5. Diabetes Basic Science

Question 1

name the 4 catabolic hormones that work against insulin

Answer 1

glucagon , catecholamine, cortisol and growth hormone

Question 2

Define diabetes mellitus

Answer 2

reduction in action of insulin enough to cause a level of hyperglycaemia

Question 3

what is non-diabetic hyperglycaemia and what 3 things does it relate to

Answer 3

insulin action is reduced to such that glucose is raised above normal but not enough to cause microvascular damage
NDH - non diabetic hyperglycaemia
IGT- impaired glucose tolerance
IFG- impaired fasting glucose

Question 4

What percentage of people will diabetes have;
type 1
type 2

Answer 4

10% type 1

90% type 2

Question 5

why are type 1 diabetes ketosis prone

Answer 5

they produce no insulin at all so fat is burned inappropriately and in an uncontrolled way which generates ketones

Question 6

why are type 2 diabetics ketosis resistant

Answer 6

you only need a small amount of insulin to stop fat being burned uncontrollably

Question 7

which cells in the islets of langerhans of the pancreas is responsible for producing

1. insulin
2. glucagon

Answer 7

insulin by beta cells

glucagon by alpha cells

Question 8

why does T1 DM occur

Answer 8

the pancreas stop producing insulin
beta-cell destruction possibly by viruses such as coxsackie B virus and enterovirus
organ specific autoimmune

Question 9

Why does T2 DM occur

Answer 9

repeated exposure to glucose and insulin makes the cells in the body become resistant to the effects of insulin

The beta cells become fatigued and resistant

insulin resistance and reduced insulin sensitivity

Question 10

What are the non-modifiable risk factors for T2 DM

Answer 10

older age
ethnicity (black, Chinese, South Asian)
note that use lower threshold for diagnosis ini these patients eg BMI
family history

Question 11

what are the modifiable risk factors for T2 DM

Answer 11

Obesity
Sedentary lifestyle
high carbohydrate diet (particularly refined carbs)

Question 12

why do people with hyperglycaemia have an increased risk of infections (opportunistic infections)

Answer 12

it weakens their immune system

Question 13

What is the difference inn mean age of onset in nT1 and T2

Answer 13

T1 less than 30

T2 greater than 30

Question 14

What other autoimmune diseases are associated with T1 DM

Answer 14

thyroid disease, perniciouus anaemia, Addisons disease, coeliac disease

Question 15

what is HbA1c and why is it used

Answer 15

glycated haemoglobin

RBC have a lifespan of around 3-4 months so this is a better estimate of glucose levels