Diabetes Type II Flashcards
Describe the pathophysiology that underlines type II diabetes
Characterised by reduced insulin secretion and insulin resistance
Name FIVE risk factors for type II diabetes
Family history of diabetes Ethnic background of afro-carribean Age 40+ in caucasian BMI greater than 25 Past history of gestational diabetes
How does type II diabetes affect the metabolism of glucose?
Lack of insulin leading to less glucose metabolism, more glucose in the blood
How is type II diabetes treated?
Initially, dietary modification and exercise (at least 30 minutes a day)
What is the diabetic diet? (3)
Low fat
Reduced refined sugar
Increase of carbohydrates and fibre
Name the FOUR categories of oral hypoglycaemics
Insulin secretagogues
Insulin sensitisers
Inhibitor of glucose absorption from the GI tract
Inhibitor of renal glucose uptake
Give the class and drug example of an insulin secretagogue
Sulphonylureas - gliclazide
How do sulphonylureas work?
Increase insulin release from the pancreas by binding to sulphonylurea receptor, closes the K+ ATP channel. Increased intracellular calcium and insulin release
What are the couselling points for gliclazide? (2)
Can induce weight gain
Can cause persistent hypoglycaemia
Give the class and drug example of an insulin sensitiser
Biguanide - metformin
How does metformin work?
Supresses hepatic glucose generation
Inhibits appetite which helps to achieve weight loss
What are the side effects to metformin and how are they avoided?
GI side effects - gradual increases to therapeutic dose or modified release preparations
What drug class is pioglitazone?
Part of the glitazones OR thiazolidinediones
How does pioglitazone work?
Binds to peroxisome proliferator activated receptor - gamma and regulates gene transcription to enhance glucose uptake
What is gestational diabetes?
Diabetes occuring for the first time during pregnancy
