Diabetes type 2

Question 1

How does type 2 diabetes occur?

Answer 1

Repeated exposure to glucose and insulin means cells become resistant to insulin

Question 2

What happens to the pancreas in type 2 diabetes?

Answer 2

They require more insulin from the pancreas to get a response
Pancreas becomes damaged, produces less insulin leading to hyperglycaemia

Question 3

What does type 2 diabetes result in?

Answer 3

Hyperglycaemia

Question 4

What are the non-modifiable risk factors for type 2 diabetes?

Answer 4

Older age
Black
Family history

Question 5

What are the modifiable risk factors for type 2 diabetes?

Answer 5

Obesity
Sedentary
High carb diet

Question 6

How does type 2 diabetes present?

Answer 6

• Fatigue
• Polyuria
• Polydipsia
• Slow healing
• Weight loss

Question 7

What is the criteria for pre-diabetes?

Answer 7

• Impaired fasting glucose=6.1-6.9mmol/l
• Impaired glucose tolerance=7.8-11.1mmol/l
• HbA1c 42-47mmol/l

Question 8

What is the criteria for diabetes?

Answer 8

• HbA1c 48mmol/l (53mmol/l beyond metaformin)
• Fasting glucose 7mmol/l
• Random glucose 11mmol/l

Question 9

What are the possible complications of diabetes?

Answer 9

• Diabetic retinopathy
• Diabetic foot
• Kidney disease

Question 10

What is the dietary management of type 2 diabetes?

Answer 10

• Low glycaemic, high fibre diet

* A low carbohydrate diet

Question 11

What would you do if HbA1c stays over 58mmol/l even with medical treatment?

Answer 11

Give insulin

Question 12

What type of drug is metformin?

Answer 12

Biguanide

Question 13

What could metformin cause?

Answer 13

Lactic acidosis

Question 14

What type of drug is sulfonylurea?

Answer 14

Gliclazide

Question 15

Who shouldn’t be given sulfonylurea?

Answer 15

People with cardiovascular problems

Obese as it causes weight gain

Question 16

What type of drug is Pioglitazone?

Answer 16

Thiazolidinedione

Question 17

Who should pioglitazone not be given to?

Answer 17

Obese as it causes weight gain
Heart failure
Fluid retention

Question 18

What type of drug is DPP-4 inhibitor?

Answer 18

Sitagliptin

Question 19

Who is Sitagliptin good to use in?

Answer 19

Obese

Question 20

What can Sitagliptin cause?

Answer 20

• GI upset

* URTI symptoms

Question 21

What is the mechanism of SGLT-2?

Answer 21

Reabsorbing glucose from the urine into the blood

Question 22

Who is an SGLT-2 good to use in?

Answer 22

Those with a cardiovascular risk

Question 23

What can SGLT-2 cause?

Answer 23

• Glucoseuria (glucose in the urine)

* Weight loss

Question 24

What are examples of SGLT-2 drugs?

Answer 24

Empagliflozin
Canagliflozin
Dapagliflozin.