Type 2 Diabetes Flashcards
Pathophysiology of T2DM
Repeated exposure to glucose + insulin —> B cells hyperplasia/hypertrophy —> resistance
Risk factors
- modifiable
- non-modifiable
Presentation
Similar to T1DM (excluding ketogenesis symptoms)
Timing of the day to perform OGTT
Prior to breakfast
HbA1c in pre diabetics
42-47 mmol/mol
Fasting glucose in pre-diabetics
6.1-6.9 mmol/l
OGTT in pre-diabetics
7.8-11 mmol/l
HbA1C in diabetics
> 48 mmol/mol
Random glucose in diabetics
> 11 mmol/l
Fasting glucose in diabetics
> 7 mmol/l
OGTT in diabetics
> 11 mmol/l
Dietary modifications to manage T1DM
- vegetables + oily fish
- low sugar, high fibre diet
How can T2DM be curable
- right lifestyle changes
- management of side effects
HbA1C target for a new T2DM diagnosis
48 mmol/mol
HbA1C in diabetics who moved beyond metformin
53 mmol/mol
1st line medication for T2DM
Metformin
2nd line medication(s) for T2DM
- sulfonylurea
- pioglitazone
- DPP-4 inhibitor
- SGLT-2 inhibitor
2 options for 3rd line for T2DM
- Triple therapy (metformin + 2 2nd line)
- metformin + insulin
Medications used in CVD
SGLT-2 inhibitors + GLP-1 mimetics
sign at intertriginous site folds indicative of T2DM that is seen in gastric cancer
acanthosis nigricans
2 mechanisms of complications due to T2DM
- non-enzymatic glycation
- sorbitol accumulation
rare artery to be artherosclerosed that is seen in diabetes
renal efferent arteriole
How to distinguish diabetic neuropathy from other neuropathies
diabetic neuropathy better proximally & worse distally
make cards on hyperosmolality symptoms
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