Type 2 Diabetes Flashcards
(24 cards)
How do you prevent type 2 diabetes
Risk identification: pre diabetic 42-47 mmol/l
Weight management using OLISTAT on patients with a BMI 28 or more {target 5-10% reduction}
Dietary advice: high fibre, low glycaemic index carbs, low fat dairy, decreased saturated and trans fatty acids,increased oily fish intake
Which diabetic medication does not cause hypoglycaemia
Metformin
What is the first line treatment for type 2 diabetes
Metformin 500mg od for one week then 500mg bd for 1 week then 500mg tds, increased to 2g/day
Is metformin safe in pregnancy
Yes
What is 2nd line for T2DM
SGLT2 inhibitors - dapagliflozin 10mg OD
What is first line for T2DM in a patient with high CV risk
SGLT2 inhibitors - dapagliflozin
What are the problems with SGLT2 inhibitors
It can cause hypoglycaemia
increase infection risk
DKA
Fournier gangrene - genital swelling and tenderness
Complicated UTI
Hypotension
Not suitable in elderly and those with renal impairment
Fournier gangrene is associated with class of medications used for T2DM
SGLT2 Inhibitors e.g. dapagliflozin
What is the 3rd line for T2DM
GLP-1 analogues - semaglutide, exenatide, liraglutide ( ozempic)
Which diabetic medication is used for treatment of T2DM in fat people (BMI >35)
GLP-1 Analogue
What are the 4 side effects of GLP-1 analogues
Weight loss
GI Upset
Mild hypoglycaemia
Pancreatitis
Which medication for TD2M cannot be in those with G6PD deficiency
SULPHONYLUREA
E.g. gliclazide 40–80mg
What issues are associated with sulphonylureas 4
Not for elderly
Hypoglycaemia
Weight gain
DKA
How are sulphonylurea’s taken
With food
Which diabetic drug is good for those with poor renal function
LINAGLIPTIN
What are the side effects associated with DPP4- inhibitors (-gliptins)
3
Mild hypoglycaemia
GI upset
Pancreatitis
What MHRA warnings are associated with thiazolidinedone’s such as Pioglitazone
Bladder cancer
Heart failure
What side effects are associated with thiazolidinedone’s such as Pioglitazone
GI Upset
Bone fractures
Weight gain
Bladder cancer
Liver dysfunction
Heart failure
Who is the use of thiazolidinedone’s such as Pioglitazone cautioned/contraindicated in
Those with :
Heart failure
Previous or active bladder cancer
DKA
Elderly
What is first line insulin for those with T2DM
NPH isophane
What is 2nd line insulin for those with T2DM
Biphasic insulin
What monitoring is required in T2DM patients on antidiabetic medication
Monitor HBA1C every 3-6 months initially
Once stable monitor HbA1c every 6 months
What is the target HbA1c in those with T2DM
53 mmol/l
What should be done if a patient on medication for T2DM has a HBA1C of over 58 mmol/l
Reinforce lifestyle modifications and adherence to
Intensity drug treatment
