Diabetes Mellitus Type 2

Question 1

Define diabetes mellitus type 2.

Answer 1

Type 2 diabetes mellitus is a progressive disorder defined by deficits in insulin secretion and action that lead to abnormal glucose metabolism and related metabolic derangements.

Question 2

Explain the aetiology/risk factors of diabetes mellitus type 2.

Answer 2

Older age
Overweight/obesity
Gestational diabetes
Pre-diabetes
Family history of type 2 diabetes
Non-white ancestry
Physical inactivity
Polycystic ovary syndrome
Hypertension
Dyslipidaemia
Cardiovascular disease
Stress

Question 3

Summarise the epidemiology of diabetes mellitus type 2.

Answer 3

Diabetes prevalence is increasing worldwide, compounded by population growth and an ageing population. In 1980, the global age-standardised diabetes prevalence was 4.3%.

Question 4

Recognise the presenting symptoms of diabetes mellitus type 2. Recognise the signs of diabetes mellitus type 2 on physical examination.

Answer 4

Asymptomatic
Candidal infections
Skin infections
Urinary tract infections
Fatigue
Blurred vision
Polydipsia
Polyphagia
Polyuria
Paraesthesias
Nocturia
Unintentional weight loss
Acanthosis nigricans

Question 5

Identify appropriate investigations for diabetes mellitus type 2 and interpret the results.

Answer 5

HbA1c
Fasting plasma glucose
Random plasma glucose
2-hour post-load glucose after 75g oral glucose

Question 6

Generate a management plan for diabetes mellitus type 2.

Answer 6

1. Lifestyle and metformin
2. Sulphonylureas + Insulin
3. Glitazones

SGLT2 inhibitors, GLP-1 agonists, DPP-4 inhibitors are used after this.

Question 7

Summarise the prognosis for patients with diabetes mellitus type 2.

Answer 7

Diabetes increases the likelihood of major cardiovascular events and death, but the increased risk is variable across patients depending on age at diabetes onset, duration of diabetes, glucose control, blood pressure control, lipid control, tobacco control, renal function, microvascular complication status, and other factors.