Type 2 diabetes Flashcards
What is type 2 diabetes?
A condition where a combination of insulin resistance and reduced insulin production cause persistently high blood sugar levels.
What causes insulin resistance in type 2 diabetes?
Repeated exposure to glucose and insulin makes the cells resistant to insulin’s effects, requiring more insulin to use glucose.
What happens to the pancreas in type 2 diabetes over time?
The pancreas becomes fatigued from overproducing insulin and its output decreases.
What complications can arise from chronic hyperglycaemia in type 2 diabetes?
Microvascular, macrovascular, and infectious complications, similar to type 1 diabetes.
What are non-modifiable risk factors for type 2 diabetes?
Older age, ethnicity (Black African/Caribbean, South Asian), and family history.
What are modifiable risk factors for type 2 diabetes?
Obesity, sedentary lifestyle, and a high carbohydrate (particularly sugar) diet.
What are common presenting features of type 2 diabetes?
Tiredness, polyuria, polydipsia, unintentional weight loss, infections, slow wound healing, glucose in urine.
What is acanthosis nigricans?
A condition characterized by thickened, darkened skin, often in the neck, axilla, and groin, associated with insulin resistance.
What is pre-diabetes?
A stage where glucose levels are higher than normal but not yet diagnostic of diabetes, indicating a risk of developing type 2 diabetes.
What HbA1c value indicates pre-diabetes?
An HbA1c of 42-47 mmol/mol.
What HbA1c level indicates type 2 diabetes?
An HbA1c of 48 mmol/mol or above.
What are the main components of managing type 2 diabetes according to NICE guidelines?
Structured education, a low-glycaemic-index diet, exercise, weight loss, antidiabetic drugs, monitoring complications.
What is the HbA1c treatment target for newly diagnosed type 2 diabetics?
48 mmol/mol.
What is the first-line drug for managing type 2 diabetes?
Metformin.
What is metformin’s action in type 2 diabetes?
It increases insulin sensitivity and decreases glucose production by the liver.
What are common side effects of metformin?
Gastrointestinal symptoms (pain, nausea, diarrhea), and lactic acidosis (especially with kidney issues).
What are SGLT-2 inhibitors used for in type 2 diabetes?
They block glucose reabsorption in the kidneys, leading to glucose excretion in urine, reducing HbA1c, blood pressure, and weight.
What is a major side effect of SGLT-2 inhibitors?
Increased risk of urinary tract infections, genital thrush, and diabetic ketoacidosis.
What is the action of pioglitazone in type 2 diabetes?
It increases insulin sensitivity and decreases liver glucose production.
What are common side effects of pioglitazone?
Weight gain, heart failure, increased risk of bone fractures, and bladder cancer.
What is the main action of sulfonylureas like gliclazide?
They stimulate insulin release from the pancreas.
What are common side effects of sulfonylureas?
Weight gain and hypoglycaemia.
What are the two types of insulin used in type 2 diabetes?
Rapid-acting insulin (e.g., NovoRapid) and long-acting insulin (e.g., Lantus).
What is the hyperosmolar hyperglycemic state (HHS)?
A rare but potentially fatal complication of type 2 diabetes, characterized by hyperosmolality, hyperglycaemia, and no ketones.
How is hyperosmolar hyperglycemic state (HHS) treated?
It is treated with IV fluids and careful monitoring.
What are common complications of type 2 diabetes?
Infections, diabetic retinopathy, neuropathies, chronic kidney disease, diabetic foot, gastroparesis, hyperosmolar hyperglycaemic state.
How are diabetic complications like hypertension managed in type 2 diabetes?
ACE inhibitors are used first-line to manage hypertension, especially in chronic kidney disease.
What is used for neuropathic pain in type 2 diabetes?
Medications like amitriptyline, duloxetine, gabapentin, and pregabalin.
What are prokinetic drugs used for in type 2 diabetes?
They are used to manage gastroparesis, though they should be used cautiously due to cardiac side effects.
What medications are used for erectile dysfunction in type 2 diabetes?
Phosphodiesterase-5 inhibitors, such as sildenafil or tadalafil.
