Type 2 Diabetes Flashcards
what is a normal fasting glucose
< 6 mmol/L
how can we diagnose type 2 diabetes using fasting glucose
if fasting glucose > 7 mmol/L
what is impaired fasting glycaemia
fasting glucose in between 6 and 7
what is oral glucose tolerant test
2 hour test
take fasting glucose
give glucose solution
measure glucose levels again
how can we use an oral glucose tolerance test to check for diabetes
if > 11 mmol/L after OGTT
what is an impaired oral glucose test value
when blood glucose is in between 7.7 and 11 after OGTT
what is a normal blood glucose after oral glucose tolerance test
< 7.7 mmol/L
what is a normal hba1c
<42 mmol/mol
what is the hba1c range for prediabetes
between 42 and 48
how can we use hba1c to to check if a patient has type 2 diabetes
> 48 mmol/mol
what should a random glucose be if normal
below 11.1 and no symptoms
if above 11.1 with symptoms = diabetes
what is the problem in type 2 diabetes
the tissues i.e muscles, fat and liver are resistant to insulin
= relative insulin deficiency
would you typically see ketoacidosis in type 2
no unless accompanied with something else eg. sepsis,infective
or when long duration of type2dm
what is the pathophysiology of type 2 diabetes
storm between internal adiposity, pro inflammatory state and production of adipose cytokines
= makes tissue resistant
what is type 2 diabetes caused by
involved with genes, intrauterine environment and adult environment
causes insulin resistance and insulin secretion defects
fatty acids are also important in pathogenesis and complications
what does reduced action of insulin do to skeletal muscle
causes less uptake of glucose
what does reduced action of insulin do to liver
produce lots of glucose = hepatic glucose production
why does liver continue to make glucose
gluconeogenesis still takes place
not inhibited by insulin
increased glycogenolysis
what happens to adipocytes in t2dm
increased fatty acid uptake from gut
and unhealthy lipids produced which usually inhibited by insulin
what are some inflammatory adipokines produced
Tnf alpha Il6 adinopectin fatty acids apelin glucocorticoids leptin resistin visfatin endocannabinoids
what does the presentation of t2dm look like
hyperglycaemia
overweight
dyslipidaemia
complications
what are some risk factors of t2dm
age high bmi pcos family hx ethnicity inactivity
what is the first line test for diagnosis of t2dm
hba1c:
1 hba1c > 48 mmol/l with symptoms
2 x hba1c if asymptomatic
symptoms of t2dm
osmotic symptoms
polyphagia
polydispsia polyuria
