
what insulin resistance occurs in IFG pre-diabetes
hepatic
what insulin resistance occurs in IGT pre-diabetes
muscle
what type of pre-diabetes is more likely to result in T2DM + CVD
IGT
mx pre-diabetes
weight loss, diet, exercise // metformin if high risk
why can a low HbA1c not rule out T2DM
not as sensitive as fasting
what other factor can cause a rise in HbA1c
red cell turnover
what conditions cause low HbA1c
sickle cell anaemia // GP6D // spherocytosis // haemodialysis
what conditions cause high HbA1c
vitB + folic acid def // iron def // splenectomy
what conditions would HbA1c not be used for diabetes diagnosis (8)
haemoglobinopathies // haemolytic anaemia // iron deficiency // GDM // children // HIV // CKD // steroid users
what initial target weight loss should T2DM aim for
5-10%
what is the HbA1c target for those on lifestyle +/- metformin mx for T2DM
48mmol (6.5%)
when should a second drug be added in T2DM
if HbA1c >58mmol (7.5%)
