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Year 3 > Diabetes TCD > Flashcards

Diabetes TCD Flashcards

1
Q

What percentage of adults with diabetes have T2DM?

A

90%

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2
Q

Which sex has the highest prevalence of diabetes?

A

Males

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3
Q

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

A

5-10%

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4
Q

Effect of uncontrolled diabetes on blood

A

Hyperglyceamia, amminoacideamia, hyperfattyacidaemia

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5
Q

What level of fasting glucose is diagnostic of diabetes?

A

more than 7 mmol/L

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6
Q

What HbA1c value is diagnostic of diabetes?

A

Greater than or equal to 48 mmol/mol

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7
Q

Main pathophysiology of T1DM?

A

beta cell destruction, autoimmune

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8
Q

Main pathophysiology of T2DM?

A

Insulin resistance and Beta cell dysfunction

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9
Q

Effect of no insulin?

A

Hyperglyceamia, gluconeogenesis, glycolysis, ketonaemia

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10
Q

What percentage of people with T2DM are obese or overweight?

A

90%

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11
Q

What distribution of obesity is worse for diabetes risk?

A

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

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12
Q

Associated autoimmune diseases with T2DM?

A

Thyroid, pernicious anaemia, Addison’s and ceoliac.

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13
Q

What is isophane?

A

A slow acting insulin

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14
Q

What improves insuin resistance in everyone?

A

Diet and exercise

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15
Q

What diabetic drugs increase weight gain?

A

Insulin, solfonylureas, meglitanides

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16
Q

Which diabetic treatment drugs can causes hypos?

A

Insulin, sulfonlyureas, meglitanides

17
Q

What diabetes medications can have GI symptoms?

A

metformin, incratins and acarbose

18
Q

What diabetes medications can cause weight loss?

A

Metformin, incratins and SGLT2 inhibitors

19
Q

How many yearly checks for someone with diabetes?

A

9

20
Q

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

A

long terms glyceamia and systolic BP

21
Q

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

A

higher than 160 mmol/L

22
Q

What drugs reduce insulin resistance?

A

Biguanides – Metformin

Thiazolidenediones e.g. Pioglitazone,

23
Q

What drugs increase beta cell activity?

A

sulphonylureas e.g Gliclazide, Glipizide, Glibenclamide

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

24
Q

What drugs increase GLP 1 activity?

A

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

25
Q

What drugs enhance glucose excretion?

A

SGL2 antagonists Dapagliflozin, Canagliflozin, Empagliflozin

26
Q

What does insulin do to blood potassium levels?

A

Insulin decreases blood potassium levels

27
Q

What are the two main side effects of metformin?

A

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

28
Q

Who is metformin contraindicated in?

A

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

29
Q

What doe thiazolidinediones act on?

A

PPAR-Gamma

30
Q

Side effects of thiazolidinediones?

A

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

31
Q

Who are thiazolidinediones contraindicated in?

A

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

32
Q

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

A

greater than 58 7.5%

33
Q

HbA1c target for patients on drugs that can cause hypos

A

53 (7%)

34
Q

BMI for GLP-1 agonist consideration

A

greater than 35 and psychological

35
Q

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

A

10% or more

36
Q

When can’t QRISK2 be used?

A

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

Year 3 (26 decks)

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