Diabetes Primary Care Flashcards

1
Q

What is the treatment pathway for type 2 diabetes?

5

A
Diagnosis
-->
Therapeutic Lifestyle Change
-->
Monotherapy
--> 
Combination Therapy (NOT INSULIN)
-->
Combination Therapy (WITH INSULIN)
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2
Q

What is the clinical target for BMI?

A

25

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3
Q

What is the clinical target for HbA1c?

A

7% (75mmol/l)

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4
Q

What is the clinical target for BP?

A

140/80 or below

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5
Q

What is the clinical target for total cholesterol?

A

< 5

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6
Q

What is the clinical target for LDL cholesterol?

A

< 3

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7
Q

What is the clinical target for triglyceride?

A

< 2.3

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8
Q

Name 6 modifiable risk factors:

A
Weight
Activity levels (exercise vs sedentary behavior)
Alcohol reduction
Smoking
Blood pressure
Glycaemic control
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9
Q

Side effects of gliclazide?

A

Weight gain

Hypoglycaemia

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10
Q

Which hypoglycaemic agent you would give to a patient with a BMI > 25?

A

Metformin (1g 3x daily)

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11
Q

Which hypoglycaemic agent you would give to a patient with a BMI < 25?

A

Gliclazide (160mg twice daily)

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12
Q

What are (3) combination therapies?

A

Metformin + gliclazide
Metformin + pioglitazone
Gliclazide + pioglitazone

(some people will need insulin to try to achieve HbA1c)

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13
Q

How many adults with type 2 diabetes have a raised bp?

A

70%

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14
Q

Name (4) types of anti-lipid therapy

A

Statins (NICE/SIGN guidelines advises to increase dose)

Fibrates

Ezetimibe

Cholestyramine (unpleasant to take)

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15
Q

What is done at the GP chronic disease review?

A
General health review
Diabetic understanding
Medication review
Smoking and alcohol
Glycaemic control
Symptoms of complications?
ICE
What does this mean to me?
Compliance/concordance or adherence
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16
Q

What is involved in GP examination of patient with type 2 diabetes?

A
Weight	/ BMI
Blood pressure
Visual acuity
Consideration of retinopathy
Consideration of foot care and neuropathy (foot examination)
Reflexes
17
Q

What is the ideal screening method for retinopathy?

A

Digital retinal photography

18
Q

What investigations would a GP do for patient with type 2 diabetes?

A

Urinalysis for protein (consider screening for microalbuminuria)
HbA1c
U&E’s
Cholesterol/lipid profile

Hba1c, U&E’s, cholesterol, urine for microalbinuria –> Should be performed before clinic visit