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BDS2 BAMS > diabetes > Flashcards

diabetes Flashcards

1
Q

diabetes mellitus vs diabetes insipidus

A

diabetes means pee alot

mellitus = glucose in pee (glucose regulation problem)

insipidus = no glucose in pee (renal function problem, lack of adh)

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2
Q

type 1 or type 2 diabetes mellitus more common

A

type 2 85%

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3
Q

type 1 vs type 2

A

o type 1 -> no insulin production

o type 2 -> poor response to insulin

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4
Q

what other medical conditions are diabetes related to?

A

infection
poor wound healing
stroke
MI
peripheral neuropathy and artery disease
retinopathy
diabetic foot
cataract
renal disease

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5
Q

how to test for diabetes?

A

high plasma glucose >11.1mmol/L

Glucose tolerance test

HbA1C >48mmol/molo (glycosylated haemoglobin)

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6
Q

what is glucose tolerance test?

A

given 75g of glucose and sugar level accessed after 2 hours

results can be normal, impaired fasting glucose or diabetes

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7
Q

if you are found to have impaired fasting glucose from a GTT test, what does it mean?

A

pre diabetic

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8
Q

what is glycosylated haemoglobin HbA1C??

A

used to MONITOR diabtes, tells you if sugar control has been good or bad for the past few weeks

o measure of how much glucose residue is stuck to the surface of Hb

o glucose residue increases with time, signifies increasing sugar concentration in blood

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9
Q

Ketoacidosis

A

body cannot access glucose for metabolism and energy so starts to metabolise fat which results in ketones and acid

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10
Q

what is GAD ICA IAA

A
  • GAD = glutamic acid decarboxylase
  • ICA = islet cell antibodies
  • IAA = insulin auto antibodies
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11
Q

What does insulin resistance mean?

A

blood glucose constantly high so insulin becomes less sensitive, requires larger amounts of insulin to lower blood glucose levels

high basal insulin levels
B cell response to hyperglycaemia is inadequate
failure of gluconeogenesis suprresion
glucose movement is poorly repsonsive so glucose uptake is reduced

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12
Q

insulin resistance found in which type of diabetes

A

2

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13
Q

Diabetes related to medications

A
  • corticosteroids (insulin antagonists)
  • immune suppressants
  • cancer meds
  • antipsychotic meds
  • antiviral
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14
Q

Diabetes related to which endocrine diseases

A
  • Cushings (excess cortisol)
  • Phaeochromocytoma (adrenaline tumour)
  • Acromegaly (excess growth hormone)

Why? Because a change in hormone levels will change the ability of the body to handle glucose load

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15
Q

what is gestational diabetes

A

pregnant women, increased metabolism but once baby born back to normal

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16
Q

type 1 causes

A

autoimmune destruction of B cells (Lymphocytes attack pancreatic islets of Langerhans )
genetic + environment

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17
Q

is type 1 and 2 rapid/ chronic progression

A

type 1 - rapid
type 2 - chronic

18
Q

in which type will there be ketoacidosis?

A

acute presentation
EMERGENCY
in type 1

rare in type 2

19
Q

increase in GAD ICA and IAA indicates what?

A

Circulating antibodies indicates loss of pancreatic function : type 1 diabetes

20
Q

is type 1 and type 2 more common in kids or adults

A

type 1 - kids but adults possible (LADA)

type 2 - adults but kids sometimes (MODY)

lada latent autoimmune diabetes in adult
mody mature onset diabetes in young

21
Q
  • polyuria (pee)
  • polydipsia (thirst)
  • tiredness
A

symptoms of type 1

22
Q

symptoms of type 2

A
  • impaired glucose tolerance
  • hypertension
  • obesity
  • early and accelerated atherosclerosis
  • retinal damage
  • infections like oral candidiasis
  • MI/stroke
23
Q

insulin injections in which type

A

1 but 2 also can

24
Q

how to manage diabetes?

A

education on diet and lifestyle more exercise less carbs

blood glucose targets

reduce risks from associated dieases using drugs

insulin injections

25
Q

how is insulin injected

A

subcutaenously

either split mix or basal bolus

26
Q

split mix vs basal bolus for insulin injections

A
  1. split mixed = less injections less controlled
  2. basal bolus = more injections more controlled
27
Q

why do we give diabetes patients CVS drugs

A

high blood sugar levels for a period of time, your blood vessels can start to get damaged, glucose sticks to your red blood cells and builds up in your blood.

leading to eye, feet problems etc

o antiplatelet
o stains
o antihypertensives

28
Q

why must exercise be planned for type 1 diabetic patients?

A

might risk hypoglycaemia

29
Q

ideal HbA1C levels

A

6-10%
o if too high -> retinopathy
o if too low -> hypoglycaemia

*glycosylated haem used to monitor sugar control over time

30
Q

why is retinopathy a complication of diabetes?

A

small blood vessels in the eye get swollen

31
Q

type 1 diabetes monitoring machine name

A

closed loop glucose monitoring

continuous glucose monitoring

32
Q

type 2 diabetes tx

A
  • avoid CHO and fat diet
  • bariatric surgery
  • medications
33
Q

first line drug for t2 diabetes

A

metformin

enhances cell insulin sensitivity

reduces hepatic gluconeogenesis

34
Q

what are gliptins

A

DDP-4 inhibitors (Gliptins)

drug for t2 diabetes

  • blocks metabolism of incretin
  • incretin stays in circulation for longer
35
Q

what is incretin

A

stimulates a decrease in blood glucose levels,

stimulates insulin release

36
Q

Sulphonylureas

A

drug for type 2

  • increases pancreas insulin secretion
  • but can cause hypoglycaemia
37
Q

Complications of diabetes treatment

A

in type 1, inject insulin but dont consume food -> acute hypogly

in typw 2, take med sulphonylurea -> too much insulin secreted can cause acute hypogly

38
Q

when to prescribe additional insulin

A

Type 1 requires more insulin during surgery

Type 2 requires insulin after operation for wound healing and prevent infection

39
Q

why is fasting before surgery a problem for type 1 diabetes

A

o might lead to acute severe hypoglycaemia since insulin taken but cannot eat food
o need insulin to prevent ketosis
o usually admitted to hospital for glucose drip

40
Q

what metabolic changes associated with surgery

A

o higher demand for energy
o adrenaline
o cortisol
o hormone changes aggravate diabetes
o more glucose formed less muscle uptake
o metabolic acidosis likely

41
Q

in dentistry what do you have to look out for in diabetic patients

A

food intake after procedure may be disrupted, patient may not want to eat after a procedure but they MUST otherwise hypogly

acute emergencies ketoacidosis or acute hypogly

infection risk

poor wound healing

BDS2 BAMS (27 decks)

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