Type 2 Diabetes

Question 1

main 2 pathological processes in T2D?

Answer 1

insulin resistance

relative insulin deficiency

Question 2

what BGL is diagnostic of T2DM?

Answer 2

> 11.1

Question 3

what dose of metformin should you give intiially then what should you move on to?

Answer 3

500mg bd THEN

1g bd

Question 4

what change do beta cells go under before dying off?

Answer 4

hyperplasia

Question 5

what effect does hyperglycaemia have on incretins?

Answer 5

decreased effect

Question 6

what effect does hyperglycaemia have on neurotransmitters?

Answer 6

lose function

Question 7

is glucose reabsorbed more or less in hyperglycaemia?

Answer 7

more

Question 8

is glucose uptake increased or decreased in hyperglycaemia?

Answer 8

decreased

Question 9

is lipolysis increased or decreased in hyperglycaemia?

Answer 9

increased

Question 10

how can you tell via test if beta cells are no longer working?

Answer 10

if there is no C peptide

Question 11

what is the systemic effect of chronic hyperglycaemia?

Answer 11

microvascular disease

Question 12

main association with macrovascular disease in diabetes?

Answer 12

insulin resistance

Question 13

what drugs can be used as prophylaxis for CVD risk from diabetes?

Answer 13

statins

anti-hypertensives

Question 14

what drug management should be given to a new presentation of T2DM?

Answer 14

metformin 500mg bd
statin
ACEI/Ca blocker

Question 15

how often should you review TRDM?

Answer 15

6 months

Question 16

non-pharmacological management plan for a new T2DM?

Answer 16

weight target (5-10% reduction)
exercise target
diet/lifestyle advice

Question 17

what does metformin do to the body?

Answer 17

decreases hepatic gluconeogenesis

increases peripheral glucose uptake

Question 18

metformin decreases HbA1C by how much?

Answer 18

0.8-2%

Question 19

adverse effects of metformin?

Answer 19

GI problems

lactic acidosis

Question 20

lowset dose of gliclazide available?

Answer 20

60mg

Question 21

what characteristics make you less likely to meet glycaemic targets?

Answer 21

younger
female
obese
on many drugs
not at bp/lipid target

Question 22

what should you give if the patient is getting hypo when on SUR?

Answer 22

change to TZD

Question 23

what should you do if thr patient is gaining weight on a TZD?

Answer 23

DPP4 inhibitors

Question 24

potential side effects of DPP4 inhibitors?

Answer 24

osmotic symptoms

rising HbA1C

Question 25

what should you give after a DPP4 inhibitor?

Answer 25

insulin

Question 26

last line treatment for T2D?

Answer 26

GLP-1 inhibitor

Question 27

do SURs increase 1st, 2nd or both phases of insulin secretion?

Answer 27

both

Question 28

maximum gliclazide dose you can give?

Answer 28

120mg

Question 29

what do SGLT2 receptors do?

Answer 29

reabsorb glucose

Question 30

what drug class increases peripheral glucose uptake?

Answer 30

TZDs

Question 31

what drug class increases fracture risk?

Answer 31

TZDs

Question 32

what drug classes are better for high BMI patients?

Answer 32

insulin sensitisers eg MF, SGLT-2, DPP-4i, TZDs

Question 33

what shoudl you give if the patient gets NAFLD?

Answer 33

TZD