Type 2 DM Flashcards
risk factors for T2DM
- over 40
- first degree relative
- high risk pop
- imparied glucose
- complications assoc. with DM
- vascular disease
- overweight
what is reccomended screening
- annually in high risk
- /3years in over 40
what is prediabetes
impaired glucose tolerance/impaired fasting glucose
- risk of pregression to DM
- alsocassociated with CVD on it’s own
what are 2 treatments for prediabetes
- lifestyle - 60% RRR – implement this!
2. metformin - 30% RRR
5 complications of DM (2 cats)
Microvascular 1. retinopathy 2. neuropathy 3. nephropathy Macro 4. MI 5. stroke
3 main defects in T2
- pancreas - insulin def.
- liver - excess glucose output
- muscle and fat - insulin resistance
** 3 treatment priorities
- aim for excellent glycemic control
- address CV risk factors
- screen and test for complicaitons
where should blood sugars be at
HbA1C -
what happens as A1C rises
retinopathy increases
how to match meds to patho
- pancreas - insulin def. : insulin, sulfonourea
- liver - excess glucose output : metformin
- muscle and fat - insulin resistance : metformin, incretins, lifestyle
4: gut - alpha- glucosidase inhib
2 actions of metformin
increases glusose sens.
- reduces glucise from liver
- increases glucose uptake in tissues
what is effect and SE of sulfonoureas
- more insulin out
SE - causes weight gain
what are incretins
GLP-1 - gut hormone released due to glucose in gut
- new drug target
- insulin better with food
what does does incretin do
stop degradation of GLP-1 in body
what is MOA of sodium glucose co-trnaporter
causes excretion of glucose in the nephron so pee out glucose
** 2 vascular protection measures
- BP target of 130/80 (ACE/ARBs)
2. lipid lowering (statins)
who needs statins
nearly everyone >40 or micro disease or macro or DM over 15years
what is leading cause of kidney failure in canada
chronic kidney disease of DM
what is screening for kidney disease
- urine albumin/creatinine ratio
2.
** why screen for nephropathy
- progression can be slowed w/ glucose control, BP and ACE ARB
- those with microalbumenuria should get ACE/ARB even without hypertnesion
3 phases of diabetic retinopathy
- macular edema
- non-proliferative retinopathy
- proliferative retinopathy
why screen for retinopathy
there is good treatment
- lasers
4 types of diabetic neuropathy
- symmetric peripheral neuropathy - gloves
- autonomic - GI, CV, bladder
- mononeuropathy - cranial N, peripheral ne
- polyradiculopathy