Type 2 Diabetes

Question 1

what is type 2 diabetes?

Answer 1

when there is a relative insulin insufficiency. So, insulin is secreted but not enough to overcome the insulin resistance

Question 2

how do we diagnose type 2 diabetes?

Answer 2

1. Hyperosmolar Hyperglycaemia State (HHS)
2. HbA1c
3. Fasting glucose

Question 3

what education courses are available for type 2 diabetes?

Answer 3

DESMOND and XPERT courses

Question 4

what are the 3 treatment targets of type 2 diabetes?

Answer 4

• Lipids
• Blood Pressure
• Blood Glucose

Question 5

when HbA1c is less than 9%, what therapy is used?

Answer 5

consider monotherapy

Question 6

when HbA1c is greater than or equal to 9%, what therapy is used?

Answer 6

consider dual therapy

Question 7

when HbA1c is greater than or equal to 10% and blood glucose is greater than or equal to 300mg/dL what therapy is used?

Answer 7

Combined injectable therapy

Question 8

what is included in monotherapy?

Answer 8

Lifestyle management and metformin

Question 9

what is included in dual therapy?

Answer 9

Lifestyle management, metformin and an additional agent

Question 10

what is included in triple therapy?

Answer 10

Lifestyle management, metformin and 2 additional agents

Question 11

what is included in combination with injectable therapy?

Answer 11

1. Basal insulin + 1 rapid acting insulin injection before largest meal
2. Basal insulin + GLP-1 inhibitor
3. Premixed insulin twice daily before breakfast and evening meal

Question 12

give an example of a biguanide?

Answer 12

metformin

Question 13

give an example of a Thiazolidinediones?

Answer 13

pioglitazone

Question 14

give an example of an alpha-glucosidase inhibitor?

Answer 14

acarbose

Question 15

what do DPP4 inhibitors end in?

Answer 15

‘liptin’ e.g. sitagliptin

Question 16

what do SGLT2 inhibitors end in?

Answer 16

“liflozin” e.g. empagliflozin

Question 17

what do GLP1 agonists end in?

Answer 17

“tide” e.g. lixisenatide

Question 18

what do sulphonylureas end it?

Answer 18

“ide” e.g. gliclazide

Question 19

give examples of meglitinides?

Answer 19

Nateglinide, repaglinide

Question 20

what are side effects of metformin?

Answer 20

GI symptoms e.g. diarrhoea and nausea and vomiting

Question 21

what is the expected HbA1c drop for metformin?

Answer 21

1-2%

Question 22

what is the expected HbA1c drop for Thiazolidinediones?

Answer 22

0.5-1.4%

Question 23

what are side effects of Thiazolidinediones?

Answer 23

1. weight gain
2. oedema
3. anaemia
4. GI disturbances,
5. headache,
6. dizziness
7. visual disturbance.

Question 24

what are side effects of sulfonylureas?

Answer 24

1. hypoglycaemia
2. GI disturbance
3. weight gain
4. rashes
5. liver function derangement

Question 25

what is the expected HbA1c drop for sulfonylureas?

Answer 25

1-2%

Question 26

what are side effects of Meglitinides?

Answer 26

gastrointestinal, hypoglycaemia.

Question 27

what are side effects of DPP4 Inhibitors?

Answer 27

1. GI disturbance
2. headache
3. nasopharyngitis
4. rash

Question 28

what is the expected HbA1c drop for DPP4 inhibitors?

Answer 28

0.8%

Question 29

what is the expected HbA1c drop for SGLT2?

Answer 29

1-1.5%

Question 30

what are side effects of SGLT2?

Answer 30

1. Dyslipidaemia
2. UTI
3. thrush
4. raised
5. haematocrit
6. nausea
7. constipation
   Others of note: euglycaemic ketoacidosis, lower limb amputation and bone fractures

Question 31

what are side effects of GLP1?

Answer 31

1. GI disturbances (N+V, indigestion, reflux etc.)
2. Hypoglycaemia if used
   with sulphonylureas.

Question 32

what is the expected HbA1c drop for GLP1?

Answer 32

0.5-1.0%