T2DM Flashcards
What two things does metformin do? (bridge)
reduces hepatic gluconeogenesis
increases peripheral glucose uptake
what does metflormin do to weight? (—)
weight neutral
what two things does metformin reduce risk of?
cancer risk and cvd risk
2 adverse affects of metformin?
GI side effects
lactic acidosis
lowering ba1c with metformin in overweight patients reduces chances of ? (2)
MI and microvascular disease
what is lada?
latent autoimmune diabetes of adults (25-40)
peak age for type 1 diabetes?
0-4 and 10-14
what 2 antibodies would you test for in type 1 diabetes?
GAD and IA2
when would c peptide be present and why would it be absent?
its part of the pre insulin, cleaved out. If insulin is still being produced it will still be present
which cells attack islet cells and what kind of deposition do you get in type 1?
lymphocytes and amyloid deposition
the triad of type 1 diabetes?
polydypsia, polyuria and weight loss
ideally keep HBA1C between?
48-58
Intensive glucose control significantly reduces the incidence and progression of microvascular complications
insulin resistance is strongly associated with the development of microvascular complications
why do you get balanitis in diabetes?
high sugar in urine
do you get hypoglycaemia when using metformin as mono therapy?
no
what is the reduction in glycated haemoglobin using metformin?
0.8-2%
what is the foundation of any type 2 diabetes treatment programme?
diet and exercise
gLITazone (PRG). what effect does this have?
increased peripheral glucose uptake
what does gLITazone do to weight?
increases by 3-5kg
3 risks of glitazone?
increases fracture risk (by 2-3x)
hepatotoxicity
fluid retention
what kind of drug is glitazone?
PPARy activator
majority of urine reabsorbed by which channels in kidney?
SGLT2
what do sulphonylureas do to weight?
increase by 3-5 kg
sulphonylurea mode of action?
blocks the B cell Katp channel. depolarises cell membrane. causing insulin secretion
sulphonulurea can increase chance of?
hypoglycaemia
name a DDP 4 inhibitor
anything that ends in “glipten”
what is the link between obesity, insulin resistance and diabetes?
Obese people are resistant to the actions of insulin. This causes a compensatory rise in secretion of insulin as pancreas tries to overcome the resistance. Eventually the pancreas can no longer keep up, and it is at this point that the patient becomes hyperglycaemic and develops diabetes.
adipose tissue is not inert. it secretes a whole range of things. what is the best known?
leptin
how does orlistat work?
inhibition of lipases blocks absorption of dietary fat
