Monitoring of diabetes

Question 1

What are the benefits of improved glucose control?

Answer 1

reduced risk of microvascular and macrovascular complications as well as enhanced well-being and overall health

Question 2

What can cause a decrease of HbA1c?

Answer 2

haemolytic anaemia; acute/chronic blood loss; pregnancy

Question 3

What is normal HbA1c?

Answer 3

below 42mmol/mol

Question 4

What is HbA1c indicateing prediabetes?

Answer 4

42-47mmol/mol

Question 5

what is a HbA1c indicating diabetes?

Answer 5

over 48mmol/mol

Question 6

What is the target for HbA1c?

Answer 6

48- 53mmol/mol

Question 7

what is the limitation of HbA1c?

Answer 7

can have same average with little varibaility in BG as well as lots of variability

Question 8

What happens during intensive drug therapy in terms of defense against hypoglycaemia?

Answer 8

the glucose threshold for release of adrenaline is lower, and the point at which they feel the hypo, is much lower BG

Question 9

What is the difference between the hormone responses to hypoglycaemia in type 1 diabetics and normal individuals?

Answer 9

In normal individuals, they can stop their insulin release and release counterregulatory hormones eg glucagon and adrenaline. In T1DM, they have no insulin to turn off and the counttergulatory and symptom responses are decreased in intensity and occur at lower glucpse

Question 10

What is the significance in the differences in responses to hypoglycaemia?

Answer 10

the window between recognition of hypoglycaemia and ability to take action before there is significant impairment of cognition is reduced leading ot higher risk of severe hypos

Question 11

What are other reasons for hypoglycaemia?

Answer 11

primary failure of horomones to raise glucose; prolongation of insulin effects; exaggerated mismatch between insulin and nutrient absorption; listeyle contribution

Question 12

What would cause hormones to fail to raise glucose?

Answer 12

hypopituitarism; adrenal cortical failure; isolated GH deficiency

Question 13

what may cause prolongation of insulin effects?

Answer 13

renal impairment; hypothyroidism; liver failure;

Question 14

What may cause an exaggerated mismatch between insulin and nutrient absoprtion?

Answer 14

malabsorption; delayed insulin administration

Question 15

What are liestyle contributors to hypoglycaemia?

Answer 15

acute increase in glucose uptake with exercise; depletion of liver glycogen with vigorou/prolonged exerces; alcohol suppresion of gluconeogensis