T2DM

Question 1

What happens

Answer 1

Reduced Insulin sensitivty

Beta cell dynfction

Question 2

Causes for reduced insulin sensitivity

Answer 2

Obesity
Inflammation
Lipotoxiciyty

Question 3

Which Hba1c reflect a diagnosis

Answer 3

Hba1c 48>

Question 4

If hba1c is hard to interpret

What fasting glucose are we looking for

Answer 4

> 7

Question 5

Which random plasma glucose reflects T2DM

Answer 5

> 11

Question 6

How often is hbalc monitored

Answer 6

3-6 months, then every 6 months

Question 7

Clincal features

Answer 7

Similar to type 1

But slower onset

Question 8

Ancanthosis nigricans can be a hallmark for type 2 - what does it look like

Answer 8

Dark pigmentation of skin folds in groin and neck - suggest insulin resistance

Question 9

Targets for those on a single drug not linked which typos

Answer 9

<48

Question 10

Targets for those on multiple drugs not accosated with hypos

Answer 10

53

Question 11

Targets for those on a single drug causing hypos

Answer 11

53

Question 12

Which drugs are linked with hypos

Answer 12

Insulin
Sulfonylureas - gliclazide (all end in ide)

Question 13

In type 1 theire is frequent monitoring of capillaries blood glucose conc, if this required in type 2

Answer 13

No

Question 14

When maybe it be required in type 2

Answer 14

Pregnant

On insulin

On a drug which causes hypos

Question 15

What is the hba1c target for those silent on life style interventions

Answer 15

48

Question 16

1st line if no HF, CVD, or CVD risk

Answer 16

Metformin

Question 17

If they Cannot tolerate metformin

Answer 17

DPP4

Then pioglitazine or sulfonylurea

Then SGLT2 inhibitor (if pio or sulf are CI due to hypos)

Question 18

1st if CHF, CVD or qrisk over 10%

Answer 18

Metofmrin THE once tolerated then SGLT2 inhibitor

Question 19

If CHF, CVD or qrisk over 10% and metformin and SGLt2 doesn’t work, what would be added

Answer 19

DPP4 inhibitor

Or

Pioglitazine or sulfonurea

Or insulin - as the third drug

Question 20

If on Triple therapy and still ineffective

Answer 20

Switch non-metformin drug for a GLP-1 against (semaglutide)

Eg. Metformin + suflonurea + GLP-1 agonist

Question 21

What are the requirements for prescribing GLP-1 against

Answer 21

bmi over 35 + physiological or med probs linked with diabetics

BMI less then 35 and insulin would have an occupational impact - driver, piolet

Question 22

Which drugs increase insulin sensitivity

Answer 22

Metformin and pioglitazone

Question 23

Which drugs increase insulin secretion

Answer 23

DPP4 inhibitor
GLP1 agonist
Sulphonylureas

Question 24

Which drug blocks reabsorption of glucose in the proximal tubule

Answer 24

SGLT2 inhibitors

Question 25

Which drug decreases hepatic glucose production - glucogensis

Answer 25

Metformin

Question 26

Which drug is a PPAR agonsit

Answer 26

Pioglitazone

Question 27

Which drug Mimi’s incretin hormone to stimulate insulin secretion

Answer 27

GLP-1 against

Question 28

Which drug blocks DPP4, an anthem which degrades endogenous GLP1 AND GIP

Answer 28

DPP4 inhibitors

Question 29

Examples of GLP1 agonist

Answer 29

-tide Semaglutide

Question 30

Examples of sulfonylurea

Answer 30

-ide Gliclazide

Question 31

Examples of DPP4 inhibitors

Answer 31

-glitins Alogliptin

Question 32

Which cause weight gain

Answer 32

Sulfonurea Insulin Pioglitazone

Question 33

Which drugs cause Hypo risk

Answer 33

Insulin Sulfonyurea

Question 34

Which drugs are CI in ketoacidosis

Answer 34

DPP4 inhibitors SGLT2 inhibitors Solfonylurea (The ones that increase insulin secreation)

Question 35

Which drug is associated with b12 deficiency and lactic acidosis

Answer 35

Metformin

Question 36

Which drug causes odema

Answer 36

Pioglitazone

Question 37

Which drugs causes weight loss

Answer 37

SGLT2 GLP1

Question 38

Which drugs can cause UTI

Answer 38

SGLT2s