Type 2 DM

Question 1

2 pathophysiolocal processes that occur?

Answer 1

Insulin resistance

Impaired insulin secretion - lesser extent

Question 2

What is the triad making up metabolic syndrome?

Answer 2

Diabetes
HTN
Obesity (High weight circumference)

Question 3

Risk factors:

List some - 2

What usually precedes full-blown DM?

Demographic:

• Male or female
• Which ethnicity is at risk?

What gynae condition increases your risk and why?

Answer 3

Obesity
Alcohol

Pre-diabetes - impaired glucose tolerance or a fasting glucose

Male
Asian

PCOS - they become insulin resistance

Question 4

Management - Lifestyle:

What dietary changes should be made?

Why do they work?

Answer 4

Lower calories
High fibre
Low glycemic-index carbs
Increased exercise

Improves insulin sensitivity

Question 5

Management - Monitoring:

How often is the HbA1C checked?

Why do they not need finger prick for glucose?

Answer 5

3-6 months - every 6 months once stable

Only if they are on insulin or there are suspected hypos

Question 6

Management - Medical:

Above what HbA1C warrants medical Rx, especially if lifestyle changes have been ineffective?

What is the first line?

Other drugs are added if it is not controlled!!! - LOOK AT GUIDELINES

What is last Rx if drugs cannot help?

Answer 6

> 48 mmol/mol

Metformin

Insulin based therapy

Question 7

Management - Other issues:

Who must everyone on insulin contact?

What is offered to patients with a BMI>35?

Answer 7

DVLA

Bariatric surgery