4. Diabetes Flashcards Preview

BDS2 BAMS Endocrinology > 4. Diabetes > Flashcards

Flashcards in 4. Diabetes Deck (46):
1

Types of diabetes (2)

Diabetes mellitus
Diabetes insipidus

2

Definition of diabetes mellitus

Abnormality of glucose regulation

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Definition of diabetes insipidus

Abnormality of renal function (water)

4

Diabetes diagnosis involves (2)

Two random plasma glucose tests
Results > 11.1mmol

5

Glucose tolerance test process (3)

Fasting test
75g glucose load
Test after 2hrs

6

Glucose tolerance test result groups before test (3)

<6.1 - normal
6.1-7.0 - impaired fasting plasma glucose
>7.0 - diabetes

7

Glucose tolerance test result groups after two hours (3)

<7.8 - normal
7.8-11.1 - impaired glucose tolerance
>11.1 - diabates

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Types of diabetes mellitus (2)

Type 1 - insulin deficient
Type 2 - insulin resistant

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Definition of type 1 diabetes (2)

Autoimmune disease
Involves immune-mediated destruction of pancreatic B cells by auto-antibodies

10

Uncontrolled type 1 DM can lead to (2)

Hyperglycaemia
Ketoacidosis

11

Circulating antibodies present in type 1 DM (3)

GAD
ICA
IAA

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Process of ketoacidosis (2)

Glucose cannot be metabolised correctly by cells
Fat is metabolised for energy, causing a build-up of acidic ketones
Leads to ketoacidosis

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Definition of hypoglycaemia

Low blood glucose levels

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Prevention of ketoacidosis

Insulin

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Prevention of hypoglycaemia

Glucose

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Type 1 DM involves (2)

Genetic influences (familial clustering, HLA)
Environmental trigger

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Types of type 1 DM (2)

Child/adolescent onset
Adult/latent onset - LADA (latent autoimmune diabetes in adults)

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Features of early onset type 1 DM (3)

Peak incidence - 10-14yrs
Higher ICA, IAA
More severe decompensation

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Features of adult/latent onset type 1 DM (4)

GAD associated
Less weight loss, less ketoacidosis
'Non-obses' type 2
Variable period until insulin required

20

Type 1 DM symptoms (3)

Polyuria
Polydipsia
Tiredness

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Acute presentation of type 1 DM (2)

Hyperglycaemia with diabetic symptoms
Ketoacidosis

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Definition of impaired glucose tolerance - IGT (2)

Peak secretion of insulin is lower than normal, but high enough to metabolise some/all glucose ingested

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Type 2 DM diagnosis

Exclude Type 1 DM

24

Most common type of DM

Type 2 - 90%

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Predisposing factors of type 2 DM (2)

Obesity
Inactivity

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Types of type 2 DM (2)

Classic (>40yrs old)
MODY - mature onset diabetes in young

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Type 2 and ketoacidosis

Type 2 do not often suffer from ketoacidosis

28

Links with type 2 DM (2)

Risk - genetic and lifestyle
Strong FH link

29

Metabolic disorders involved in type 2 DM (4)

Defect in insulin resistance
Defect in insulin secretion
Basal hepatic glucose output increased
Insulin stimulated muscle glucose uptake is reduced

30

Effects of type 2 DM include metabolic syndromes (7)

IGT
Hyperinsulinaemia
HTN
Obesity with abdominal distribution
Dyslipidaemia
Procoagulant epithelial markers
Early and accelerated atherosclerosis

31

Complications of type 2 DM

Retinal damage

32

Symptoms of type 2 DM (6)

Rarely acute presentation
Polyuria
Polydipsia
Tiredness
Unusual infections
Diabetic complications

33

Typical presentation of type 1 DM (6)

Younger
Thin
Often FH of type 1
Often FH of autoimmune disease
Diabetic symptoms
Easily get ketosis

34

Typical presentation of type 2 DM (6)

Older
Obese
Strong FH
Often diabetic symptoms
Present with complications
Rarely get ketosis

35

Diabetes management (7)

Education
Setting glucose target levels
Drugs
Insulin
Nutrition
Exercise
Monitoring

36

Insulin regimes (2)

Basal bolus - more infections, better control
Split-mixed - fewer injections, poorer control

37

Type 1 DM management (2)

SC insulin administration
Target sugar 4-7mmol/l

38

Type 2 DM management (5)

Weight loss
Diet restriction
Diet pills
Surgery
Oral hypoglycaemic agents

39

Types of oral hypoglycaemic agents (2)

Insulin secretagogues (sulphonylureas)
Insulin sensitisers (biguanides)

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Complications of diabetes can be (2)

Acute
Chronic

41

Acute complications of diabetes

Hypoglycaemia

42

Chronic complications of diabetes (3)

CV risk
Infection risk
Neuropathy

43

Other complications of diabetes (2)

Large vessel (atheroma)
Small vessel (poor wound healing)

44

Diabetic eye disease includes (3)

Cataracts
Maculopathy
Proliferative retinopathy

45

Treatment of diabetic eye disease

Laser treatment

46

Diabetic neuropathy includes (3)

General sensation
Motor neuropathy
Autoimmune regulation