diabetes

Question 1

what is diabetes melitus?

Answer 1

abnormality of glucose regulation

Question 2

what is diabetes insipidus?

Answer 2

abnormality of renal function

Question 3

what is diabetes?

Answer 3

a series of metabolic conditions sharing the major characteristic of hyperglycaemia

Question 4

what does exposure to chronic hyperglycaemia risk?

Answer 4

microvascular complications and long term macrovascular disease

Question 5

what tests can diagnose diabetes?

Answer 5

plasma glucose

glucose tolerance test

Question 6

what is the intermediate zone between normal and diabetes termed?

Answer 6

pre-diabetic

strong indicators of future diabetes

Question 7

what can be tested for diabetes?

Answer 7

random sugar
fasting sugar
GTT
HbA1c

Question 8

when is GTT used?

Answer 8

if random plasma glucose >11.1mmol/L on 2 occasions

Question 9

what test does not require a fasting sample?

Answer 9

HbA1c >48mmol/mol

Question 10

what is type 1?

Answer 10

insulin deficiency
autoimmune destruction of pancreatic B cells
immune mediated pancreatic b cell destruction

Question 11

what causes type 1?

Answer 11

interplay between genetic and environmental factors

-familial clustering

Question 12

what determines clinical presentation?

Answer 12

rate of destruction

-spectrum of ages

Question 13

how does diabetes usually present in young?

Answer 13

with ketoacidosis

-body cells cannot access glucose for metabolism so start to metabolise fate resulting in ketones

Question 14

which antibodies are present in type 1?

Answer 14

GAD-glutamic acid decarboxylase
ICA- islet cell antibodies
IAA- insulin autoantibodies

Question 15

what are the characteristics in adult onset (Type 1) ?

Answer 15

LADA- latent autoimmune diabetes in adults (>25y.o)
GAD associates
less weight loss
less ketoacidosis
variable period until insulin required

Question 16

what are the symptoms of type 1?

Answer 16

polyuria
polydipsia
tiredness

Question 17

what is the acute presentation of type 1?

Answer 17

hyperglycaemia with diabetic symptoms

ketoacidosis

Question 18

describe the presentation of type 2

Answer 18

most common
associated with obesity & inactivity
usually >40
strong family history
rarely ketoacidosis

Question 19

what is type 2?

Answer 19

heterogeneous group of hyperglycaemic disorders with multiple dif mechanisms

Question 20

what are the characteristics of type 2

Answer 20

defective & delayed insulin secretion and abnormal postprandial suppression of glucagon

Question 21

what can cure type 2?

Answer 21

bariatric surgery

Question 22

describe insulin resistance

Answer 22

B cell response to hyperglycaemia inadequate
elevated basal insulin levels
failure of gluconeogenesis suppression
insulin stimulated glucose uptake is reduced
inadequate release/response to incretins
increased absorption of glucose fron GIT due to increased transporter

Question 23

what are the effects of type 2?

Answer 23

impaired glucose tolerance
hyperinsulinaemia
hypertension
obesity w/ abdominal distribution
dyslipidaemia
procoagulant epithelial markers
early & accelerated atherosclerosis

Question 24

describe the onset of type 2

Answer 24

gradual
over many years
usually IGT for some time
often retinal damage at diagnosis
ability to secrete insulin falls with time

Question 25

describe the presentation of type 2

Answer 25

polyuria
polydipsia
tiredness
unusual infections
diabetic complications

Question 26

what slows decline from IGT?

Answer 26

strict diet and exercise

Question 27

which medications can induce diabetes?

Answer 27

medicine which interferes with secretion of insulin/glucagon
corticosteriods
immune suppressants
cancer medication
antipsychotics
antiviral- protease inhibitors

Question 28

what conditions are related to diabetes?

Answer 28

endocrine
-Cushing's
-pheochromocytoma
-acromegaly
pregnancy- gestational
risk factors
-overweight
-family hsitory
-some ethnic groups
-previous