T2DM Flashcards
What are the 3 measurements used for glucose levels in assessing T2DM?
Fasting glucose
2 hour oral glucose tolerance test
HbA1c
How does beta cell insulin production differ in T1DM and T2DM?
Higher function rate in T2DM as they are not attacked by autoantibodies and they are trying to overcompensate for the resistance
However they will both end up at 0
Should you stop insulin treatment if beta cell production reached 0 in either types of diabetes?
No, even though they rely on pancreatic beta cell function
Risk of diabetic ketoacidosis
How does T2DM affect glucose production (LIVER) and absorption?
Production- more gluconeogenesis by liver
Absorption- b cell dysfunction and resistance lead to inflammatory visceral fat which stops glucose uptake by adipocytes and skeletal muscle - more in blood
What is a hyperglycaemic clamp?
Gold standard in assessing insulin secretion
Test used to assess insulin sensitivity and secretion by administering glucose and seeing how body reacts
How does T2DM affect the prandial peak of insulin release?
What is this a result from?
The first peak is not present, only the second
This is due to the insufficienct insulin made
How does the relationship between insulin secretion and sensitivity present in a control patient and one with T2DM?
Higher sensitivity for insulin means you will produce less insulin
T2DM patients have a reduced insulin sensitivity, but insulin secretion is also low rather than rising as expected, so they ‘fall off the curve’
What are inflammatory adipokines made by and what is their function?
What are the levels of them in T2DM?
Adipocytes
Impact insulin action and sensitivity driving insulin resistance
Excess levels
How does T2DM present?
Hyperglycaemia, overweight, dyslipidaemia (too much lipids) insulin resistance, later insulin deficiency
What is the first line screening for T2DM?
How many tests need to be done?
HbA1c
Two readings
What glycaemic state is often associated with renal failure?
How does this present?
Will this result in ketoacidosis?
Hyperosmolar Hyperglycaemic State (HSS)
Présentation: hypovolemic (dehydration), hyperglycaemia, normal ketones, confusion
No because insulin levels are high enough to avoid it but low enough to prevent hyperglycaemia
What should you not administer when dealing with HHS?
Do not give IV fluids to avoid demylenation of brain
What T2DM drugs cause best results in weight loss?
Metformin
DDP-4 inhibitors
