Type 2 diabetes Flashcards

1
Q

What is the definition of type 2 diabetes?

A

Chronic high blood glucose levels due to insensitivity and insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How common is type 2 diabetes?

A

Very common and % rapidly rising

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the pathophysiology of type 2 diabetes?

A
  • Insulin resistance – due to free fatty acids and pro-inflammatory cytokines in plasma
  • = ↓ glucose transport into muscle cells, ↑ hepatic glucose production and ↑ breakdown of fat
  • ↓ insulin secretion by pancreatic beta cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the risk factors/aetiology of type 2 diabetes?

A
  • Older age
  • Obesity
  • Ethnicity – Asian, African
  • Family history
  • Low birth weight
  • Non-alcoholic fatty liver disease
  • Excessive alcohol
  • Previous gestational diabetes
  • Hypertension
  • Low birth weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the signs/symptoms of type 2 diabetes?

A
  • Polyuria
  • Polydipsia (excessive thirst)
  • Unexplained weight loss
  • Visual blurring/Diabetic retinopathy
  • Arterial disease
  • Polyneuropathy – tingling and numbness in the feet
  • Genital thrush
  • Erectile dysfunction
  • Lethargy
  • Venous glucose >7mmol/L when fasting or >11mmol/L when random
  • Acanthosis nigrcans – severe insulin resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What investigations are conducted when type 2 diabetes is suspected?

A
  • U&Es
  • Albumin:creatinine ratio
  • TFTs
  • Lipid profile
  • HbA1c
  • Blood glucose finger prink
  • Glucose tolerance test
  • Diabetic specific autoantibody titres/C-peptide – only if atypical features (e.g. >50), clinical suspicion of monogenic form of diabetes, classification uncertain
  • Serological testing for coeliac disease – in order to exclude
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should patients with type 2 diabetes be told about their ability to drive?

A

Do not drive and inform DVLA during hypoglycaemic spells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the surgical treatments for type 2 diabetes?

A

Bariatric surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the pharmacological treatments for type 2 diabetes?

A
  • Metformin – 1st line
  • Sulfonylruea e.g. gliclazide
  • Glitazone
  • Sulfonylurea receptor binders e.g. nateglinide
  • GLP analogues
  • DPP-4 inhibitor: sitagliptin/vilagliptin
  • Insulin
  • Exanatide
  • Orlistat – aid weight loss
  • Statin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the non pharmacological treatments for type 2 diabetes?

A
  • Foot care
  • Eating a healthy, balanced diet
  • Maintaining a healthy weight
  • Smoking cessation
  • Drinking alcohol in moderation
  • Exercising regularly
  • Checking glucose levels regularly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly