Diabetes

Question 1

Symptoms of hyperglycaemia

Answer 1

• polyuria
• polydipsia
• blurred vision
• urogenital infections (bacteria thrive on glucose in urine)
  Due to inadequate energy utilisation:
• tiredness
• weakness
• weight loss (other energy sources e.g. Adipose supply utilised

Question 2

Diabetes diagnosis

Answer 2

NEED laboratory confirmation! 
Symptoms + 1 abnormal test or no symptoms + 2 abnormal tests 
- fasting blood glucose 
- oral glucose tolerance test 
- HbA1c (type 2 only)

Question 3

Type 1

Answer 3

• insulin deficiency
• autoimmune (or non-autoimmune)
• 5-10% of all diabetes
• 90% diagnosed under the age of 30 - but can occur at any age
• rapid onset
• dramatic weight loss
• late onset may cause vomiting due to ketoacidosis (presence of ketones in the urine)
  MUST BE TREATED URGENTLY WITH EXOGENOUS INSULIN

Question 4

Type 2

Answer 4

Insulin deficiency and insulin resistance
- genetic defects of beta cells
- genetic defects of insulin action
- drug induced diabetes
- other hormone disorders
- iron overload - haemochromatosis - bronze diabetes - iron laid down in the skin
- pancreatectomy
Usually people are overweight (many diagnosed form routine screening)
Dramatic weight loss can sometimes reverse diabetes - decreased liver fat content
(No ketones in urine)
If untreated can lead to onset of complications, increased morbidity and mortality
Lifestyle changes and drugs first then insulin

Question 5

Insulin

Answer 5

Glucose metabolism
- enhances uptake of glucose by liver
- enhances uptake by muscle and adipose tissue
- inhibits liver glycogen breakdown
Fat metabolism
- insulin promotes clearance of free fatty acids
- prevents lipolysis
Amino acid metabolism
- active transport of amino acids into cells
- inhibits catabolism of proteins
- inhibits gluconeogenesis in the liver

Question 6

Monitoring people with diabetes

Answer 6

• wellbeing
• glucose control - capillary blood glucose testing
• HbAc1 (glycated Haemoglobin) TYPE 2 - quality control to assess patients control of diabetes over the last 120 days
• blood pressure
• surveillance for chronic conditions (retinopathy, neuropathic ulcers, nephropathy - kidney damage)

Question 7

Diabetes

Answer 7

Hyperglycaemia
- causes damage to small and large blood vessels causing premature death from cardiovascular disease
- causes by inability to produce insulin (beta cell failure)
- and/or insulin resistance prevents insulin working effectively
Macrovascular
- coronary artery disease, Stoke, poor peripheral circulation (feet)
Microvascular
- retinopathy, neuropathy, nephropathy