30 Questions
How does diabetes mellitus result?
From lack, or reduced effectiveness, of endogenous insulin.
Why should diabetes mellitus be considered as a vascular disease?
Because it causes serious microvascular and macrovascular problems such as retinopathy, nephropathy, neuropathy, stroke, MI, renovascular disease, and limb ischemia.
Why is blood glucose homeostasis essential?
Blood glucose homeostasis is essential to ensure a continuous supply of glucose to the central nervous system.
How does the brain depend on the liver for energy supply?
The brain depends on the liver for a constant supply of glucose for oxidation to generate ATP.
What is the main organ responsible for glucose homeostasis?
The liver is mainly responsible for maintaining glucose homeostasis.
Why is it important to consider other cardiovascular risk factors in diabetes management?
It is important to consider other cardiovascular risk factors to adopt a holistic approach and prevent associated complications.
What is the main cause of Type 2 Diabetes Mellitus?
Reduced sensitivity to the action of insulin and an inability to produce sufficient insulin to overcome this 'insulin resistance'.
What lifestyle factors are associated with Type 2 Diabetes Mellitus?
Obesity, lack of exercise, calorie excess, and alcohol excess.
What is the unique window for lifestyle intervention in Type 2 Diabetes Mellitus?
Impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) phase.
What is the main genetic influence in Type 2 Diabetes Mellitus?
Stronger genetic influence than in Type 1 DM, with ≥80% concordance in identical twins.
What is Maturity Onset Diabetes of the Young (MODY)?
A rare autosomal dominant form of Type 2 DM affecting young people.
What is the role of Sulfonylurea in treating Type 2 Diabetes Mellitus?
It increases insulin secretion, e.g., gliclazide 40mg/d.
Why is it important to write UNITS in full when prescribing insulin?
To avoid misinterpretation of U for zero
What is the purpose of Isophane insulin?
It has a variable peak at 4-12 hours
How can a partner help abort hypoglycemia?
By providing sugary drinks or GlucoGelR PO if in a coma
What is the role of long-acting recombinant human insulin analogues like insulin glargine?
They are used at bedtime and are good if nocturnal hypoglycemia is an issue
How does SGLT2 inhibitor work in the treatment of type 2 DM?
It blocks the reabsorption of glucose in the kidneys and promotes excretion in the urine
What are some factors to consider when educating a patient to self-adjust insulin doses?
Exercise, finger prick glucose, calorie intake, and carbohydrate counting
What is the 'BD biphasic regimen' useful for in diabetes management?
Type 2 DM or type 1 with regular lifestyle.
Describe the 'QDS regimen' and its usefulness in diabetes management.
It involves before meals ultra-fast insulin + bedtime long-acting analogue, useful in type 1 DM for achieving a flexible lifestyle.
When is once-daily before-bed long-acting insulin a good initial regimen?
When switching from tablets in type 2 DM.
What is the typical dosing recommendation when initiating insulin therapy in adults?
≥1U/24h for every unit of BMI.
Under what conditions should patients consider using Glucagon-like peptide (GLP) analogues?
BMI >35 with specific psychological or medical problems associated with obesity, or BMI <35 with occupational implications or obesity-related comorbidities.
What metabolic and weight loss criteria are required for a person to continue using a GLP-1 mimetic?
Reduction of HbA1C by at least 11mmol/mol and weight loss of at least 3% of initial body weight in 6 months.
What is the role of insulin detemir in intensive insulin regimens for overweight type 2 diabetes mellitus?
Insulin detemir has a role in intensive insulin regimens for overweight type 2 DM.
What did the DAFNE study find in relation to insulin dosing and its impact on glycaemic control and wellbeing?
Training in flexible, intensive insulin dosing improved glycaemic control as well as wellbeing.
What advice should be given to patients regarding insulin dosing during intercurrent illnesses like influenza?
Advise patients to avoid stopping insulin during acute illness.
What should be done to manage insulin dosing during intercurrent illnesses when insulin requirements may increase despite reduced food intake?
Check blood glucose ≥ 4 times a day and look for ketonuria.
When should patients be advised to seek help from a specialist diabetes nurse or GP during intercurrent illnesses?
Advise to get help if concerned, especially if glucose levels are rising or ketonuria is present.
In what situations should patients be admitted when managing insulin dosing during intercurrent illnesses?
Admit if vomiting, dehydrated, ketotic, a child, or pregnant.
This quiz covers topics related to monitoring glucose levels in cases of hypoglycemia, the mechanism of action of SGLT2 inhibitors, and the importance of insulin education for self-adjusting doses. It also includes phone support and strategies for managing glucose levels in patients with type 2 diabetes mellitus.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
