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Endocrinology > Type 2 Diabetes > Flashcards

Type 2 Diabetes Flashcards

To learn about T2DM

1
Q

What is T2DM?

A

A chronic metabolic condition characterised by insulin resistance resulting in high blood glucose levels

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2
Q

What are the features of T2DM?

A
  1. Obesity, physical inactivity, raised blood pressure, disturbed blood lipid levels
  2. Tendency to develop thrombosis inc CV risk
  3. Long term micro and macrovascular changes
  4. Reduced life expectancy
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3
Q

What are the characteristics of T1DM?

A
  1. Onset after 40 years old
  2. 58% concordance in iden twins
  3. No islet cell antibodies
  4. Insulin resistance
  5. Glucagon secretion increased
  6. Patient not prone to ketoacidosis
  7. No association with autoimmune disease
  8. Common in African, Afro-caribbean, Asian
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4
Q

What are the environmental factors that affect T2DM?

A
  1. Western diet, lack of exercise, obesity hypertension
  2. Migrant pops exposed to western diet
  3. Correlation between BMI and incidence
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5
Q

What is the pathogenesis of T2DM?

A
  1. Decreased insulin secretion
  2. Increased insulin resistance
  3. Beta cell mass is reduced by half
  4. Presence of amyloid polypeptide in proportion of patients
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6
Q

What are the features of HONK: hyperglycaemic hypperosmolar nonketotic coma?

A

Patients will have (and may be old):

  1. hyperglycemia
  2. Dehydration with thirst
  3. Marked drowsiness
  4. Convulsions
  5. Coma
  6. Focal CNS signs
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7
Q

If lifestyle changes aren’t enough what are the treatment options?

A

Meformin:

  1. Patients who are overweight
  2. 1st line or in combination with patients who are not overweight
  3. If serum creatinine xceeds 130 and eGFR below 45 dose should be reviewed
  4. Stop metformin if creatinine exceeds 150 and eGFR is below 30
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8
Q

What is the mode of action of Metformin?

A
  1. Increases insulin sensitivity

2. Decreases hepatic gluconeogenesis

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9
Q

How is metformin taken?

A

Orally

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10
Q

What are the main side effects of Metformin?

A
  1. GI upset

2. Lactic acidosis

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11
Q

What is the first line medication in T2DM?

A
  1. Metformin

2. Cannot be used in patients with eGFR <30ml/min

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12
Q

What is the mode of action Sulfonylureas?

A

Stimulate pancreatic beta cells to secrete insulin

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13
Q

How is sulphonylureas taken?

A

Orally

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14
Q

What are the side effects of sulphonylureas

A
  1. Hypoglycemia
  2. Weight gain
  3. Hyponatraemia
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15
Q

What are examples of sulphonylureas

A
  1. Glicazide

2. Glimaperide

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16
Q

How do the Thiaziolidinediones work?

A

Activate PPAR-gamma receptor in adipocytes to promote adipogenesis and fatty acid uptake

17
Q

How are thiazolidinediones taken?

A

Orally

18
Q

What are the side effects of thiazolidinediones?

A
  1. Weight gain

2. Fluid retention

19
Q

What is the only example of a thiazolidinedione?

A

Pioglitazone

20
Q

How do DPP-4(gliptins) inhibitors work?

A

Increase incretin levels which inhibit glucagon secretion

21
Q

How are DPP-4 inhibitors taken?

A

Orally

22
Q

What are the side effects of DPP-4 inhibitors?

A
  1. Well tolerated but increase the risk of pancreatitis
23
Q

What is the mode of action of SGLT-2 inhibitors (gliflozins)?

A

Inhibit reabsorption of glucose in the kidney in the kidney

24
Q

How are SGLT-2 inhibitors taken?

A

Orally

25
Q

What are the side effects of SGLT-2 inhibitors (gliflozins)?

A
  1. Urinary tract infection

2. Weight loss

26
Q

What is the mode of action of GLP-1 agonists (tides)

A

Incretin mimetic which inhibits glucagon secretion

27
Q

How are GLP-1 agonists (tides) given?

A

Subcutaneous

28
Q

What are the side effects of GLP-1 agonists?

A

Nausea, vomiting and pancreatitis. Also weight loss.

Endocrinology (13 decks)

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