4: What is diabetes? Flashcards
The number of people with diabetes in Scotland is (increasing / decreasing).
increasing
Which types of diabetes involve
a) an absolute
b) a relative
insulin deficiency?
a) Type 1 diabetes - absolute insulin deficiency
b) Type 2 diabetes - relative insulin deficiency
What is the definition of diabetes mellitus?
Group of diseases featuring hyperglycaemia
caused by probs with insulin secretion, insulin action or both
What is the normal range for glycated haemoglobin (HbA1c)?
41 mmol/L or less
What concentration of HbA1c is diagnostic of diabetes?
48 mmol/L or above
What is the upper limit of normal fasting glucose concentration?
6.0 mmol/L
Normal is around 5.5 mmol/L
What fasting glucose concentration is diagnostic of diabetes?
7.0 mmol/L or above
What is the upper limit of normal glucose concentration 2 hours after an oral glucose tolerance test?
7.7 mmol/L
What 2-hr OGTT glucose concentration is diagnostic of diabetes?
11.1 mmol/L or more
If you were to take a random glucose measurement and it was more than __._ mmol/L, that would be diagnostic of diabetes.
11.1 mmol/L
Type _ diabetes is characterised by autoimmune beta cell destruction.
Type 2 diabetes is a diagnosis of ___.
Type 1 diabetes is autoimmune
Type 2 is a diagnosis of exclusion
What is the name for the inflammation seen in beta cells in Type 1 diabetes?
Insulitis
Insulitis in Type 1 diabetes eventually causes total ___ of beta cells.
destruction
What follows hyperglycaemia in Type 2 diabetes, creating a vicious cycle of disease?
Hyperglycaemia > Hyperinsulinaemia > Insulin resistance > Hyperglycaemia…
Which type of diabetes is associated with ketoacidosis?
Type 1 diabetes
Which patients does Type 1 diabetes tend to present in?
Young patients
Type 1 diabetics tend to be (lean / overweight).
lean
Weight loss is a symptom
Type 1 diabetics immediately require which treatment upon diagnosis?
Insulin
What are the classical symptoms of Type 1 diabetes?
Increased urination frequency (polyuria, often smells sugary)
Increased thirst (polydipsia)
Fatigue
Weight loss
TOILET, THIRSTY, TIRED, THIN
What four Ts describe the presentation of Type 1 diabetes?
Toilet
Thirsty
Tired
Thin
What age are patients who present with Type 2 diabetes?
Older (mid 30s and up)
Type 2 diabetics tend to be (lean / overweight).
overweight
The pre-diabetic period before Type 2 diabetes starts in earnest lasts how long?
6 - 10 years
so by the time they’re diagnosed, complications have usually occurred :(
Type 1 diabetes has a (rapid / insidious) onset.
Type 1 diabetes - rapid onset
Type 2 diabetes - insidious, over 6-10 years
Do Type 2 diabetics tend to have smelly urine?
No, but you would know if it was Type 1/2 based off the history (older, overweight etc.)
Is Type 2 diabetes managed with insulin injections?
Not the first line therapy
but many go on to need injections when they get older
What kind of diabetes occurs temporarily in pregnant mothers and increases their risk of developing Type 2 diabetes in the future?
Gestational diabetes
Patients with a ___ history of diabetes are more likely to develop it.
family history
it likely has a genetic component
Patients with a history of ___ disease are more likely to develop Type 2 diabetes.
cardiovascular disease
People with diabetes tend to get what fungal infection?
Where?
Candida spp. i.e yeast infection - THRUSH
Groin
What early vision problem can Type 2 diabetics present with?
Blurred vision
What are the general names for the complications of poorly controlled diabetes?
Neuropathy
Retinopathy
Cardiovascular disease - atherosclerosis, diabetic foot etc.
Nephropathy
In which type of diabetes do you get a positive anti-Islet antibody test?
Type 1 diabetes
autoimmune basis
If a person’s ketones are elevated they likely have which type of diabetes?
Type 1
ketoacidosis
C-peptide is a component of proinsulin that is cleaved off during insulin production. It is used as a marker to distinguish Type 1 and Type 2 diabetes?
How?
Type 1 diabetics have little / no insulin production (because their beta cells are destroyed), so they will have little / no C-peptide
Type 2 diabetics still produce some insulin so they will have greater levels of C-peptide (once the disease has advanced to the point they can’t produce insulin either, the test isn’t any good)
What are the four types of diabetes?
Type 1
Type 2
Type “3” - other diseases like pancreatitis, endocrine syndromes, drug-induced and MODY
Gestational diabetes
What is LADA?
Late onset Type 1 diabetes
What is MODY?
Mature onset diabetes of the young
caused by a genetic mutation - a Type “3” diabetes
Apart from cardiovascular disease causing nephropathy, neuropathy and retinopathy, what is another complication of diabetes diagnosis?
Psychological illness
depression, anxiety etc.
