Fichas
Diabetes - Type 2
Fichas del conjunto (20)
- 1List FOUR non-modifiable factors that may contribute to the onset of type 2 diabetes mellitusAge.
•Ethnicity.
•History of polycystic ovary disease.
•Family history (parents or sibling).
•Gestational diabetes.
•Large birthweight baby. - 2Describe the mechanism of action of the incretinsIncretins are peptide hormones.
Produced by endocrine cells in epithelium of small intestines in response to meals.
Stimulate beta cells to release more insulin in response to same glucose load. - 3List FOUR modifiable factors that may contribute to the onset of type 2 diabetes mellitusOverweight or obese - BMI > 25 kg/m2
Lack of physical activity
Hypertension or dyslipidaemia
Pre-diabetes - 4Describe the MOA of first-line hypoglycaemic agent for Type 2 Diabetes?Metformin - Biguanide Oral Hypoglycaemic Agent especially for patients with >25-BMI.
Stimulation of the AMPK enzyme involved in insulin signalling and hepatic glucose production. - 5What is the dose for Metformin?500 mg OD with food for 2 weeks, then 500 mg BD for 2 weeks and then 500 mg TDS with food; max 2g/day.
- 6What are the Side Effects for Metformin?Anorexia, GIT, reduced vitamin B12 absorption. (No Hypos).
- 7What are the Cautions and Contraindications of Metformin?Cautions: Renal impairment.
CI: Ketoacidosis - 8What is the first OHA if the patient is not overweight (<25 BMI)? Example?Sulphonylureas; Gliclazide.
Insulin secretagogues, require functioning B-cells. - 9What is the MOA (Mode of Action) of Sulphonylureas?Stimulate the pancreas to release insulin. Bind to SUR on K-ATP channels on cell membrane of pancreatic B-cells. Block K-ATP channels, this depolarises B-cells activating voltage sensitive Ca2+ channels which leads to influx of Ca2+ and insulin secretion. Insulin enters the portal circulation, where it inhibits hepatic glucose production.
- 10What are the side effects and caution of Sulphonylureas?Dose related hypoglycaemia most common side effect.
Appetite stimulate - weight gain.
GIT.
Caution - mild to moderate renal disease and in liver disease. - 11What is the MOA of Meglitinides? Examples of drug names?Non-sulphonylurea secretagogues.
Stimulate insulin release from the pancreas relative to glucose levels.
Decreased insulin release at low blood glucose levels, therefore less risk of hypoglycaemic episodes.
Repaglinide and Nateglinide. - 12Side effects for Meglitinides?Risk of hypoglycaemia. Hypersensitivity reactions (rash, itch. urticaria)
GI effects with repaglinide. - 13Define DiabetesA chronic disease characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action or both.
- 14Counter-regulatory hormones are...? And they do...?Glucagon, Adrenaline, Cortisol and Growth Hormone.
Increase liver glucose production - 15What is normal blood glucose?18mg/dl = 1mmol/L
- 16Describe the microvascular and macrovascular complications of Type 2 DiabetesMacrovascular disease: Myocardial infarction, stroke and peripheral vascular disease
Microvascular disease: Retinopathy, Nephropathy - 17What are the early signs of hypoglycaemia?Early signs include weakness, hunger, anxiety, dizziness, sweating, palpitations, irritability and tremor
(Early signs are due to effects of adrenaline/NA)
Blurred vision, drowsiness, confusion, lack of judgement & self control due to low brain glucose (CNS effect). - 18What blood glucose level does early signs of hypoglycaemia begin?Symptoms are not apparent until blood glucose levels fall below 3.5 mmol/L
- 19What is the management of hypoglycaemia if patient is conscious?10-20g oral glucose:
•2 teaspoons of sugar
•100ml coca cola
•200ml milk
Repeat in 10-15 min if symptoms persist
Follow with carbohydrate meal until recovery - 20What is the management of a hypoglycaemic patient if unconscious?It is a medical emergency.
Glucagon s.c, i.m., or IV for acute insulin.
OR 50ml glucose 20% IV infusion
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- Pham1056 Fichas sobre Diabetes - Type 2, creado por Affy MD el 26/04/2013.
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- Affy MD
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