Type 2 Diabetes

Question 1

What is type 2 diabetes?

Answer 1

• relative insulin deficiency
• insulin resistance
• progressive insulin secretory defect

Question 2

Etiology of Type 2

Answer 2

• obesity
• genetic predisposiiton
• metabolic syndrome
• race/ethnicity
• SGA infants, GDM/child

Question 3

What age is DM2 usually diagnosed?

Answer 3

> 30 years

Question 4

Are antibodies present in DM2?

Answer 4

no antibodies

Question 5

What is weight like in DM2?

Answer 5

90% are obese

Question 6

What are the lifestyle modifications recommended for DM2?

Answer 6

• exercise: improves glycemic control, insulin sensitivity

- moderate activity 150 mins/wk with resistance exercise 2-3x/wk

Question 7

What is medical nutrition therapy for DM2?

Answer 7

• weight loss
• calorie restriction
• lower CHO and fat
• exercise
• pharmacotherapy

Question 8

What medications are an option for DM2 treatment?

Answer 8

• insulin
• insulin sensitizers: metformin, TZD agents
• sulfonylureas: glipizide, glyburide
• incretins (DPP4 inhibitors and GLP1 agonists): sitagliptin, saxagliptin
• bromocriptin
• bile acid sequestrants

Question 9

Screening Guidelines for Type 2 DM

Answer 9

• identify those at risk and initiate early intervention/prevention
• best done in health care setting with follow up with diagnostic tests
• start at 45, q3 years for pts with risk factors (FPG, OGTT, HgbA1C)

Question 10

What are risk factors for type 2 DM?

Answer 10

• inactivity, extreme obesity
• primary relative with DM
• previous IGT, HTN, hyperlipidemia
• PCOS, acanthosis nigricans
• ethnicity (Native Am > Pacific Islander > Af American > Hispanic > Asian American)

Question 11

Clinical Presentation of Type 2 DM

Answer 11

• frequent infections, vaginal yeast, skin bacterial and yeast infections
• blurred vision, retinopathy
• neuropathy
• sxs of comorbidities
• glucosuria, insulin measurable/elevated
• metabolic syndrome