CS. Diabetes

Question 1

What is diabetes?

Answer 1

Complex metabolic disorder characterised by persistent hyperglycaemia [in association with other CV risk factors]

Question 2

What does glucose attach to hen absorbed across the gut wall?

Answer 2

Hb [HbA1C]

Question 3

What is the diagnostic criteria for diabetes?

Answer 3

FBG: >7.0 mmol/L
OGTT: >11.1 mmol/L

Question 4

How long do erythrocytes last before being renewed?

Answer 4

8-12 weeks

Question 5

What is the relationship between amount of glucose and glycated haemoglobin (HbA1c)?

Answer 5

Directly proportional

Question 6

Normal BG levels

Answer 6

60-110 mg/dL

Question 7

Typical symptoms of hyperglycaemia

Answer 7

Polyuria
Polydipsia
Unexplained weight loss

Question 8

Typical plasma values of hyperglycaemia

Answer 8

Random venous plasma glucose ±11.1 mmol/L

Fasting PG ±7.0 mmol/L

2 hour PG ±11.1 mmol/L

Question 9

How is hyperglycaemia diagnosed when individual is asymptomatic?

Answer 9

Minimum of 2 lab PG tests on different days, within diabetic range

Question 10

Where is insulin secreted from?

Answer 10

b-cells of pancreatic islet

Question 11

Give 3 more actions of insulin other than controlling blood sugar

Answer 11

Lipid metabolism

Cell Growth

Protein synthesis

Question 12

What does excess glucose lead to in terms of osmosis?

Answer 12

Osmotic diuresis

Question 13

What type of molecule is insulin?

Answer 13

Peptide hormone

Question 14

Explain the mechanism of action of Insulin

Answer 14

Binds to transmembrane insulin receptor

Increases GLUT-4 surface expression - ensure directly proportional glucose flow into cells

Insulin signal transduction cascade also results in: Hexokinase activation and Glycolysis

Question 15

IDDM

Answer 15

Type 1

Immune mediated or idopathic

Question 16

NIDDM

Answer 16

Type 2

Insulin resistance or insulin secretory defect

Question 17

State the auto-antibodies associated with T1 Diabetes

Answer 17

GAD65 (Glutamate Decarboxylase)

IA-2 (Islet Tyrosine Phosphatase)

ZnT8 (Zn Transporter Required for b-cell function

Question 18

Risk factors for T1 diabetes

Answer 18

Enteroviruses, Coxackie, Rubella

Environmental Agents

Genetic Factors

Question 19

Risk factors for T2 diabetes

Answer 19

Genes
Environment
Obesity
Hep B

Question 20

State 4 microvascular complications of diabetes

Answer 20

Retinopathy
Nephropathy
Neuropathy
Small vessel arteriopathy

Question 21

Explain effects of hepatic glucose production

Answer 21

Decrease insulin resistance

Bedtime insulin/metformin needed

Question 22

Explain effects of insulin thiazolidinediones

Answer 22

Decrease insulin resistant

Muscle glucose uptake