Type 2 Diabetes Mellitus Flashcards
Define type 2 DM
Decrease in insulin secretion with or without insulin resistance
What are some risk factors for T2DM?
Age, Male, some ethnicities, obesity, HTN
What is MODY?
Maturity-onset diabetes of the young, a rare AD form of T2DM
How does impaired insulin action cause pathology?
Reduced glucose uptake into muscle and fat after eating leads to failure to suppress lipolysis and high circulating FFAs
In T2DM, is muscle breakdown/gluconeogenesis restrained or unrestrained?
Restrained
In T2DM, is ketone production usually excessive?
No
What are the key presentations of T2DM?
Polydipsia, polyuria, glycosuria
What random plasma glucose level is diagnostic?
Greater or equal to 11.1 mmol per L
What fasting plasma glucose level is diagnostic?
Greater or equal to 7.0 mmol per L
What test would you perform if the patient is asymptomatic?
OGTT
What HbA1c level indicates diabetes?
Greater or equal to 48 mmol per mol
What is the first line management?
Lifestyle modification
What is the first line therapy?
Metformin
What other drugs are available?
DPP4i, TZD, SU, SGLT-2i
When would you consider insulin treatment?
After triple therapy
What options for insulin are used for type 2 diabetes?
Basal initially, prandial to cover meals if necessary, pre-mixed insulin
What should be the HbA1c target?
About 53 mmol per mol for recent-onset disease
How is T2DM monitored?
With annual diabetic reviews
What are some complications of T2DM?
Hypoglycaemia, HHS, Vascular disease, Nephropathy, Diabetic retinopathy, Neuropathy
