Type 2 Diabetes Flashcards
what is T2DM
Insulin resistance leading to decreased glucose uptake
What are the symptoms of T2DM
Polydipsia Polyuria Glycosuria Obesity Acanthosis Nigracans (Dark skin fold)
What are the diagnosis values for T2DM
HbA1c >48mmol/L
Random Plasma Glucose >11.1 mmol/L
Fasting Plasma glucose >7mmol/L
What are some risk factors of T2DM
Age Male South Asian Obesity Socioeconomic HTN
What is the first line management for T2DM
lifestyle advice
What is the overall management of T2DM
- Lifestyle Advice
- Metformin(Biguanide)
- Metformin with Sulfonylurea
- Metformin with Sulfnylurea/DPP-4 Inhibitor/Pioglitiazone/SGLT2 Inhibitor
- Insulin
What is an example of Sulfonylurea
increase insulin secretion from the Pancreas
Gliclazide
What is an example of DPP-4 inhibitor
Blocks DPP-4 which destroys incretin so insulin can’t be produced
Sitagliptin
What is an example of a thiazolidinedione
Improves the use of insulin by the body
Pioglitiazone
What is an example of SGLT2 inhibitor
They decrease blood sugar in the body by inhibiting kidney reabsorption into the blood
Glilozin
What investigations are used for T2DM
Urine dipstick = glycosuria
High ACR ratio
Low serum creatinine
Fasting lipid profile = dyslipidemia
What is the Gold standard for T2DM investigation
HbA1c >48mmol/L >6.5%
What are some macrovascular complications of T2DM
Stroke
PAD
MI
What are some microvascular complications of T2DM
CKD
Retinopathy
Neuropathy (Gloves and stocking)
Diabetic foot
What can uncontrolled T2DM cause
Hyperosmotic Hyperglycemia
What is the difference between ketoacidosis and hyperosmotic hyperglycemia
No KETONES in HO HG
How to diagnose HO HG
rpg >11.1 mmol/L
Urine dipstick = glycosuria
High plasma osmolality
What are the presentations of T2DM
Lack consciousness Dehydrated Hyperglycemic Hyperosmotic NO KETONES
How to treat HOHG
1st = Insulin and Potassium
- 0.9% Saline Replacement
- LMWH (Enoxaparin) to thin blood
What causes gastroparesis
Poor glycemic control causing autonomic nerve damage
What are the two prediabetic states
IGT and IGF
How is IGT diagnosed
FPG = >6
2hr Oral Glucose Tolerance = 7.8-11
How is IGF diagnosed
FPG = 6.1 - 6.9
2hr Oral Glucose Tolerance = <7.8
What is the main function of metformin/Biguanide
Increase peripheral sensitivity to Insulin
What is HOHS
Excessive hepatic gluconeogenesis with no ketones
What re the macrovascular complications of Diabetes
MI
Stroke
PVD
What are the microvascular complications fo Diabtetes
Retinopathy
Neuropathy
Nephropathy
