Final Exam - Diabetes

Question 1

What characterises T1DM in terms of insulin deficiency?

Answer 1

Absolute deficiency of insulin due to pancreatic beta-cell destruction.

Question 2

What primarily causes T2DM in relation to insulin?

Answer 2

peripheral resistance to insulin action and inadequate secretory response by pancreatic beta-cells, resulting in relative insulin deficiency.

Question 3

Which type of diabetes involves the autoimmune destruction of pancreatic beta-cells?

Answer 3

T1DM

Question 4

What is the primary mechanism responsible for insulin deficiency in T2DM?

Answer 4

peripheral insulin resistance and inadequate insulin secretion

Question 5

What is the primary cause of insulin deficiency in T2DM?

Answer 5

Insufficient secretory response by pancreatic beta-cells

Question 6

What are the general symptoms often observed in individuals with diabetes?

Answer 6

lethargy, polyuria (excessive urination), polydipsia (excessive thirst), frequent fungal/bacterial infections, blurred vision, and loss of sensation, as well as poor wound healing.

Question 7

What specific symptoms are typically associated with Type 1 Diabetes (T1DM)?

Answer 7

ketosis or ketonuria, weight loss, polyuria, polydipsia (especially at a young age), and a rapid onset of symptoms. A family history of autoimmune disease can also be significant

Question 8

What is acanthosis nigricans, and how is it linked to diabetes?

Answer 8

skin condition characterised by hyperpigmentation, often occurring in skin folds. It can be associated with insulin resistance and an increased risk of diabetes

Question 9

What are some common signs of insulin resistance?

Answer 9

acanthosis nigricans (skin hyperpigmentation), the presence of skin tags, menstrual irregularities, and hirsutism (excessive hair growth).

Question 10

Under what circumstances should individuals consider getting tested for diabetes?

Answer 10

if they have symptoms or complications of diabetes, are at risk of developing diabetes, or display clinical signs of insulin resistance

Question 11

What does FBG stand for in the context of diabetes diagnosis?

Answer 11

Fasting Blood Glucose

Question 12

What does RBG stand for, and when is it typically used for testing?

Answer 12

Random Blood Glucose, and it is used for on-the-spot testing of blood sugar levels, regardless of meal timing.

Question 13

What does OGTT stand for, and how is it performed?

Answer 13

Oral Glucose Tolerance Test and involves drinking a glucose solution, followed by blood sugar measurements at specific intervals.

Question 14

What does HbA1c measure, and what is its significance in diabetes diagnosis?

Answer 14

HbA1c measures glycated hemoglobin and provides an average of blood sugar levels over the past 2-3 months, aiding in diabetes diagnosis and long-term glucose control assessment.

Question 15

Which test is commonly used to diagnose diabetes through a person’s response to a glucose challenge?

Answer 15

The Oral Glucose Tolerance Test (OGTT) is often used to diagnose diabetes by assessing how the body processes glucose after consuming a standardised amount of glucose solution.

Question 16

What does “K.N.I.V.E.S” represent in the context of chronic complications of diabetes?

Answer 16

Kidney, Nerves, Infection, Vascular, Eyes, and Skin, which are common categories of chronic complications in diabetes.

Question 17

What are the two main categories of chronic complications in diabetes based on the size of blood vessels affected?

Answer 17

• microvascular (small blood vessel)
• macrovascular (large blood vessel) complications.

Question 18

What does “Nephropathy” refer to in the context of diabetes?

Answer 18

kidney disease and complications associated with diabetes, which can lead to conditions like kidney failure and portal hypertension.

Question 18

What term describes nerve-related complications in diabetes?

Answer 18

Neuropathy, which can manifest as diabetic neuropathy and paraesthesia (abnormal sensations).

Question 19

What are some common eye-related complications seen in individuals with diabetes?

Answer 19

retinopathy, macular oedema, cataracts, and glaucoma

Question 20

Which population groups are at a higher risk for T2DM due to their age and ethnicity?

Answer 20

People aged 35 years and above originating from Pacific Islands, the Indian subcontinent, or China

Question 20

What risk factors are associated with age, high BMI, and hypertension in relation to T2DM?

Answer 20

Individuals aged over 40 years old, with a BMI over 30 or hypertension, have an elevated risk of T2DM.

Question 21

What are two risk factors for T2DM in women?

Answer 21

Women with a history of gestational diabetes mellitus (GDM) and women with polycystic ovary syndrome (PCOS) who are obese are at increased risk for T2DM.

Question 22

Why are medications used to provide symptom relief in diabetes management?

Answer 22

alleviate symptoms like polyuria (excessive urination) and polydipsia (excessive thirst)

Question 22

Why is drug therapy essential for preventing or delaying long-term microvascular complications in diabetes?

Answer 22

Medications help in preventing or delaying complications such as nephropathy (kidney disease) and neuropathy (nerve damage) associated with diabetes.

Question 22

What is the primary goal of using drugs to control blood glucose concentration in diabetes?

Answer 22

Medications aim to regulate and maintain blood glucose levels within a target range to prevent hyperglycemia and hypoglycemia.

Question 22

How do diabetes medications contribute to the prevention of macrovascular events?

Answer 22

help reduce the risk of macrovascular events, such as heart disease and stroke

Question 23

In summary, what are the key rationales for using drugs in the management of diabetes?

Answer 23

symptom relief, blood glucose control, and the prevention or delay of both microvascular and macrovascular complications.

Question 23

What is a key advantage of the split mixed insulin regimen in managing T1DM?

Answer 23

simple and convenient, requiring only 2 daily injections of pre-mixed insulin.

Question 24

What is a significant disadvantage of the split mixed regimen in T1DM management?

Answer 24

decreased flexibility, as it may not allow for skipping meals.

Question 24

What is the primary advantage of the basal bolus regimen in T1DM management?

Answer 24

flexibility and better control of blood sugar levels (BSL) with 3 daily injections of short-acting insulin and 1 daily injection of long-acting insulin.

Question 25

What is a notable disadvantage of the basal bolus regimen in T1DM management?

Answer 25

It requires regular blood sugar level (BSL) monitoring and may fail to cover the insulin needed for snacks, potentially resulting in a higher risk of hypoglycemia.

Question 26

What is a common difference between these two regimens regarding the number of injections required?

Answer 26

requires fewer injections, while the basal bolus regimen involves more injections for better control.

Question 27

What is a key advantage of short-acting insulin in diabetes management?

Answer 27

better control of blood sugar levels (BSL) and offers flexibility in mealtime dosing.

Question 28

What is one notable disadvantage of short-acting insulin?

Answer 28

requires more injections, which can be seen as a disadvantage.

Question 29

What is a primary advantage of long-acting insulin in diabetes management?

Answer 29

requires fewer injections and carries a lower risk of hypoglycaemia, making it advantageous in certain situations.

Question 30

What is a common difference between these two types of insulins concerning the risk of hypoglycaemia?

Answer 30

Short-acting insulin has a higher risk of hypoglycaemia due to its rapid action, while long-acting insulin carries a lower risk.

Question 30

What is a significant disadvantage associated with long-acting insulin?

Answer 30

• looser control of BSL and is generally less flexible in terms of timing compared to short-acting insulin.

Question 30

What is the drug class of metformin, and what is its primary mechanism of action?

Answer 30

Metformin - MOA: It reduces hepatic glucose production and increases peripheral utilization of glucose.

Question 31

What are some common gastrointestinal (GI) adverse effects associated with metformin?

Answer 31

Nausea, vomiting, anorexia, and diarrhea.

Question 32

What is a rare but potentially fatal side effect associated with metformin use?

Answer 32

Lactic acidosis

Question 32

What drug class includes DPP-4 inhibitors, and what is their primary mechanism of action?

Answer 32

DPP-4 inhibitors “-gliptin” Linagliptin – MOA They inhibit DPP-4, increasing the concentration of incretin hormones, resulting in an increase in glucose-dependent insulin secretion and a decrease in glucagon production.

Question 33

What is a potential risk when using DPP-4 inhibitors in combination with metformin or sulfonylureas?

Answer 33

There is a risk of hypoglycemia when DPP-4 inhibitors are used in combination with metformin or sulfonylureas.

Question 34

What drug class includes GLP-1 agonists, and what is their primary mechanism of action?

Answer 34

GLP-1 agonists “-tide” Dulaglutide. MOA: They increase glucose-dependent insulin secretion, suppress inappropriate glucagon secretion, delay gastric emptying, slow glucose absorption, and decrease appetite.

Question 35

What is a common GI adverse effect associated with GLP-1 agonists?

Answer 35

Nausea and vomiting in approximately 50% of patients using GLP-1 agonists.

Question 36

What drug class includes SGLT-2 inhibitors, and what is their primary mechanism of action?

Answer 36

SGLT-2 inhibitors -flozin Dapagliflozin MOA: They inhibit sodium-glucose co-transporter 2 (SGLT2), reducing glucose absorption in the kidney and increasing its excretion in urine.

Question 37

What drug class includes sulfonylureas, and what is their primary mechanism of action?

Answer 37

Sulfonylureas “gli-“ Glicazide. MOA: They increase pancreatic insulin secretion.

Question 37

What are potential side effects when using SGLT-2 inhibitors in combination with insulin or sulfonylureas?

Answer 37

There is a risk of hypoglycemia when SGLT-2 inhibitors are used in combination with insulin or sulfonylureas, along with urinary and genital infections and a risk of euglycemic diabetic ketoacidosis (DKA).

Question 38

What is the primary mechanism of action of Thiazolidinedione, such as Pioglitazone, in managing Type 2 Diabetes (T2DM)?

Answer 38

Thiazolidinediones, like Pioglitazone, increase the sensitivity of peripheral tissues to insulin and decrease hepatic glucose output.

Question 39

What is the primary mechanism of action of Acarbose in T2DM management?

Answer 39

Acarbose inhibits the digestion of carbohydrates in the gastrointestinal tract (GIT), slowing the rate of glucose delivery into the bloodstream.

Question 39

What are some common side effects associated with Thiazolidinedione, particularly Pioglitazone?

Answer 39

Peripheral oedema, an increased risk of bone fractures, worsening of diabetic macular oedema, and an increased risk of bladder cancer.

Question 39

What are common gastrointestinal side effects associated with the use of Acarbose?

Answer 39

flatulence and abdominal bloating.

Question 39

What are the advantages of using Metformin as a first-line therapy for diabetes?

Answer 39

It is recommended as first-line therapy, but it may have a slow onset of effect, and caution is needed for individuals with renal impairment. It should be used cautiously with iodinated contrast media.

Question 40

What advantages are associated with DPP-4 inhibitors in diabetes management?

Answer 40

not causing weight gain and are associated with a lower risk of hypoglycaemia. However, they may be less effective in reducing HbA1c compared to other agents like metformin, sulfonylureas, and thiazolidinediones.

Question 41

What benefit is typically observed with GLP-1 agonists in diabetes treatment?

Answer 41

GLP-1 agonists typically lead to weight loss in patients. However, there is a safety alert regarding exenatide and its potential association with pancreatic damage, although this is rare.

Question 41

What advantages are linked to SGLT2 inhibitors in diabetes management?

Answer 41

SGLT2 inhibitors may reduce blood pressure and weight, improve cardiovascular outcomes, and reduce the incidence of chronic kidney disease (CKD) and complications associated with CKD.

Question 41

What are some important disadvantages to consider when using SGLT2 inhibitors?

Answer 41

SGLT2 inhibitors should not be used in individuals with renal impairment, they are associated with an increased risk of genital and urinary infections, and monitoring for ketones may be necessary.

Question 41

What is a significant advantage of sulfonylureas in diabetes treatment?

Answer 41

Sulfonylureas significantly reduce the incidence of diabetes-related complications.

Question 42

What disadvantages are commonly associated with sulfonylureas?

Answer 42

Sulfonylureas can lead to weight gain and may cause rashes.

Question 43

What is a notable feature of thiazolidinediones in diabetes management?

Answer 43

Thiazolidinediones have a higher chance of causing adverse effects, and they are typically reserved for patients who cannot take alternative agents.

Question 44

What is a key disadvantage of using Acarbose in diabetes management?

Answer 44

Acarbose is often considered a last-line option due to poor tolerability and is associated with many gastrointestinal adverse effects.