Type 2 Diabetes

Question 1

What is the typical history associated with type 2 diabetes?

Answer 1

Polyuria, polydipsia, polyphagia. Fatigue, blurred vision. Obesity, sedentary lifestyle. Family history of diabetes.

Question 2

What are the key physical examination findings in type 2 diabetes?

Answer 2

Often asymptomatic in early stages. Obesity, particularly central. Acanthosis nigricans. Hypertension.

Question 3

What investigations are necessary for diagnosing type 2 diabetes?

Answer 3

Fasting blood glucose ?126 mg/dL. HbA1c ?6.5%. Random blood glucose ?200 mg/dL with symptoms. Oral glucose tolerance test (OGTT) ?200 mg/dL.

Question 4

What are the non-pharmacological management strategies for type 2 diabetes?

Answer 4

Lifestyle modifications: diet, exercise, weight loss. Patient education on blood glucose monitoring. Regular physical activity.

Question 5

What are the pharmacological management options for type 2 diabetes?

Answer 5

Metformin as first-line therapy. Other oral agents: sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors. Insulin therapy in advanced cases.

Question 6

What are the red flags to look for in type 2 diabetes patients?

Answer 6

Severe hyperglycemia with symptoms. Signs of hyperosmolar hyperglycemic state (HHS): extreme thirst, confusion, coma. Persistent hypoglycemia or hyperglycemia despite treatment.

Question 7

When should a patient with type 2 diabetes be referred to a specialist?

Answer 7

Poor glycemic control despite treatment. Complications: retinopathy, nephropathy, neuropathy. Need for insulin initiation or adjustment. Obesity management support.

Question 8

What is one key piece of pathophysiology related to type 2 diabetes?

Answer 8

Insulin resistance and relative insulin deficiency. Associated with obesity, sedentary lifestyle, genetic factors. Progressive beta cell dysfunction.