Diabetes TCD

Question 1

What percentage of adults with diabetes have T2DM?

Answer 1

90%

Question 2

Which sex has the highest prevalence of diabetes?

Answer 2

Males

Question 3

What percentage of people with pre diabetes develop diabetes each year?

Answer 3

5-10%

Question 4

Effect of uncontrolled diabetes on blood

Answer 4

Hyperglyceamia, amminoacideamia, hyperfattyacidaemia

Question 5

What level of fasting glucose is diagnostic of diabetes?

Answer 5

more than 7 mmol/L

Question 6

What HbA1c value is diagnostic of diabetes?

Answer 6

Greater than or equal to 48 mmol/mol

Question 7

Main pathophysiology of T1DM?

Answer 7

beta cell destruction, autoimmune

Question 8

Main pathophysiology of T2DM?

Answer 8

Insulin resistance and Beta cell dysfunction

Question 9

Effect of no insulin?

Answer 9

Hyperglyceamia, gluconeogenesis, glycolysis, ketonaemia

Question 10

What percentage of people with T2DM are obese or overweight?

Answer 10

90%

Question 11

What distribution of obesity is worse for diabetes risk?

Answer 11

visceral obesity. Abdominal circumference can be used as a risk calculator.

Question 12

Associated autoimmune diseases with T2DM?

Answer 12

Thyroid, pernicious anaemia, Addison’s and ceoliac.

Question 13

What is isophane?

Answer 13

A slow acting insulin

Question 14

What improves insuin resistance in everyone?

Answer 14

Diet and exercise

Question 15

What diabetic drugs increase weight gain?

Answer 15

Insulin, solfonylureas, meglitanides

Question 16

Which diabetic treatment drugs can causes hypos?

Answer 16

Insulin, sulfonlyureas, meglitanides

Question 17

What diabetes medications can have GI symptoms?

Answer 17

metformin, incratins and acarbose

Question 18

What diabetes medications can cause weight loss?

Answer 18

Metformin, incratins and SGLT2 inhibitors

Question 19

How many yearly checks for someone with diabetes?

Answer 19

9

Question 20

What two values, if controlled, can decrease the risk of microvascular complications?

Answer 20

long terms glyceamia and systolic BP

Question 21

What is the value of Na+ conc in blood in HHS?

Answer 21

higher than 160 mmol/L

Question 22

What drugs reduce insulin resistance?

Answer 22

Biguanides – Metformin

Thiazolidenediones e.g. Pioglitazone,

Question 23

What drugs increase beta cell activity?

Answer 23

sulphonylureas e.g Gliclazide, Glipizide, Glibenclamide

Meglitinides e.g. Nateglinide, Repaglinide (shorter acting)

Question 24

What drugs increase GLP 1 activity?

Answer 24

DPP4 inhibitors e.g. Sitagliptin, Vildagliptin, Linagliptin, Alogliptin
Incretins, GLP1 agonists e.g. Exenatide, Liraglutide

Question 25

What drugs enhance glucose excretion?

Answer 25

SGL2 antagonists Dapagliflozin, Canagliflozin, Empagliflozin

Question 26

What does insulin do to blood potassium levels?

Answer 26

Insulin decreases blood potassium levels

Question 27

What are the two main side effects of metformin?

Answer 27

GI upset and lactic acidosis. Diarrhoea should never be investigated in diabetic patient without stopping metformin first. Lactic acidosis risk increase with alcohol intoxication.

Question 28

Who is metformin contraindicated in?

Answer 28

Renal impairment, including kidney injury. Hepatic insufficiency and chronic alcohol use.

Question 29

What doe thiazolidinediones act on?

Answer 29

PPAR-Gamma

Question 30

Side effects of thiazolidinediones?

Answer 30

GI upset, oedema and cardiac failure, bladder cancer and general neurological symptoms

Question 31

Who are thiazolidinediones contraindicated in?

Answer 31

Heart failure and bladder cancer. Should not be given if haematuria

Question 32

In type two diabetes, if a patient is on metformin, what HBA1C do they need to have to add a second drug?

Answer 32

greater than 58 7.5%

Question 33

HbA1c target for patients on drugs that can cause hypos

Answer 33

53 (7%)

Question 34

BMI for GLP-1 agonist consideration

Answer 34

greater than 35 and psychological

Question 35

Lipid lowering drugs should be offered to patients with a QRISK2 score of

Answer 35

10% or more

Question 36

When can't QRISK2 be used?

Answer 36

T1DM, GFR less than 60, over 84 years old, familial hyperlipidaemia