Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2A - Endocrine System > Management of Type 2 Diabetes Mellitus Part 1 > Flashcards

Management of Type 2 Diabetes Mellitus Part 1 Flashcards

1
Q

What is the prevalence of type 2 diabetes, is this increasing or decreasing?

A

5.4% (increasing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Does diabetes affect more men or woman?

A

Men (55% men, 45% woman)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Who is in the diabetes team?

A

Patient

Specialist nurse

GPs

Clinical psychologists

Dietitians

Podiatrists

Diabetes doctors

Other specialties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where can advice about diabetes be found?

A

Practice nurse/GP

Online education (DUK, mydiabetesmyway)

Group education sessions

Dietetic advice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What should patients expect from their diabetic care?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give an example of what would typically occur in a consultation for type 2 diabetes?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is diabetic information shared between healthcare professionals?

A

Using SCI diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some of the aims of diabetic treatment?

A

Relief of primary symptoms

Prevention of complications

Preservation of quality of life

Damage minimalisation (avoidance of emergencies)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some examples of the primary symptoms due to type 2 diabetes?

A

Polyuria

Polydipsia

Myopia

Fatigue

Weight loss

Paraesthesia

Slow or improper healing of bruises or cuts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What kinds of things need to be considered to prevent complications due to type 2 diabetes?

A

Mood

Dietary changes

Physical activity

Blood pressure

Statins

Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What drugs increase insulin release?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What drug increases excretion of glucose?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What drugs improve insulin action?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the 5 step framework for choosing glucose lowering drugs?

A
  1. Set a target HbA1c
  2. Are there any other risk factors that should be treated first
  3. Are the current treatments optimised
    1. Max dose, tolerated, taken
  4. What are the glucose lowering options
    1. Remove any that are contraindicated
    2. Of the remaining what are pros and cons
    3. Select preferred choice
  5. Agree a review date and the target HbA1c with patient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some ways of optimising current treatment drug for type 2 diabetes?

A

Max dose

Tolerated

Is it taken correctly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Target HbA1c should be set on a case by case basis, what kinds of things impact this HbA1c target level?

A

People who are older or frail

For adults with reduced life expectancy or high risk of consequences of hypoglycaemia (such as those at increased risk of falling, or who drive)

Intenstive management not appropriate, multiple co-morbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the first 3 lines of drugs for type 2 diabetes?

A
  1. Metformin (improves insulin action, acts on liver and muscle)
  2. Sulphonylureas (increases insulin release, acts on pancreas)
  3. Thiazolidinediones (improves insulin action, acts on liver, muscle and adipose tissue)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What organs does metformin act on?

A

Liver and muscle

19
Q

What organ does sulphonylureas act on?

A

Pancreas

20
Q

What organs does thiazolidinediones act on?

A

Muscle and adipose tissue

21
Q

What is the effect of metformin?

A

Improves insulin action

22
Q

What is the effect of sulphonylureas?

A

Increases insulin release

23
Q

What is the effect of thiazolidinediones?

A

Improves insulin action

24
Q

What is the first line for treatment of type 2 diabetes?

A

Metformin

25
Q

Why is metformin the first line for treatment of type 2 diabetes?

A

Improves outcomes

Well tolerated

Cheap

26
Q

How does metformin improve insulin sensitivity?

A

Affects glucose production, decreases fatty acid synthesis

Improves receptor function

Inhibits gluconeogenic pathway

27
Q

What is the half life of metformin?

A

6 hours

28
Q

What kind of drug is metformin?

A

Biguanide (group of drugs that work by preventing the production of glucose by the liver, improving the bodies sensitivity towards insulin)

29
Q

What are some advantages of metformin?

A
30
Q

What are some disadvantages of metformin?

A
31
Q

Explain the mechanism of action of sulphonylureas?

A
  1. Binds to sulfonylurea receptors (SUR-1) on functioning pancreatic beta cells
  2. Binding closes linked ATP sensitive potassium channels
  3. Decreased potassium influx depolarises beta cell
  4. Voltage dependent calcium channel opens and cause influx of calcium
  5. Translocation and exocytosis of secretory granules of insulin to the cell surface
32
Q

What receptors does sulphonylureas bind to?

A

Sulfonylurea receptors (SUR-1) on functioning pancreatic beta cells

33
Q

What are some sulphonylureas?

A
34
Q

What are some advantages of sulphonylureas?

A
35
Q

What are some disadvantages of sulphonylureas?

A
36
Q

What drug is the main thiazolidinedione?

A

Pioglitazone

37
Q

Explain the mechanism of action of pioglitazone (thiazolidinedione)?

A
  1. Selectively stimulates the nuclear receptor peroxisome proliferator – activated receptor gamma (PPAR-gamma) and to lesser extent PPAR-alpha
  2. Modulates transcription of insulin sensitive genes involved in control of glucose and lipid metabolism in muscle, adipose tissue and liver
  3. Reduces insulin resistance in liver and peripheral tissues
  4. Increases expense of insulin dependent glucose
  5. Decreases withdrawal of glucose form liver
  6. Reduces quantity of glucose, insulin and glycated haemoglobin in bloodstream
38
Q

What receptors does pioglitazone (thiazolidinedione) act on?

A

Selectively stimulates the nuclear receptor peroxisome proliferators - activated receptor gamma (PPAR-gamma) and to lesser extent PPAR-alpha

39
Q

What are some advantages of pioglitazone?

A
40
Q

What are some disadvantages of pioglitazone?

A
41
Q

Out of metforming, sulphonyleus and glitazone, which has the better CV outcomes?

A
42
Q

Out of metforming, sulphonyleus and glitazone, which impacts the patients weight?

A
43
Q

Out of metforming, sulphonyleus and glitazone, what are contraindications?

A
44
Q

Out of metforming, sulphonyleus and glitazone, what are potential adverse effects for each?

A

2A - Endocrine System (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions