T2DM P2 Flashcards
Signs and symptoms
• weight loss
• blurred vision
• slow healing wounds
• recurrent uti UTI
• excessive thirst
• sweet smelling urine
What is the primary prevention of cholesterol in those who have 10% risk of developing CVD?
Atorvastatin 20mg daily
What is the dose of Atorvastatin in established CVD
80mg
Which statins are lipophilic, thus more likely to myophathy as an ADR
Atorvastant and simvastatin
What are the symptoms of Peripheral vascular disease
• change in skin colour - pale/blue
• cold limbs
What examinations would you do for PAD
• capillary refill time
• check for ulceration
• temperature of limbs
• listen for any abnormal sounds in arteries
• check pulses
What drugs are used for PAD treatment and prevention
Prevention - clopidogrel 75mg
Treatment - naftidrofuryl 100mg TDS
Which part of the nervous system is affected by neuropathy
Stoma sensory nervous system
Excitable/continous fired signal
Management of painful diabetic neuropathy
Step1
• paracetamol
Step 2
• 1st line - duloxitine
If pain is severe/persistant
1. Refer to specialist
2. Tamadol (if CI use lidocaine)
Management of other neuropathic pain
Step 1
• paracetamol
Step 2
• 1st line: gabapentin or amitriptyline
• 2nd line: use one which has not been used
What is autonomic neuropathy Gastroparesis?
Damage to the nerve (vagus) responsible for GIT function
What are the signs and symptoms of Gastroparesis?
• feeling full
• N&V
• abdominal pain
What examinations are needed for diagnosis
• endoscopy
• abdominal imaging
• presence of symptoms
1st line management of Gastroparesis is diet. What would you recommend?
• avoid spicy
• increase fibre intake
2st line management of Gastroparesis prokinetics . What would you recommend?
They help GI motility
• mirtazipine
• erythromycin
• domperidone
• metoclopramide
Describe diabetic nephropathy?
Increase in blood glucose, damages the surrounding blood vessels of nephron and tubules, affecting nephrons ability to filter waste effectively
Creatinine is used in the prognosis. What does it test for?
Measures how well the kidneys are wintering waste
High levels = impaired kidney function
Low levels = decreased kidney function
(Also for prognosis - urine albumin test)
What is the treatment of nephropathy
ACE inhibitor and SHLT2 inhibitor + bicarbonate supplement
What drug is used for weight gain management?
Tripeptide - tirzepatide
What two peptides are made up in tirzepatide
GIP and GLP1
Smocking cessation management options?
•NRT
• e-cigarettes
• bupropion
What are the general long term monitoring of type 2 diabetes?
• BMI
• blood pressure
• HbA1c
• cholesterol
• smocking cessation
• eye screening
• foot examinations
• kidney function
• urinary albumin
What results of HbA1c is diabetics
> 48
What fasting blood glucose is considered diabetic?
> 7
If HbA1 is over >48 and no symptoms are present, when to repeat again
After 3 months
Self monitoring is usually not advised, unless..
• on insulin
• on sulphonylureas
• using heavy machinery
• pregnant
