Type 2 Diabetes Mellitus Flashcards
what is the pathophysiology of type 2 diabetes?
combination of insulin resistance and beta-cell failure, resulting in hyperglycemia and associated with obesity
what is the initial treatment for someone with type 2 diabetes?
lifestyle changes and weight loss
can type 2 diabetes be reversible?
yes
what level of fasting glucose is normal?
less than or equal to 6mmol/L
what level of fasting glucose classes as impaired fasting glycaemia (intermediate state) ?
from 6 to 6.9 mmol/L
what level of fasting glucose classes as type 2 diabetes?
greater than or equal to 7 mmol/L
2 hour glucose in the OGTT at which values is considered normal?
<7.7mmol/L
2 hour glucose in the OGTT at which values is considered impaired glucose tolerance (an intermediate state) ?
7.7-10.9mmol/L
2 hour glucose in the OGTT at which values is considered diabetic?
greater than or equal to 11
hbA1c at which values is considered
- normal
- pre-diabetes (intermediate state)
- diabetes
- <42mmol/mol
- 42-47.9mmol/mol
- greater than or equal to 48mmol/mol
how do insulin resistance and insulin production change going from normal to intermediate state to diabetic state?
Normal -> intermediate: insulin resistance increases and insulin production increases to compensate
Intermediate -> diabetic: insulin production decreases and insulin resistance plateaus.
when can we use random glucose to diagnose diabetes type 2?
when someone also has symptoms of diabetes
why do people with type 2 diabetes not tend to get ketosis?
enough insulin is present in circulation to inhibit/suppress lipolysis and fatty acid beta-oxidation
why do people with long-duration type 2 diabetes sometimes get ketoacidosis?
because all their beta cell function has been lost
In healthy people, what is the relationship between insulin secretion and insulin sensitivity?
as insulin sensitivity decreases, insulin production increases
In type 2 diabetes, what happens in the liver, adipocytes and muscle?
Liver: produces excess glucose (insulin usually causes glucose to convert to glycogen whereas lack of insulin converts glycogen to glucose)
Muscle: no uptake of glucose from blood by GLUT transporter
Adipocytes: No uptake of glucose into adipocytes and number of triglycerides in the blood rising (because insulin encourages the conversion of triglycerides to NEFA)
adipocytes produce adipokines, what are these?
inflammatory chemicals which contribute to development of type 2 diabetes
MODY stands for what and what is it caused by?
Maturity Onset Diabetes in the Young and it is caused by a single gene mutation
Diabetes mellitus types 1 and 2 have what type of genetic inheritability?
polygenic
where is the part of the body that poses the highest risk for type 2 diabetes when it has more body fat?
visceral obesity > subcutaneous obesity
what is the presentation of type 2 diabetes mellitus?
hyperglycaemia overweight dyslipidaemia fewer osmotic symptoms complications insulin resistance later insulin deficiency
What are the risk factors for T2DM?
age BMI ethnicity PCOS family history inactivity
first line test for diagnosis of type 2 diabetes mellitus?
HbA1c
what is the key management for hyperosmolar hyperglycaemic state in people with type 2 diabetes?
rehydration with IV fluids
