Mixed Notes

Question 1

how often should HbA1c be checked?

Answer 1

every 3-6 months until stable then 6 monthly

Question 2

HbA1c targets for over 18s?

Answer 2

53

Question 3

HbA1c targets for under 18s?

Answer 3

59

Question 4

first line treatment of T2DM if lifestyle not enough?

Answer 4

metformin

Question 5

when should another drug be added to metformin?

Answer 5

if HbA1c still above 58 while taking metformin

Question 6

what drug should be added to metformin?

Answer 6

sulphonylurea
gliptin
pioglitazone
SGLT-2 inhibitor

Question 7

what is added if HBA1c still above 58 on two drugs?

Answer 7

triple therapy with either
- metformin + gliptin + SUR
- metformin + pioglitazone + SUR
- metformin + SUR + SGLT-2 inhibitor
- metformin + pioglitazone + SGLT-2 inhibitor
or consider insulin

Question 8

blood pressure targets in T2DM?

Answer 8

same as normal patients (140/90)

Question 9

first line antihypertensives in T2DM?

Answer 9

ACEi or ARB

ARB preferred if african-caribbean origin

Question 10

are antiplatelets given in T2DM?

Answer 10

not unless they have existing cardiovascular disease

Question 11

who gets offered a statin?

Answer 11

QRISK score showing >10% 10 year risk

Question 12

first line statin for primary prevention (high 10 year risk)?

Answer 12

atorvastatin 20mg

Question 13

first line statin for secondary prevention (known ischaemic heart disease/cerebrovascular disease/peripheral vascular disease)?

Answer 13

atorvastatin 80mg