Summary
Summary Type 2 Diabetes and Treatment
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Diagnosis, symptoms, cause, tests, sick day rules, annual review, complications and treatments
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Type 2 Diabeteshttps://www.youtube.com/watch?v=LWDQyaKVols&ab_channel=SpeedPharmacology
Definition: Insulin resistance and a relative insulin deficiency result in persistent
hyperglycaemia.
Cause
o The pancreas is unable to secrete enough insulin.
o This hormone regulates the movement of sugar into the cells.
o Cells respond poorly to insulin and take in less sugar.
o Leading to high levels of sugar in the blood.
o Over time this can lead to type 1 diabetes
o Where beta cells no longer make insulin.
Diagnose
Hb1Ac
o A blood test used to diagnose type 2 diabetes.
o Short for glycated haemoglobin: levels of sugar in the blood
o High: over 6.5% means you have diabetes.
o This isn’t used in all patients e.g., children, pregnant, and medication that can cause
hyperglycaemia, pancreatic damage, CKD or HIV.
o They are also used cautiously for people with an abnormal red blood cell level.
Symptoms
o Blurred vision
o Unexplained weight loss
o Recurrent infections
o Tiredness
o Polydipsia: excessive thirst
, o Polyuria: increased urination
o Dark skin pigmentation (acanthosis nigricans)
o Fruity smelling breath
o tachycardia
Other tests
o Fasting plasma glucose of 7mmol/L or more
o Random plasma glucose of 11.1mmol/L or more
Risk factors
o Obesity: overeating and inactivity leads to high plasma levels over long periods of
time.
o Family history
o Low birth weight:
o Ethnicity: Asian, African and Caribbean are 3-4 times more likely to develop it.
o Polycystic ovary syndrome
o Diet: low fibre, high glycaemic index foods which are broken down quickly and cause
a rapid increase in blood glucose. As they are used faster it also makes you hungry
faster than low GI foods.
o Drug treatments: statins, corticosteroids, thiazide diuretics.
Complications
o Too much sugar: damage to vessels: decreased elasticity causing them to narrow.
o It can also cause plaque build-up in vessels.
o An increase in sugar can increase triglyceride levels which deposit in vessels.
o These cause the hardening of vessels.
o Elevated glucose levels also lead to nerve damage
o Glucose can react with proteins and lipids via the process of glycation.
o This results in the formation of advanced glycation end products AGEPs.
o These AGEs are hWhyarmful, and accumulation can interfere with the extracellular
matrix and alter the function of proteins and nerve tissues.
Macrovascular
o Foot problems: Peripheral artery disease and peripheral neuropathy. This loses
protective foot sensation. Foot ulcers.
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