Type 2 diabetets Flashcards

1
Q

what is type 2 diabetes?

A

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

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2
Q

how do we diagnose type 2 diabetes?

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

what education courses are available for type 2 diabetes?

A

DESMOND and XPERT courses

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4
Q

what are the 3 treatment targets of type 2 diabetes?

A
  • Lipids
  • Blood Pressure

• Blood Glucose

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5
Q

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

A

consider monotherapy

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6
Q

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

A

consider dual therapy

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7
Q

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

A

Combined injectable therapy

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8
Q

what is included in monotherapy?

A

Lifestyle management and metformin

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9
Q

what is included in dual therapy?

A

Lifestyle management, metformin and an additional agent

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10
Q

what is included in triple therapy?

A

Lifestyle management, metformin and 2 additional agents

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11
Q

what is included in combination with injectable therapy?

A
  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
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12
Q

give an example of a biguanide?

A

metformin

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13
Q

give an example of a Thiazolidinediones?

A

pioglitazone

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14
Q

give an example of an alpha-glucosidase inhibitor?

A

acarbose

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15
Q

what do DPP4 inhibitors end in?

A

‘liptin’ e.g. sitagliptin

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16
Q

what do SGLT2 inhibitors end in?

A

“liflozin” e.g. dapagliflozin

17
Q

what do GLP1 agonists end in?

A

“tide” e.g. lixisenatide

18
Q

what do sulphonylureas end it?

A

“ide” e.g. gliclazide

19
Q

give examples of meglitinides?

A

Nateglinide, repaglinide

20
Q

what are side effects of metformin?

A

GI symptoms e.g. diarrhoea and nausea and vomiting

21
Q

what is the expected HbA1c drop for metformin?

22
Q

what is the expected HbA1c drop for Thiazolidinediones?

23
Q

what are side effects of Thiazolidinediones?

A
  1. weight gain
  2. oedema
  3. anaemia
  4. GI disturbances,
  5. headache,
  6. dizziness
  7. visual disturbance.
24
Q

what are side effects of sulfonylureas?

A
  1. hypoglycaemia
  2. GI disturbance
  3. weight gain
  4. rashes
  5. liver function derangement
25
what is the expected HbA1c drop for sulfonylureas?
1-2%
26
what are side effects of Meglitinides?
gastrointestinal, hypoglycaemia.
27
what are side effects of DPP4 Inhibitors?
1. GI disturbance 2. headache 3. nasopharyngitis 4. rash
28
what is the expected HbA1c drop for DPP4 inhibitors?
0.8%
29
what is the expected HbA1c drop for SGLT2?
1-1.5%
30
what are side effects of SGLT2?
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
31
what are side effects of GLP1?
1. GI disturbances (N+V, indigestion, reflux etc.) 2. Hypoglycaemia if used with sulphonylureas.
32
what is the expected HbA1c drop for GLP1?
0.5-1%