type 2 diabetes

Question 1

define type 2 diabetes?

Answer 1

characterised by increased peripheral resistance to insulin action, impaired insulin secretion and increased hepatic glucose output

Question 2

what are the risk factors of T2DM?

Answer 2

• can be monogenic
• increased risk with obesity
• can be secondary to other conditions eg. pancreatic, endocrine, drugs

Question 3

what is the epidemiology of T2DM?

Answer 3

• UK prevalence is 5-10%

- asian, african and hispanic people at a greater risk.

Question 4

presenting symptoms of T2DM?

Answer 4

• polyuria
• polydipsia
• tiredness
• HSS
• many infections
• tingling in fingers

Question 5

what are the signs of T2DM on physical examination?

Answer 5

• diabetic foot
• skin changes
• check BP
• calculate BMI =

Question 6

what skin changes can T2DM present with?

Answer 6

• Necrobiosis lipoidica diabeticorum
• Granuloma annulare
• Diabetic dermopathy

Question 7

what are the methods of assessing glucose?

Answer 7

• finger prick test
• one off blood glucose
• HbA1c
• glucose tolerance test

Question 8

how can T2DM be diagnosed?

Answer 8

• Symptoms of diabetes and a random plasma glucose > 11.1 mmol/L
• Fasting plasma glucose > 7 mmol/L
• Two-hour plasma glucose > 11.1 mmol/L after glucose tolerance test

Question 9

management for T2DM?

Answer 9

• metformin
• metformin + one other drug
• metformin + 2 drugs
  assess based on HbA1c

Question 10

when should the dose be increased? HbA1c?

Answer 10

when HbA1c reached 58mmol/mol (7.5%)

Question 11

what complications must be screened for?

Answer 11

• retinopathy
• nephropathy
• vascular disease
• diabetic foot
• CVD
• HHS

Question 12

what are the complications of T2DM?

Answer 12

• HHS
• Neuropathy
• nephropathy
• retinopathy
• macrovascular

Question 13

what is pre diabetes?

Answer 13

• Impaired Fasting Glucose = 5.6-6.9 mmol/L
• Impaired Glucose Tolerance = 7.8-11.0 mmol/L
• increased risk of developing type 2 diabetes