ENDO 141 Diabetics Mellitus Type II

Question 1

What are the presentations of diabetes?

Answer 1

Polyuria, polydipsia, lack of energy, vision blurring, polyneuropathy, erectile dysfunction

Question 2

What fasting plasma glucose level is diagnostic for diabetes?

Answer 2

> 7.00mmol/L

Question 3

What random plasma glucose level is diagnostic for diabetes?

Answer 3

> 11.1mmol/L

Question 4

What HBA1c level is diagnostic for diabetes?

Answer 4

> 6.5 or 48mmol/mol

Question 5

What is HBA1c a measure of?

Answer 5

Glycosylated haemoglobin

Question 6

What can interfere with HBA1c measurements?

Answer 6

Anything that affects the blood e.g. anaemia, hemolysis or renal impairement

Question 7

What group of drugs is metformin in and roughly how does it work?

Answer 7

Biguanides and it slows the rate of gluconeogenesis

Question 8

Why is metformin good for diabetes?

Answer 8

Helps lower blood glucose and patients to lose weight without inducing hypoglycaemia

Question 9

How do sulphonylureas work and who do they not work for?

Answer 9

act on beta cells to promote insulin secretion therefore won’t work on anyone without intrinsic insulin production

Question 10

Give an example of a sulphonylurea

Answer 10

Gliclazide or tolbutamide

Question 11

What are metaglitinids?

Answer 11

Insulin secretagogues that promote insulin secretion

Question 12

How do thiazolidinediones work and who are they contraindicated in?

Answer 12

Reduce insulin resistance and increase peripheral sensitivity to insulin - cannot be used in those with heart failure due to fluid retention

Question 13

What do DPP4 inhibitors do?

Answer 13

Prevent DPP4 from breaking down GLP1 therefore potentiating the incretin effect

Question 14

Give an example of a DPP4 inhibitor

Answer 14

Linagliptin, sitagliptin, saxagliptin

Question 15

What do SGLT2 inhibitors do?

Answer 15

Inhibit the receptor in the kidney tubules that reabsorbs glucose

Question 16

What may SGLT2 inhibitors cause?

Answer 16

Increase UTI’s and genital infections

Question 17

What are normal blood glucose levels?

Answer 17

3.5-9.0mmol/L

Question 18

What uses most of the glucose produced?

Answer 18

the brain

Question 19

What is the incretin effect?

Answer 19

Incretins cause a much larger spike in insulin release just after a meal

Question 20

What receptor does glucose act on to stimulate insulin release?

Answer 20

GLUT 2

Question 21

What is the glucose receptor in skeletal muscle and fat?

Answer 21

GLUT4

Question 22

What happens to insulin and its effects in type 2 diabetes?

Answer 22

sensitivity decreases, resistance increases and it is secreted more slowl

Question 23

What are the two phases of insulin release after a meal?

Which is first affected in diabetes?

Answer 23

First insulin spike then a slow steady release as pancreas goes into overdrive
First phase is diminished in diabetes and second is eventually lost

Question 24

What are the macrovascular complications of diabetes?

Answer 24

Stroke, myocardial infarction

Question 25

What are the microvascular complications of diabetes?

Answer 25

retinopathy, nephropathy, peripheral neuropathy and ischaemic lesions