Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endocrine > Type 2 Diabetes Mellitus > Flashcards

Type 2 Diabetes Mellitus Flashcards

1
Q

What is T2DM?

A

Relative insulin reduction and insulin insensitivity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can cause T2DM?

A

Genetics- very strongly linked
Obesity
Insulin insensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the blood chemistry of T2DM?

A

Hyperinsulinemia

Hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes hyperinsulinemia in T2DM?

A

Increased body mass requiring more insulin

Insulin insensitivity requiring more insulin for normal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does the insulin profile change as the disease progresses?

A

Drops as beta cells wear out.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does beta cell failure lead to?

A 
Decreased insulin secretion and effect
Decreased muscular glucose uptake
Increased lipolysis
Increased gluconeogenesis
Increased glucagon secretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does T2DM usually present?

A 
Often obese
Slow onset
Microvascular disease
Unexplained weight loss
Fatigue
Recurrent infection
Blurred vision
Foot damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you diagnose T2DM?

A

Fasting blood glucose
OGTT
Random blood glucose + symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What additional factor can be used to support T2DM diagnosis?

A

HbA1c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the ranges for fasting blood glucose?

A

<6mmol/l normal
6.1-6.9mmol/l prediabetes
>7mmol/l diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the ranges for OGTT?

A

<7.7mmol/l normal
7.8-11 mmol/l prediabetic
>11.1 mmol/l diabetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What must a random blood glucose be for diabetes to be diagnosed?

A

> 11.1 mmol/l

Plus symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the ranges for HbA1c?

A

<41 normal
42-47 prediabetic
>48 diabetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Who should be tested regularly for T2DM?

A 
BMI >25 w/1+ of:
1st degree relative affected
Black, Latino, Asian, Pacific islander
CVD
Hypertension
HDL < 35mg/dl
Polycystic ovary disease
Physical inactivity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the treatment options for diabetes?

A

Weight loss
BP control
Drugs
Insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the best treatment for diabetes?

A

Weight loss and exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What BP control drug is claimed to be the best for diabetic control?

A

ACEI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 4 mechanism by which drugs can control diabetes?

A

Increase insulin secretion
Increase insulin sensitivity
Slow glucose absorption
Enhance renal glucose excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What classes of drugs increase insulin secretion?

A

Sulfonylureas
Incretin mimics
Glinides
Gliptins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do sulfonylureas work?

A

Bind to SUR1 causing Kir6 closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Give some example of sulfonylureas

A

Tolbutamide
Glibenclamide
Gliclazide
Glipizide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are three benefits of sulfonylureas?

A

Reduce microvascular complications
Well tolerated
Oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are three negatives of sulfonylureas?

A

Can cause hypo
Weight gain- ~2kg
Urine retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do incretin mimics work?

A

Mimic GLP-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Give some examples of incretin mimics
Exenatide | Liraglutide
26
What are five benefits of incretin mimics?
``` Increase insulin secretion Suppress glucagon secretion Slow gastric emptying Decrease appetite Modest weight loss ```
27
What are three of the negatives of incretin mimics?
Nausea Pancreatitis Subcut injection
28
How do glinides work?
Similar to SUs but augmented by glycemia
29
What do glinides end in?
-glinide
30
Give three benefits of glinides?
Oral Rapid onset (1h to max, 4 to offset) Less likely to cause hypo
31
When should you not use glinides?
Severe hepatic impairment Pregnant Breast feeding
32
How do gliptins work?
Inhibit DDP-4 enzyme which breaks down incretins
33
What do gliptins end in?
-gliptin
34
Give four benefits of gliptins?
Oral Once daily Weight neutral No hypo
35
Give a negative of gliptins?
Nausea
36
How can gliptins be used?
In monotherapy | With Su or metformin
37
What classes of drug can increase insulin sensitivity?
Biguanides | Glitazones (TZD)
38
What is the only biguanide in use?
Metformin
39
What is metformin?
Biguanide
40
How does metformin work?
Reduced hepatic gluconeogenesis Increases skeletal muscle glucose uptake (similar to exercise) Reduces carb absorption Increases FA oxidation
41
Give five benefits of metformin
``` Oral Reduces microvascular complications No hypo Weight loss Good in combo ```
42
Give two negatives of metformin
GI upsets | Lactic acidosis
43
Who should you not give metformin to?
Alcoholics | Severe hepatic or renal dysfunction
44
What must you have to be given metformin?
Normal hepatic and renal function
45
How do glitazones work?
Increase insulin sensitivity by genetically increasing signalling.
46
What is the only glitazone licenced in the UK?
Pioglitazone
47
When is pioglitazone used?
In combo with metformin or SUs
48
Give three positives of pioglitazone
FA taken up into adipocytes- healthier Increased glucose uptake No hypo
49
Give four negatives of pioglitazone?
Weight gain Fluid retention Hepatotoxicity Increased bone fractures
50
What is the only drug class that inhibits glucose absorption?
Glucosidase inhibitors
51
Name a glucosidase inhibitor?
Acarbose
52
How do glucosidase inhibitors work?
Inhibit alpha glucosidase which breaks down monosaccharides thus preventing absorption
53
Give a benefit of glucosidase inhibitors
No hypo
54
Give two negatives of glucosidase inhibitors
Not very effective | GI upsets- Diarrhoea and flatulence etc
55
When should glucosidase inhibitors be used?
Only in those with poor lifestyle and drug control.
56
What is the only class of drug this increases renal excretion of glucose?
SGLT2 inhibitors
57
How do SGLT2 inhibitors work?
Inhibit the SGLT2 channel in the proximal nephron resulting in less glucose reuptake
58
What do SGLT2 inhibitors end in?
-liflozin
59
Give three positives of SGLT2 inhibitors
Lowers blood glucose Low risk of hypo Calorie loss
60
Give a negative of SGLT2 inhibitors?
Dehydration
61
What drugs are first line T2DM treatment?
Metformin | SUs in those who cannot tolerate metformin
62
What drugs are second line T2DM treatment?
SUs TZD/glitazones- If hypoglycemia is a concern Gliptins- If weight gain is a concern
63
What drugs are third line T2DM treatment?
TZD/glitazones Gliptins- If weight gain is a concern Insulin- For rising HbA1c Incretin analogues- Only if BMI >30

Endocrine (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions