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Junior Medicine- Endocrine > DM- Type 2 > Flashcards

DM- Type 2 Flashcards

1
Q

What causes T2DM?

A
  1. Repeated exposure to glucose and insulin

2. Cells develop resistance and require more insulin to respond

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2
Q

What are the non-modifiable risk factors for T2DM?

A
  • Family history
  • Age
  • Ethnicity (Black, Chinese, South Asia)
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3
Q

What are the modifiable risk factors of T2DM?

A
  • Obesity
  • Sedentary lifestyle
  • High carbohydrate diet
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4
Q

How does T2DM present?

A
  • Polydipsia
  • Polyuria
  • Weight loss
  • Fatigue
  • Infections and poor healing
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5
Q

What bedside investigation will detect diabetes?

A

Dipstick- glucosuria

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6
Q

What screening test is used for diabetes?

A

HbA1c

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7
Q

What is the normal range for glucose?

A

4.4-6.1mmol/L

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8
Q

What other test is used in T2DM detection?

A

Oral glucose tolerance test

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9
Q

How does a glucose tolerance test work?

A
  1. Baseline cap glucose taken
  2. Pt takes a 75g glucose drink
  3. Cap glucose measured 2 hours later
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10
Q

How are pre-diabetes and diabetes diagnosed?

A

HbA1c

Fasted glucose

Oral glucose

(One)

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11
Q

What ranges of HbA1c suggest Pre-Diabetes and Diabetes?

A

Pre-diabetes 42-47mmol/mol or 6-6.5%

Diabetes 48+mmol/mol or 6.6%+

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12
Q

What ranges of fasted glucose suggest Pre-Diabetes and Diabetes?

A

Pre-diabetes 6.1-6.9 mmol/L

Diabetes 7+ mmol/L

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13
Q

What ranges of oral glucose suggest Pre-Diabetes and Diabetes?

A

Pre-diabetes 7.8-11.1 mmol/L

Diabetes 11.1+

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14
Q

How is pre-diabetes managed?

A

Dietary modification and lifestyle changes

Diet- vegetables and oily fish, low glycaemic and high fibre

Lifestyle- exercise and weight loss, smoking cessation

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15
Q

What monitoring is used in diabetes?

A

Diabetic review

  • Diabetic retinopathy
  • Diabetic foot
  • UsEs
  • HbA1c
  • BP readings
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16
Q

What HbA1c target is used for new type 2 DM?

A

<48 mmol/mol

<6.5%

17
Q

When is the HbA1c target higher for diabetics?

A

If on more than just metformin

18
Q

What is the target HbA1c in diabetics on more than just metformin?

A

<53mmol/mol

<7%

19
Q

What is the first line medication for T2DM?

A

Metformin

20
Q

What are the second line medications for T2DM?

A

Added to metformin:

  • Sulfondylurea (Gliclazide)
  • Pioglitazone (Thiazolidinedione)
  • Incretins (GLP-1)
  • SGLT-2 inhibitor (empagliflozin)
21
Q

How does metformin work?

A
  • Biguanide

- Increases insulin sensitivity and decreases hepatic gluconeogenesis

22
Q

What is important about metformin?

A

Weight-neutral

23
Q

What side effects are there with Metformin?

A
  • LACTIC ACIDOSIS

- Diarrhoea and abdo pain

24
Q

Does metformin cause hypoglycaemia?

A

No

25
Q

How is the diarrhoea relieved with metformin?

A

Dose-dependent

Junior Medicine- Endocrine (10 decks)

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