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MEH > 10 Diabetes > Flashcards

10 Diabetes Flashcards

1
Q

What is diabetes?

A

-Elevated blood glucose concentration (hyperglycaemia) which leads to damage of small and large blood vessels causing cardiovascular disease
-Premature death

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2
Q

Three main presentations of diabetes

A

Polyuria
Polydipsia
Weight loss

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3
Q

What is polyuria?

A

Excessive urine production

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4
Q

What is polydipsia?

A

Excessive thirst

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5
Q

Diagnosis of diabetes

A

Lab tests:
-oral glucose intolerance test
-HBA1c
-fasting glucose

Symptoms + 1 abnormal test or asymptomatic + 2 abnormal tests

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6
Q

What is type 1 diabetes?

A

Autoimmune disease
Destroys beta cells in pancreas which secretes insulin

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7
Q

Type 1 symptoms

A

-Rapid onset weight loss
-Polyuria
-Polydipsia
-Presence of ketones > acetone smell on breath
-Increased venous plasma glucose
-Vomiting due to ketoacidosis in late presentation

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8
Q

What is type 2 diabetes?

A
  • Cells don’t respond to insulin correctly
  • Pancreas doesn’t produce enough insulin
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9
Q

Causes of type 2 diabetes

A

-obesity
-physical activity
-genetics
-muscle and liver fat deposition
-increased circulating free fatty acids

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10
Q

Symptoms of type 2 diabetes

A

-Polyuria
-Polydipsia
-Weight loss
-Non urinary ketones
-Can be asymptomatic

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11
Q

Treatment of type 2

A

Weight loss
Lifestyle changes

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12
Q

Monitoring of diabetes

A

-capillary testing in both types
-ketone testing in urine and plasma in type 1
-flash continuous glucose monitoring

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13
Q

Chronic complications of diabetes
Macro and micro vascular disease

A

Macro vascular/large vessel disease:
- stroke
- heart attack
- gangrene

Micro vascular/small vessel disease:
- retinopathy
- nephropathy
- neuropathy

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14
Q

Acute complications of diabetes

A

Hyperglycaemia:
- metabolic decomposition
- diabetic ketoacidosis in type 1
- hypeosmolar non-ketoacidosis syndrome in type 2

Hypoglycaemia:
- coma - brain is glucose dependent

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15
Q

What suppressed ketone production?

A

Insulin

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16
Q

What is broken down into ketones?

A

Fats

17
Q

What is needed in the presence of ketones?

A

Immediate insulin therapy

18
Q

Why do patients with type 1 diabetes need immediate referral?

A
  • insulin suppressed ketone production
  • lack of insulin > ketones produced
  • ketoacidosis if not treated rapidly
19
Q

Reasons for poor adherence to treatment regimens of diabetes

A
  • hard to control diet
  • change in lifestyle
  • forgetting
  • complicated initially
  • may not like needles
20
Q

Macro vascular complications of diabetes

A

Stoke
Myocardial infarction
Gangrene

21
Q

Micro vascular complications of diabetes

A

Retinopathy
Nephropathy
Neuropathy
Diabetic foot - nerve and vascular damage
Diabetic eye disease

22
Q

Type 2 diabete treatment

A

-first: changed diet and exercise
-second: oral hypoglycaemic therapy (metfmorin and sulpheryureas)
-last: insulin therapy

23
Q

Treatment of type 1 diabetes

A

Exogenous insulin from immediate subcutaneous injection

24
Q

What is metabolic syndrome?

A

Group of the most dangerous risk factors of cardiovascular disease:
- diabetes + raised fasting plasma glucose
- abdominal obesity
- hypertension
- high cholesterol

25
Q

What is needed for a person to have metabolic syndrome?

A

Waist >94 cm for men >80 cm for women
PLUS 2 from:
- raised triglycerides
- reduced HDLs
- raised fasting blood glucose
- raised blood pressure

26
Q

What causes metabolic syndrome?

A

Insulin resistance
Central obesity
Genetics
Inactivity
Ageing

27
Q

Compare and contrast the feature of type 1 and type 2 diabetes

A

Type 1:
Childhood
Sudden onset
Ketoacidosis
No C peptide - insulin not produced
Autoimmunity
Recent weight loss

Type 2:
Middle age
Gradual onset
Non-ketoacidosis
C-peptide detectable - insulin still produced
Not autoimmunity
Often no weight loss

28
Q

What does untreated type 1 diabetes mellitus cause?

A

Ketoacidosis:
- hyperventilation
- nausea + vomiting
- abdominal pain
- coma

Hyperglycaemia:
- glycosuria
- polyuria
- polydipsia

29
Q

Consequences of ketoacidosis

A
  • hyperventilation
  • nausea + vomiting
  • abdominal pain
  • coma
30
Q

Consequences of hyperglycaemia

A
  • glycosuria
  • polyuria
  • polydipsia
31
Q

Action of metformin to treat type 2 diabetes

A

Inhibits hepatic gluconeogenesis

32
Q

Normal range of blood glucose

A

3.3-6.0mmol/litre

33
Q

Why does insulin need to been given as an injection not orally?

A

Insulin is a peptide hormone
Would get broken down in GI tract into amino acids if it was taken orally

MEH (23 decks)

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