What is the biggest environment risk factor for T2DM?
What variables are present in a absolute cardiac risk calculator?
Systolic blood pressure
How might someone present with T2DM?
Unexplained weight loss
Delayed wound healing
How often should you check Hba1c?
What does SNAP stand for?
What relationship does T2DM have with haemochromatosis?
Have haemochromatosis puts people at a higher risk of developing T2DM
What should be performed on examination of a patient with diabetes?
Monofilament test and reflexes
Foot examination for ulcers
Visual acuity and fundoscopy
BP and postural drop
Assessment of cardiovascular risk
BMI and weight circumference
What is the mechanism of action of the GLP-1 analogue?
Increase endogenous pancreatic release of insulin in response to glucose
Slows gastric emptying and improves satiety leading to weight loss
Increases glucose uptake in muscles
What are the various way that the diagnosis of diabetes can be confirmed?
Symptoms + RBG >11.1mmol/L
Fast glucose >7mmol/L
2 hour glucose tolerance test >11.1mmol/L
How would you Ix a new diagnosis of diabetes?
UEC - Creatinine
What is diabetic acute painful neuropathy/rest pain? What is it's pattern of time course?
Burning pain in the feet, shins and anterior thighs, typically worse at night.
Due to microvascular changes as a complication of diabetes.
Can be present at diagnosis or can occur spontaneously when good glycaemic control is achieved. Usually remits spontaneously after 3-12 months if good control is maintained
What are the fasting and post prandal blood glucose targets?
Fasting = 6-8mmol/L
2h post prandal = 6-10mmol/L
What is a structure for answering a Mx question for the long case diabetic patient?
- Albumin/Creatinine ratio
- Acutely first: Aim BSL 5-10, novorapid sliding scale
- Novorapid sliding scale
- Referrals to allied health
Why does cataracts occur in T2DM?
When glucose is present in tissue at a high concentration it gets converted to sorbitol by aldose reductase