Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

4th Year CCC > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Is the HbA1c target set in stone?

A

No can individualise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is HbA1c?

A

Average BM for last 2-3mths. glycated Hb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

An HbA1c of what number = diabetes diagnosis?

A

48

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What should HbA1c target be if controlled by lifestyle or a single agent?

A

48 (if not achieved indicates need further Rx)

Or 53 if the drug has a hypo risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If HbA1c exceeds 58 what should you do?

A

Use dual therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should HbA1c target be on dual therapy?

A

53

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should you do if HbA1c exceeds 58 on treatment?

A

Intensify therapy e.g. triple therapy or injectable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How often should you test HbA1c?

A

3-6monthly, then 6 monthly when stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If the first drug you prescribe has a risk of hypo, should your HbA1c target change? If so, what should it be?

A

Yes should be 53 (if no hypo risk is 48)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If they are on triple therapy, what should HbA1c target be?

A

53

Or personal target

Or if they are elderly or frail, relax the target but max 70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does individualised HbA1c target and care depend on?

A

HbA1c + HbA1c target

eGFR (drugs excreted renally)

BMI (some = wt change)

Age

Occupation (e.g. would a hypo be v bad?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do type 1 and type 2 presentations differ?

A

Type 1 is sudden onset, wt loss, ketones in urine dip

Type 2 gradual onset, wt gain and no ketones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does microalbuminurea mean in diabetes?

A

Increased risk of renal and cardiac disease- consider ACEi/ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How can achieving the recommended physical activity levels help HbA1c?

A

Can reduce it by 10!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name the 6 categories if pre-insulin drugs

A

Metformin

Sulfonylureas (gliclazide etc)

Gliptin (DPP-4 inhib)

Glitazones

GLP-1 agonist

SGLT2 inibitors (-flozin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the action of metformin

A

Limits glucose release from liver and decreases insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Does metformin work immediately?

A

No takes a while (month)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Does metformin have a risk of hypo?

A

Low risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Does metformin cause weight gain?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the cautions/SEs metformin?

A

Caution in low eGFR

Risk lactic acidosis in dehydrated

GI SEs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Action of sulfonylureas?

A

Spank the panc to increase insulin prod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

risk in sulfonylureas?

A

Hypo and wt gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Name two sulfonylureas

A

Gliclazide

Glimepiride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Do sulfonylureas work quickly?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Action of gliptins?

A

Inhibit DPP-4 which means GLP-1 is not broken down

GLP-1 increases insulin production and decreases glucose

26
Q

How are gliptins taken?

A

Once daily oral

27
Q

Do gliptins have a hypo risk?

A

Low risk

28
Q

Do gliptins effect weight?

A

No

29
Q

What is the problem with gliptins

A

Often stop working

30
Q

Can gliptins be prescribed in kidney disease?

A

Yes

31
Q

SEs gliptins?

A

Headache, URTI, sinus infection

32
Q

What do glitazones do?

A

Decrease insulin resistance

33
Q

Do glitazones work straight away?

A

Take up to 12 weeks so no

34
Q

SEs glitazones?

A

Weight gain

Fluid retention

Fracture risk

35
Q

Should glitazones be prescribed in HF?

A

No as fluid retention SE

36
Q

Liraglutide is an example of what sort of drug?

A

GLP-1 agonist

37
Q

What do GLP-1 agonists do?

A

Mimic GLP-1 to stimulate pancreatic insulin production and decrease glucagon production.

38
Q

Do GLP-1 agonists effect weight?

A

Yes wt loss as slows stomach emptying

39
Q

How are GLP-1 agonists taken?

A

Injection

40
Q

Do GLP-1 agonists have a hypo risk?

A

No

41
Q

GLP-1 agonists SEs

A

N&V

42
Q

What is a requirement in the patient for prescribing GLP-1 agonists?

A

> 35 in caucasian patients as very expensive

43
Q

What is the action if flozins/SGLT2 inhibs?

A

Prevent glucose reabsorption in kidneys- ‘wee out sugar’

44
Q

flozins/SGLT2 inhibs SEs?

A

Increased frequency, UTI, thrush (this may have implications for occupation)

45
Q

Do SGLT2 inhibitors have a hypo risk?

A

No

46
Q

Which diabetes drugs have a hypo risk

A

Sulfonylureas

glinides

Pioglitazones only if in combination with others

47
Q

Which diabetes drugs risk weight gain?

A

Sulfonylureas

Pioglitazones

48
Q

What proportion of diabetics will have an MI or stroke?

A

75%

49
Q

What is a good drug option for a patient who is a lorry driver so doesn’t want GI side effects, can’t risk a hypo and doesn’t want to need a wee all the time. They are caucasian with a BMI of 33

A

Pioglitazone

or

Gliptins

50
Q

What is more important in reducing MI/stroke- cholesterol, BP or HbA1c?

A

BP lowest number needed to treat

51
Q

How can you advise a patient that they can prevent complications of diabetes?

A

Diet, exercise

Stop smoking and drinking

Control BM well

Attend annual review

52
Q

What is done at the annual review?

A

BMI

Waist circumference

Mood screen

Smoking status

Neuropathy (erectile, neuropathic pain, autonomic neuropathy (bladder and bowel), gastroparesis)

53
Q

What else needs to be done annually?

A

Retinoapthy screen

foot check

Nephropathy - early morning urine A:CR and serum creatinine eGFR

Cardio risk factors assessed

54
Q

What are the cardiac risk factors that should be assessed in diabetics?

A

Age

Albuminaemia

Smoking

BP

Lipid profile

FHx

Waist circumference

55
Q

What needs to be checked 6 monthly?

A

HbA1c

56
Q

How should you manage a diabetic person presenting with a foot ulcer?

A

Fluclox, see again in 48hrs and refer to community diabetic nurse.

57
Q

what are glinide’s mode of action similar to?

A

Sulfonlyureas

58
Q

Do glinides have a hypo risk?

A

Yes

59
Q

How are glinides taken?

A

Before meals (up to TDS) to reduce post-prandial glucose spike.

60
Q

Who are glinides good for?

A

If have unpredictable meal times.

61
Q

SE glinides?

A

GI

62
Q

What is metformin’s drug class?

A

Biguanide

4th Year CCC (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions