Type 2 Diabetes

Question 1

What is Type 2 Diabetes?

Answer 1

condition with insulin resistance and beta cells which cannot produce enough insulin to keep blood glucose normal

Question 2

How are the islets characterised in T2DM?

Answer 2

• A deficit in β-cells
• Increased β-cell apoptosis,
• Extracellular amyloid deposits derived from IAPP- Islet amylin polypeptide Polymers

Question 3

Aetiology of T2DM

Answer 3

Decrease in beta cell mass
Polygenic

Epigenetics (Maternal hyperglycaemia and intrauterine growth retardation)

Question 4

Diabetes and Retinopathy

Answer 4

Maculopathy

Cataracts- increased generation of Polyols from glucose

Question 5

Major consequences of T2DM

Answer 5

• Hyperglycaemia per se - Dysregulation of Lipid metabolism
• High levels of Proinflamatory cytokines
• High levels of Free radicals
• Increased susceptibility to Infection

Question 6

Other aetiological causes of T2 DM

Answer 6

Gut bacterial change

SOX-5 gene mutation- beta cell regression

autoimmune

old age

decreased incretin action (reduced GLP-1, GIP)

Abnormal glucagon action

glucotoxicity and lipotoxicity

Question 7

HbA1c

Answer 7

=glycated haemoglobin

Diabetes if HbA1c> 48 mmol/mol or 6.5%

Question 8

Describe the 75g GTT

Answer 8

Method of diagnosing T2DM

1. Fasted period
   - Diagnose if blood glucose >7mmol/L
   - Impaired Fasting Glucose 6 – 6.9 mmol/l
2. Injection of 75g, 2hrs wait
   - DM if blood blood glucose > 11.1 mmol/l
   - Impaired Glucose Tolerance 7 -11 mmol/l

Question 9

Dyslipidaemia in T2DM

Answer 9

High levels of LDL, chylomicrons, VLDL+ their catabolic remnants

• Proinflammatory
• Increases atherosclerotic formation

Leads to vascular pathologies- CHD

Question 10

What is the pathophysiology behind the increased morbidity associated with T2DM?

Answer 10

• Hyperglycaemia per se
• Dysregulation of Lipid metabolism
• High levels of Proinflamatory cytokines
• High levels of Free radicals
• Increased susceptibility to Infection

Question 11

What is Cheiroarthropathy

Answer 11

characterized by thickened skin
limited joint mobility of the hands and fingers, leading to flexion contractures,
a condition associated with diabetes mellitus and it is observed in roughly 30% of diabetic patients

due to glycolysation of CT

Question 12

What is bone like in pts with T2DM

Answer 12

Normal bone density but mechanically weaker bone