Diabetes

Question 1

T2DM HbA1c target range

Answer 1

48: Lifestyle modifications only, on monotherapy without hypoglycaemic effect
53: On a hypoglycaemic agent

Question 2

HbA1c monitoring

Answer 2

After initiation: 3-6/12, and then every 6/12

Question 3

When to intensify T2DM Tx

Answer 3

HbA1c 58:
1st: Reinforce lifestyle changes
2nd: ?Adherance to drugs
3rd: Support patient to target Hba1c at 53
4th: Add drug Tx, if appropriate

Question 4

For T2DM patitent who has cardiovascular disease or high risk

Answer 4

Offer Metformin + SGLT-2 as 1st line

Question 5

How to initiate people w/ dual therapy of metformin + SGLT-2 inhibitors?

Answer 5

Initiate Metformin 1st and ensure tolerability and then initiate SGLT-2

Question 6

According to CKS, what drugs can Dapa only be taken with

Answer 6

Metformin + Sulfonylureae ONLY

Question 7

When to consider GLP-1?

Answer 7

1. Triple therapy w/ BMI >35
2. Insulin therapy would be an sig. occupational implication OR
3. WL would benefit other obesity-related comorbidities

Question 8

Hypoglycaemic glucose level

Answer 8

< 3.5mmol/L

Question 9

When to consider insulin therapy for patient?

Answer 9

1. On maximum drug therapy
2. If unable to tolerate anti-DM drugs

Question 10

BP target for Pt < 80 w/ T2DM

Answer 10

< 140/90

Question 11

BP Target for Pt > 80 w/ T2DM

Answer 11

< 150/90

Question 12

Autonomic complications of DM

Answer 12

• Gastroparesis: Delayed gastric emptying by Vagus nerve dysfunction

Question 13

T2DM glucose Diagnostic range