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Diabetes Flashcards

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1
Q

diabetes is…

A

elevation of blood-glucose above diagnostic threshold

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2
Q

c-ppetide is a good measure of ____

A

endogenous insulin secretion- pro-insulin cleaved into insulin and c-peptide so c-peptide used

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3
Q

2 pathophysiology mechanisms for diabetes are

A

disorder of b-cells, impaired insulin secretion

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4
Q

s/s of diabetes

A

polydipsia, polyuria, fatigue, wt loss

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5
Q

ix for diabetes

A

random blood glucose: >11mmol/l
fasting blood glucose: >7mmol/L
2hr post glucose: >11mmol/L

HbA1c: >48mmol/L

Auto antibodies for T1: GAD

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6
Q

what is a ketosis reading for blood-ketones

A

> 5mmol/L

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7
Q

which 2 tests form the glucose tolerance test

A

fasting plasma glucose, 2hr plasma glucose post 75g solution

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8
Q

tx for diabetes

A

MONITOR: HbA1c, capillary blood-glucose, continuous blood glucose monitoring

Rx: insulin, metaphotmin, sulphonylureas, TDZ. SGLT2i (mono, combo, combo + insulin)

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9
Q

what are 2 surgical options for diabetes

A

pancreatic-kidney transplant, islet transplant

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10
Q

what actually is HbA1c?

A

how much glucose is attached to haemoglobin molecule

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11
Q

main complications of T1 diabetes

A

microvascular: retinopathy, nephropathy, neuropathy

hypoglycaemia, DKA

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12
Q

Type 1 diabetes mellitus is…

A

T cell mediated AI destruction of pancreatic b-cells (can’t produce insulin)

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13
Q

aetiology of T1

A

genetic (HLA gene), idiopathic

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14
Q

classic triad of T1 in kids

A

polyuria. polydipsia, wt loss/ not gaining wt

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15
Q

if pt is symptomatic…

A

tes random glucose. Dx = >11mmol/L

asymptomatic- do glucose tolerance test

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16
Q

c-peptide +ve test

A

<0.2mmol/L

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17
Q

classic insulin regimen for T1

A

Background + long acting + short acting (30mins pre-meal)

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18
Q

why must you inject insulin in different locations

A

to avoid lipodystrophy

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19
Q

how does microvascular injury occur

A

chronic hyperglycaemia causes inc vessel wall thickness but it hence becomes weaker and most susceptible to leakage and bursting

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20
Q

50% of T1 diabetics will develop ______

A

nephropahty

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21
Q

T2 diabetes is…

A

mix of insulin resistance and insulin deficiency

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22
Q

pathophysiology of T2

A

obesity > exceeding fat storage threshold > deposited in other sites > lipotoxicity > insulin resistance

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23
Q

s/s of T2

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A

fits risks (overweight, older etc), dx of exclusion- polydipsia, polyuria

24
Q

mx for T2

Study These Flashcards
A

lifestyle

Rx- metformin, MF + another drug, MF + another drug + insulin

25
what are tx aims for new T2 diabetic
HbA1c 48mmol/L | others 53mmol/L
26
comps for T2
HT, HL, hyperglycaemia, microvascular disease
27
what is hypoglycaemia and causes
low blood-sugar levels, T1 diabetes, t2 diabetes with insulin therapy, missed meal/lots of exercise
28
s/s of hypo
ANS- trembling, anxious, palpitations, tingling fingertips, irritable, hungry neuroglycopenic: weakness, concentration, coordination, slurred speech, seizures
29
dx reading of a hypo
glucose <4mmol/L
30
tx for hypo
if swallowing- rapid sugar (lucozade) + slow acting (biscuit) drowsy- glucose gel severe- IV dextrose (glucose), IM glucagon
31
hyperglycaemia is...
too much glucose, tx is to alter urine which may result in hypo
32
what is DKA
production of ketones due to insufficient levels of insulin
33
how does DKA happen
no insulin to use up glucose > ketones produced > ketones use up HCO3-= acidosis so ketoacidosis
34
aetiology of DKA
insulin deficiency- new dx of diabetes, malcompliance inc insulin demand: infection. inflammation, intoxication, infarcion
35
s/s of DKA
hyperglycaemia, polydipsia/ polyuria ketone body related: vomiting, flushed, abd pain, kussmaul's resp, acetonic breath, hypotension
36
dx of DKA
hyperglycaemia >11mmol/L ketosis >3mmol/L acidosis <7.35pH and HCO3- low potassium >5.5mmol/L
37
tx for DKA acronym
FIG PICK Fluids Insulin Glucose Potassium Infection (check) Chart fluid balance Ketones
38
what is hyperglycaemia hyperosmolar syndrome
hyperglycaemia + hyperosmolarity
39
why does HHS occur
in T2 diabetics usually due to new dx of DM or infection
40
ix for diagnosis of HSS
hyperglycaemia (usually >30mmol/L), osmolarity >320mosmol/kg
41
how to measure osmolarity
2x Na + urea + glucose
42
mx of HSS
monitor and chart plasma osmolarity, blood-glucose and Na | fluids*
43
why else can ketoacidosis occur (other than insulin lack)
alcohol or starvation
44
lactic acidosis is...
lactate is end-product of anaerobic respiration
45
causes of lactic acidosis
fasting
46
what are 2 types of lactic acidosis
typeA: tissue hypoxaemia, sepsis, haemorrhage | type B: liver disease, leukaemic states, diabetes
47
s/s of lactic acidosis
hypervent, confusion, stupor, coma
48
ix for lactic acidosis
hypolactataemia (<0.6mmol/L) | reduced bicarbonate, raised anion gap, raised phosphate, no ketonaemia
49
what is monogenic diabetes
diabetes caused by mutation in a single gene usually affecting b-cell function
50
types of monogenic diabetes
subcategories are- defects in insulin secretion and defects in insulin action secretion: MODY (GCK MODY and TNF a MODY), neonatal diabetes
51
epi of MODY
occurs before 25yo
52
MODY run down
onset <25yo, non-insulin dependent diabetes - GCK mutation: b-cel glucose sensor muttaion - TF mutation: HNF-1a most common
53
what are the most common mutations that cause neonatal diabetes
KCNJ11, ABCC8 genes | block Katp channel so membrane doesn't polarise
54
s/s of MODY
acanthosis nigricans, lipodystrophy GCK: stable hyperglycaemia TF: progressive
55
how to differentiate between the 2 MODYs
oral glucose test, c-peptide
56
tx for MODY
GCK: mainly diet | HNF-1a TF MOFY: 1/3rd diet, 1/3rd sulphonylureas, 1/3rd insulin
57
tx for neonatal diabetes
insulin then sulphonylureas

Endocrine (14 decks)

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