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Endocrine- Diabetes > Type 2 Diabetes > Flashcards

Type 2 Diabetes Flashcards

1
Q

When is type 2 diabetes diagnosed?

A

Adulthood - early (rare < 25)

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2
Q

How likely is it that a person with type 2 diabetes will have a family history?

A

Frequent, around 30%

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3
Q

Describe the duration and severity of symptoms in type 2 diabetes?

A

Long duration (months-years) of mild symptoms

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4
Q

Will patients with type 2 diabetes present with complications?

A

Yes, this is likely

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5
Q

Is weight loss a feature of type 2 diabetes?

A

No

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6
Q

Do patients with type 2 diabetes usually have ketonuria?

A

Unlikely

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7
Q

In order for the pathophysiology of T2DM to occur, what must there be?

A

Genetic susceptibility

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8
Q

What is the simple explanation of T2DM?

A

The body makes insulin but the tissues don’t respond as well to it

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9
Q

At the beginning of Type 2 diabetes, the beta cells still produce insulin. What happens to this insulin?

A

It binds to its receptor, but in response to this the GLUT4 transporter is not moved to the cell membrane so no glucose can get into the cell

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10
Q

The process of the insulin binding with its receptor, but no transporter being moved to the cell surface is known as what?

A

Insulin resistance

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11
Q

In type 2, because the cells don’t respond to insulin, what must the body do?

A

Produce more insulin, in order to have the same effect a it did before

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12
Q

How do the beta cells produce more insulin in response to insulin resistance? How long does this last?

A

Beta cell hypertrophy/hyperplasia. This manages to compensate for a while but will eventually wear out.

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13
Q

What is the phase in type 2 diabetes where the beta cells undergo hyperplasia to keep producing more insulin known as?

A

Normoglycaemia (this compensation manages to keep the BG normal)

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14
Q

What happens when the act of beta cell hyperplasia/hypertrophy wears out?

A

The beta cells undergo hypotrophy and hypoplasia until they die off

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15
Q

What happens when the beta cells die in type 2?

A

Insulin decreases, so the blood glucose starts to rise, leading to similar clinical signs as type 1

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16
Q

In type 2 diabetes, there is generally still some circulating insulin when compared with type 1. What is the significance of this?

A

DKA is not likely to occur

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17
Q

When is the process of type 2 diabetes actually classed as diabetes?

A

When the beta cells begin to fail. (insulin resistance is not diabetes)

18
Q

What are the 4 major determinants of type 2 diabetes risk?

A

Increased age, obesity, ethnicity and family history

19
Q

Type 2 diabetes are associated with what variables which make up part of metabolic syndrome?

A

Central obesity, hypertension, hypertriglyceridaemia, low HDL

20
Q

If an individual’s identical twin has type 2 diabetes, what is their chance of getting it?

A

> 50%

21
Q

If an individual’s non-identical twin has type 2 diabetes, what is their chance of getting it?

A

25%

22
Q

Is type 2 diabetes a monogenic or polygenic disease?

A

Polygenic

23
Q

Why is low birth weight a risk factor for type 2 diabetes?

A

Poor nutrition early in life is said to impair beta cell development and function, pre-disposing to diabetes later in life

24
Q

In terms of ethnicity, what populations are more at risk of type 2 diabetes?

A

Asian, African, Afro-Caribbean

25
Q

In European individuals, what BMI implies an increased risk of diabetes?

A

> 25

26
Q

In Asian individuals, what BMI implies an increased risk of diabetes?

A

> 19/20

27
Q

In terms of macrovascular complications in type 2, how is CV risk best treated?

A

Statins and anti-hypertensives

28
Q

In terms of control, what will help decrease the risk of complications of diabetes?

A

Tight glycaemic control and avoidance of hypoglycaemia

29
Q

What types of type 2 drugs are insulin secretagogues?

A

Sulphonylureas, DDP-IV inhibitors and GLP-1 agonists

30
Q

What is the normal first line drug?

A

Metformin

31
Q

When should a sulphonylurea be used as the first line drug?

A

In underweight type 2’s or those intolerant of metformin

32
Q

What is the normal second line drug, in addition to metformin?

A

Sulphonylurea

33
Q

If there is a type 2 diabetic who is on metformin and requiring a second line drug but they are overweight and have a high CV risk, what could be used?

A

SGLT2 inhibitor

34
Q

When should a thiozolinedione be used second line?

A

If hypoglycaemia is a concern, and there is no heart failure

35
Q

When should a DDP-IV inhibitor be used second line?

A

If weight gain is a concern

36
Q

What is the normal 3rd line drug?

A

Thiazolinediones

37
Q

When should a DDP-IV inhibitor be used 3rd line?

A

If weight gain is a concern

38
Q

When should a GLP-1 agonist be used 3rd line?

A

If BMI > 30

39
Q

If there are osmotic symptoms and a rapidly rising HbA1c, what should be used as 3rd line treatment?

A

Insulin

40
Q

What forms the foundation of type 2 diabetes treatment?

A

Diet, exercise and education

Endocrine- Diabetes (11 decks)

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