Self Assessment
  1. The cardinal feature of diabetes is hyperglycemia but it actually is a metabolic disorder affecting not only carbohydrates but also………….
  2. The most common type of diabetes is Type 2 DM and its main pathophysiology is………….
  3. It is important to recognise Type 1 DM at any age because such patients must only be treated with…………..
  4. When a patient has DM and chronic diarrhoea, we can assume that the diabetes may be due to ………………
  5. In pregnancy, the recommended screening for DM is a standard or modified glucose tolerance test at ………..weeks of pregnancy.
  6. A glucose tolerance test is often not needed to diagnose DM in the non-pregnant state. It may be needed only when ………………
  7. The criteria for diagnosing gestational diabetes is not the same as in the non-pregnant state. The values that indicate DM in pregnancy (for fasting and postprandial plasma glucose) are ……….
  8. Gestational diabetes is best treated with these two medicines: …….. and ……………. The aim is to keep the preprandial plasma glucose values below 5.3mmol/L.
  9. The first drug to use in treating most people with Type 2 DM is………..because this drug reduces insulin resistance. Other drugs than can also reduce insulin resistance are …………. and ……………
  10. Glucagon levels are often elevated in DM and this leads to hyperglycemia. The drugs that can reduce glucagon levels in diabetes are those acting on the ……………pathway. An example of this kind of drug is……………………..
  11. Free fatty acids can also be elevated in DM. An example of a drug that can reduce plasma glucose and FFA is ………………………..
  12. To protect the beta cells of the pancreas from progressive damage, the antidiabetic drugs ……………….and ………………… are good.
  13. Screening for diabetic retinopathy should start 5 years after the diagnosis of DM while screening for diabetic nephropathy should start ………
  14. The earliest sign of diabetic nephropathy is the presence of ………
  15. When there is a marked discordance between glycosylated haemoglobin values and measured plasma glucose values, the possibility of …………….must be considered.
  16. A reasonable goal for glycosylated haemoglobin for most non-pregnant adults is …… while for those who are elderly and who have multiple other medical illnesses, the goal can be …………
  17. When initiating insulin in Type 2 DM, always begin with a single injection of …………….. or a single injection of a biphasic combination insulin.
  18. When initiating insulin in Type 1 DM, always ensure that ……… insulin is given before each meal and ………….insulin is given to cover the interval between meals.
  19. The combination of insulin and ……………in a patient with Type 2 DM is potentially dangerous.
  20. A plasma glucose value above 20mmol/L may herald impending ketoacidosis and should be treated with …………………… insulin
  21. (Related to the fasting month): When people with diabetes undergo prolonged fasting, the safest oral hypoglycemic drugs to use are ………. and the gliptins. Short acting ………… have also been used safely.
  22. (Related to the fasting month): When a person is on both insulin and oral hypoglycemic drugs, the total dose of insulin should be reduced to ……..percent of the previous dose and the oral drugs can either be stopped or given in a reduced dose during the fasting period.
  23. (Related to the fasting month): One strategy for those who are on multiple doses of insulin, is to omit the afternoon dose, invert the morning and evening doses so that the morning dose is given before the ……………meal and ………percent of the evening dose is given with the meal in the morning.
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