Diabetes

Question 1

Diet

Answer 1

low sugar
high carbs
high fibre
low fat
encourage to lose weight

Question 2

once a day insulin

Answer 2

type 2

oral agents alongside

Question 3

twice daily

Answer 3

used in 1/2
need 3 meals a day
short acting + intermediate

Question 4

basal/bolus

Answer 4

long acting
then separate short/rapid at each meal
vary dose with carb content

Question 5

continuous subcut insulin

Answer 5

best if varied routine

basal @ mealtimes

Question 6

fixed dose insulin therapy

Answer 6

no flexibility

Question 7

flexible insulin therapy

Answer 7

o The amount of insulin taken is chosen with each meal
o Common for those on a basal-bolus regimen
o Gives more control of what is eaten, and balancing of blood glucose levels
o Requires a lot of education to understand

Question 8

Biguanides (metformin)

Answer 8

increases insulin uptake and decreases gluconeogenesis
GI upset
lactic acidosis
risk of OD no weight gain
CI: anaesthesia, DKA, impaired liver/kidney

Question 9

Sulfonylureas (Glicazide)

Answer 9

increases insulin secretion
only good if residual function
dont give if pregnant
can cause hypos and weight gain

Question 10

pioglitazone

Answer 10

reduces peripheral insulin resistance
increases risk of bladder cancer
worsens CHF (fluid retention)
fractures
cvs EVENTS

Question 11

piaglitazone CIs

Answer 11

heart failure
bladder cancer Hx/active
liver disease

Question 12

gliptin

Answer 12

increase insulin secretion
dont give in DKA
SEs: 
	Cold/flu like symptoms
	Slightly increased risk of CHF
	Low risk of hypoglycaemia but increases the risk if also taking gliclazide
	Cause minimal weight gain
	Severe hypersensitivity reactions

Question 13

Gliflozins

Answer 13

makes you wee glucose
increased UTIs/balantitis/thrush
dka
low risk of hypos

Question 14

noninsulin injectable glp 1 analogue

Answer 14

increases insulin secretion
nausea
weight loss

Question 15

hypoglycaemia

Answer 15

• Blood sugar should be immediately raised through ingestion of carbohydrates or IV glucagon if comatose
• The cause should be determined
• Measures should be taken to prevent further episodes
• IV dextrose should be used if the patient can’t ingest anything

Question 16

proliferative retinopathy

Answer 16

laser photocoagulation

panretinal

Question 17

maculopathy

Answer 17

laser photocoag if getting to fovea

if in centre, use grid

Question 18

painful neuropathy

Answer 18

need good control
duloxetine
TCAs
gabapentin
pregabalin
TENS
topical capsacin