Type 2 diabetes Flashcards
What are the two key physiological changes in type 2 diabetes?
Insulin resistance
Beta cell dysfunction
Explain the concept of insulin resistance
The insulin receptor is not responsive to insulin resulting in a build up of glucose in the blood
What is beta cell dysfunction?
Reduced ability of beta cells to secrete insulin in response to hyperglycaemia
How does insulin production change over the course of type 2 diabetes?
Initially beta-cells compensate for inceasing insulin resistance.
eventually beta cells cannot keep up anymore and insulin production fails
What level will beta cell function be at in a newly diagnosed type 2 diabetic?
Beta-cell dysfunction is already significantly reduced at time of diagnosis
50% of beta cell function
Is beta-cell dysfunction reversible?
Yes but only with extreme low calorie diet
What are the steps in the type 2 diabetes therapy staircase?
Diet and excercise
Oral monotherapy
Oral combination
Injectable and oral therapy
What do diabetic patients get neuropathy?
Microvascular disease leading to poor blood supply to peripheral nerves
What are the four types of neuropathy?
Peripheral
Autonomic
Proximal
Focal Neuropathy
What are the symptoms of peripheral neuropathy?
Pain/loss of feeling in hands and feet
What are the symptoms of autonomic neuropathy?
Changes in bowel, bladder function, sexual response, sweating , heart rate, blood pressure
What are the symptoms of proximal neuropathy?
Pain in the thighs, hips or buttocks leading to weakness in the legs
What oral drugs can be used for painful neuropathy?
Amitriptyline
Duloxetine
Gabapentin
Pregabalin
What drug can you use in painful neuropathy if the patient cannot tolerate oral medication?
Capsaicin cream
What does gastroparesis mean?
Slow stomach emptying
