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Year 2 MBChB Endocrine > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Is is important to think of diabetes as what type of disease?

A

Vascular

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2
Q

What is insulin dependent diabetes?

A

Damage to beta cells is the cause

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3
Q

What is insulin independent diabetes + give 2 examples?

A

Beta cells are functional so condition caused by other factors
Resistance
Channel mutations

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4
Q

What is HbA1c and what + what is the normal level + what is the level diabetes is diagnosed at + target level for reducing microvascular complications?

A

Average blood glucose over 3 months
< 41 mmol/l
> 48 mmol/l
< 53 mmol/l

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5
Q

Name 3 tests for diagnosing diabetes.

A

Fasting glucose
Random glucose
Oral glucose tolerance test

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6
Q

How long is a fasting glucose + how long and how much glucose for an OGTT?

A 
Fasting = 8 hours
OGTT = 75g and 2 hours
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7
Q

How many venous glucose samples for symptomatic and non-symptomatic DM patients?

A

1 for symptomatic

2 for non-symptomatic

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8
Q

Diagnosis of DM for symptomatic patients?

A

Presence of classic symptoms
Fasting glucose > 7
Random or OGTT > 11.1

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9
Q

Diagnosis of DM for non-symptomatic patients?

A

2 separate findings of:
Fasting glucose > 7
Random or OGTT > 11.1
HbA1c > 48 mol/l

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10
Q

What is T1DM?

A

Autoimmune beta cell loss causing insulin deficiency

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11
Q

Is T1DM associated with other autoimmune conditions. If so, what is the genetic link?

A

Yes

DR3, DR4, DQ2 and DQ8 genes

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12
Q

How can T1DM present?

A 
Young
Weight loss
Fatigue
Polyuria/dipsia
DKA
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13
Q

Name 3 islet cell autoantibodies associated with T1DM + do they appear before or after symptoms?.

A

GAD65
IA-2
ZnT8
Before symptoms

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13
Q

What is the general treatment for T1DM?

A

MDI or insulin pump (CSI)

DAFNE education

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14
Q

What 4 things can be tested in the blood for T1DM and will they be high/low/present/absent?

A

Autoantibodies = present
C-peptide = low
HbA1c = high
Blood glucose = high

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16
Q

Name a complication of MDI.

A

Lipohypertrophy

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17
Q

Name 2 common MDI regimes for T1DM.

A

BD - 2 x mixed insulin

QD - bedtime long acting + rapid acting before meals

18
Q

What is LADA?

A

T1DM subtype presenting later in life

19
Q

What are the SICK day rules + which 2 DM drugs need to be stopped + 3 other drugs which need to be stopped?

A 
S (sugar) = check BG every 2-3 hours
I (insulin) = keep taking insulin
C (carbs) = keep eating and drinking
K (ketones) = check ketones every 4 hours
Metformin and SGLT2i
ACEi/ARB, NSAIDs, diuretics
20
Q

T1DM has a … concordance in twins and T2DM has a … concordance meaning … is more genetically influenced?

A

30%
80%
T2DM

21
Q

What is T2DM?

A

Reduced insulin sensitivity causing hyperinsulinemia

22
Q

How can T2DM present?

A 
Older
Obese
Polydipsia/uria
Fatigue
Thrush/UTI
Visual blurring
Mental health issues
Erectile dysfunction
23
Q

Will C-peptide be high or low in T1DM + T2DM?

A 
T1DM = low
T2DM = high
24
Q

Name a cutaneous sign of insulin resistant diabetes.

A

Acanthosis nigricans

25
Q

Name 7 risk factors for T2DM.

A 
Smoking
Obesity
Alcohol
Anti-psychotics
Asian
CVD
POS
26
Q

How often should people with HbA1c > 39 or IGTT/IFG be screened?

A

Every year

27
Q

Name 3 tests that diagnosed diabetics should have every year.

A

Retinal screening
Foot screening
Kidney screening

28
Q

What is the stepwise treatment for T2DM?

A 
Lifestyle changes
Metformin (or SU)
Metformin + 1
Metformin + 2
Insulin therapy
29
Q

What 2 other drugs should be considered in the treatment of T2DM to reduce CVD disease?

A

Statin if > 40

Anti-hypertensives

30
Q

What is metabolic syndrome (syndrome X)?

A

Having a range of risk factors for stroke, CVD and diabetes

31
Q

Name the 5 features of metabolic syndrome.

A 
Visceral obesity
Insulin resistance
Hypertension
Hypertriglyceridemia 
Low HDL
32
Q

What is MODY + inheritance + age of onset?

A

AD monogenetic diabetes

< 25

33
Q

Which 2 features of T1DM does MODY lack?

A

Auto-antibdies

DKA

34
Q

Name the 3 types of MODY in order of prevalence + mutation.

A

MODY 1,3 and 5 = HNF TF
MODY 2 = glucokinase
MODY X = none

35
Q

Name the 3 differences between MODY 2 and MODY 1, 3 and 5.

A

MODY 2 = birth onset, complications rare, stable hyperglycaemia
MODY 1, 3 and 5 = young adult onset, complications common and unstable hyperglycaemia

36
Q

What is the treatment and for MODY 2?

A

Diet modification

37
Q

What is the treatment for MODY 1, 3 and 5?

A

Diet + SU + insulin

38
Q

Name 2 conditions caused by Kir6.1 and SUR1 subunit mutations.

A

Congenital hyperinsulinism

Neonatal diabetes

39
Q

Name the 2 subtypes of neonatal diabetes and how they are treated.

A 
Transient = periodic insulin 
Permanent = lifelong insulin + SU
40
Q

What is the target BG before a meal and 1-2 hours after?

A 
Before = 3.9-7.2 mmol/l
After = < 10 mmol/l

Year 2 MBChB Endocrine (14 decks)

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