Chempath 14: Diabetes Cases Flashcards

1
Q

What is the formula for working out osmolarity ?

A

Osmolarity= 2(Na + k) + urea + glucose

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2
Q

How do you calculate anion gap ?

A

Anion gap = (Na + K) - (Cl + HC03)

Anion gap calculates how many ‘other” anions there are. E.g PO4
Normally in the body there are some because we are not electrically charged so all anions + all cations should balance.

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3
Q

Which metabolic disturbance is caused by metformin overdose ?

A

Lactic acidosis

Metformin inhibits gluconeogenesis in the liver by blocking a step in the Cori cycle where lactate is converted back to glucose. This causes excess lactate

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4
Q

Name 2 tests that can be used to diagnose Diabetes or Impaired glucose tolerance ?

A

Fasting plasma glucose: >7mM = Diabeted
Oral glucose tolerance test: >11.1mM at 2 hours = diabetes
oral glucose tolerance test 7.8-11.1mM at 2 hours = Impaired glucose tolerance

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5
Q

What result defines impaired glucose tolerance ?

A

Oral glucose tolerance test >7.8 but < 11.1 mM at 2 hours

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6
Q

What result defines impaired fasting glucose ?

A

Fasting glucose >6.1 but <7.1

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7
Q

What is HHS ?

A
  • Hyperosmolar hyperglycaemic state
  • More common in Type 2 DM
  • No ketones (because still have insulin)
  • very high plasma glucose >30mM
  • High osmolarity >320mOsm
  • Develops over days
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8
Q

What is DKA?

A
  • Diabetic ketoacidosis
  • Ketones in the blood and urine
  • more common in type 1 DM
  • caused by very low insulin levels
  • Hyperglycaemic >11 mM
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