Type 2 Diabetes Mellitus

Question 1

Define type 2 DM

Answer 1

Decrease in insulin secretion with or without insulin resistance

Question 2

What are some risk factors for T2DM?

Answer 2

Age, Male, some ethnicities, obesity, HTN

Question 3

What is MODY?

Answer 3

Maturity-onset diabetes of the young, a rare AD form of T2DM

Question 4

How does impaired insulin action cause pathology?

Answer 4

Reduced glucose uptake into muscle and fat after eating leads to failure to suppress lipolysis and high circulating FFAs

Question 5

In T2DM, is muscle breakdown/gluconeogenesis restrained or unrestrained?

Answer 5

Restrained

Question 6

In T2DM, is ketone production usually excessive?

Answer 6

No

Question 7

What are the key presentations of T2DM?

Answer 7

Polydipsia, polyuria, glycosuria

Question 8

What random plasma glucose level is diagnostic?

Answer 8

Greater or equal to 11.1 mmol per L

Question 9

What fasting plasma glucose level is diagnostic?

Answer 9

Greater or equal to 7.0 mmol per L

Question 10

What test would you perform if the patient is asymptomatic?

Answer 10

OGTT

Question 11

What HbA1c level indicates diabetes?

Answer 11

Greater or equal to 48 mmol per mol

Question 12

What is the first line management?

Answer 12

Lifestyle modification

Question 13

What is the first line therapy?

Answer 13

Metformin

Question 14

What other drugs are available?

Answer 14

DPP4i, TZD, SU, SGLT-2i

Question 15

When would you consider insulin treatment?

Answer 15

After triple therapy

Question 16

What options for insulin are used for type 2 diabetes?

Answer 16

Basal initially, prandial to cover meals if necessary, pre-mixed insulin

Question 17

What should be the HbA1c target?

Answer 17

About 53 mmol per mol for recent-onset disease

Question 18

How is T2DM monitored?

Answer 18

With annual diabetic reviews

Question 19

What are some complications of T2DM?

Answer 19

Hypoglycaemia, HHS, Vascular disease, Nephropathy, Diabetic retinopathy, Neuropathy