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Endocrinology > Type 2 Diabetes > Flashcards

Type 2 Diabetes Flashcards

1
Q

At what age should you screen an adult for Type 2 Diabetes?

A

40 years for all adults; under 40 with risk factors

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2
Q

What is the recommended method to diagnose and screen for Type 2 Diabetes in British Columbia?

A

Hb A1C or fasting plasma glucose

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3
Q

How much glycemic targets be set for all patients living with Type 2 Diabetes?

A

Indivdiualized - try to aim for <7 or <6.5 if low risk for hypoglycemia

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4
Q

To assess Type 2 Diabetes goals, what test should you measure and how often?

A

A1C every 3 months, then every 6 months if stable

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5
Q

An 89-year-old with Alzheimer’s and Type 2 Diabetes should have an A1C target of…

A

7.1-8.5

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6
Q

What are 3 very common complications of Type 2 Diabetes?

A
  1. Renal failure
  2. Cardiovascular disease
  3. Diabetic retinopathy
  4. Renal failure
  5. Skin wounds
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7
Q

In Canada, what are the top three populations most at risk for diabetes?

A
  1. Indigenous people living on-reserve
  2. South Asians
  3. African descent
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8
Q

Type 2 Diabetes can be broadly classified into three categories:

A
  1. Insulin resistent
  2. Insulin deficient
  3. Both 1 and 2
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9
Q

What non-pharmacological strategies can reduce the risk of developing Type 2 Diabetes?

A
  1. Eating well-balanced diet
  2. Minimum of 150 minutes of exercise over 5 days a week
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10
Q

An adult with Type 2 Diabetes who has never had hypoglycemia and who monitors their health well can have an A1C target of…

A

<6.5

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11
Q

Most people with Type 1 or 2 Diabetes should have an A1C target of….

A

<7

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12
Q

What are 5 psychosocial risk factors for hypoglycemia in patients who have Type 1 or 2 Diabetes?

A
  1. Low economic status
  2. Food insecurity
  3. Low health litercy
  4. Preschool aged children
  5. Dependant people
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13
Q

Describe hypoglycemia unawareness to a patient

A

Normally you should feel weak, dizzy, hungry, and have problems concentrating if your blood sugar is low. If you have hypoglycemia unawareness, your blood sugar is low and you don’t feel those symptoms which puts you at risk for a diabetic coma.

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14
Q

What are neuroglycopenic symptoms?

A

Focal neurological symptoms when there is low cereberal glucose

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15
Q

List 3 neuroglycopenic symptoms

A
  1. Difficulty concentrating
  2. Confusion
  3. Weakness
  4. Drowsiness
  5. Vision changes
  6. Difficulty speaking
  7. Headache
  8. Dizziness
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16
Q

What type of report should nurse practitioners complete for people who live with diabetic nephropathy and neuropathy?

A

Driver’s Medical Examination Report

17
Q

At what point should people with diabetes self monitor their blood glucose?

A

Self-monitoring should be individualized, and based on agreement with patient.

Generally, people with low risk of hypoglycemia may need less self-monitoring.

18
Q

What are the ABCDES of diabetes per Diabetes Canada?

A

A1C
BP
Cholesterol
Drugs for cardiovascular risk reduction
Exercise
Screening for complications
Smoking cessation
Self-management, stress

19
Q

How can patients get blood glucose strips covered by pharmacare benefits?

A

They must complete a self-monitoring blood glucose training program at an accredited BC diabetes education centre

20
Q

What drug class should be added to patients with diabetes and atherosclerotic heart disease AND/OR heart failure AND/OR chronic kidney disease?

A

Serum glucose transport-2 inhibitors (SGTL2i)

21
Q

What are three common side effects of metformin?

A
  1. GI upset
  2. Chest discomfort and palpitations
  3. B1 deficiency
  4. Hypoglycemia
  5. Headache
22
Q

What are three common side effects of gliclazide?

A
  1. Hypoglycemia
  2. Hypertension
  3. Peripheral edema
  4. Headache
  5. Rash
  6. GI upset
23
Q

What should you monitor when you start a patient with diabetes on metformin?

A

Check renal function before starting metformin, and at least annually in those with GFR <60

24
Q

What is the mechanism of action of metformin?

A

Increases insulin sensivity, decreases absorption of glucose and hepatic glucose production

25
Q

A person with Type 2 Diabetes managed on metformin is pregnant.

What should you consider with metformin and pregnancy?

A

Metformin crosses the placenta and probably safe; typically it is an agent restricted to select patients.

Insulin is the preferred agent for managing diabetes in pregnancy.

Endocrinology (7 decks)

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