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CSI > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Prediabetes also recognised as

A

Borderline diabetes

Impaired fasting glucose (IFG)
Impaired glucose tolerance (IGT)
Impaired glucose regulation (IGR)

Non diabetic hyperglycaemia

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2
Q

Biomarkers checked in blood test for T2D

A

HbA1C levels - average blood glucose for past 2-3 months (should be below 42mmol/mol (6%)

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3
Q

HbA1C range

A

Should be below 42mmol/mol (6%)

Person with diabetes type 2 should be 48mmol/mol (6.5%) ideally

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4
Q

What is prediabetes

A

Warning sign that you are at risk of developing type 2 diabetes

Early, reversible stage of diabetes

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5
Q

Symptoms of prediabetes

A

None

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6
Q

Prevent t2d

A

Manage weight
Eat healthy, balanced diet
Be more active

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7
Q

Components of diet that increase risk of t2d

A

High fat content
High glycemic index
Low fibre

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8
Q

Diets linked to a DECREASED risk of t2d

A

Mediterranean diet

Vegetarian and vegan

Nordic diet

Cutting down on carbs

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9
Q

Mediterranean diet

A

Largely based on plant foods (fruit, veg, beans, pulses, nuts, seed)

Some dairy

Lean protein chicken eggs fish

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10
Q

Nordic diet

A

Replacing processed foods with single ingredient ones

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11
Q

Foods to cut down on to reduce risk of t2d

A

Red and processed meat
Refined carbs
Sugar sweetened drinks

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12
Q

What is the NHS DPP

A

NHS diabetes prevention programme

Evidence based behavioural interventions for individuals at high risk of t2d

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13
Q

Diabetes treatment accounts for how much of the annual NHS budget

A

10%

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14
Q

Aims of NHS DPP

A

Reduce incidence of t2d
Reduce incidence of complications associated with diabetes
Long term reduce health inequalities associated with incidence of diabetss

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15
Q

Short term drawback of NHS DPP

A

Increased incidence due to more undiagnosed cases being uncovered

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16
Q

How is the NHS DPP programme run

A

Set and achieve goals and make positive changes to their life

Goals include
- achieving a healthy weight
- dietary recommendations
- achieving physical activity recommendations

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17
Q

Core defects of t2d

A

Insulin RESISTANCE in muscles and the liver

Impaired insulin secretion by pancreatic beta cells

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18
Q

Which peptide contributes to the progressive failure of function of beta cells in the pancreas

A

Beta cell resistance to GLP1 (glucagon like peptide 1)

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19
Q

What contributes to excessive glucose production

A

Increased glucagon levels and hepatic sensitivity to glucagon

Increas3d secretion of glucagon from pancreatic alpha cells as they become insulin resistant

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20
Q

What aggravates the insulin resistance in muscle and liver to contribute to beta cell failure

A

Insulin resistance in adipocytes results in increased plasma free fatty acids (from accelerated lipolysis)

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21
Q

What contributes to maintenance of hyperglycaemia related to the kidney

A

Increased renal glucose reabsorption by SGLT2 in proximal consulates tubule
Increased threshold for glucose spillage in the urine

22
Q

Why is there weight gain in t2d

A

Resistance to appetite suppressive effects of hormones

Low brain dopamine and increased serotonin

23
Q

What is the ominous octet

A

8 different defects in sugar metabolism that lead to high blood sugars

24
Q

Decadent decoplet

A

Vascular insulin resistance, inflammation and ominous octet

25
Q

What processes lead to hyperglycaemia in t2d

A
  • decreased insulin secretion by beta cells
  • increased glucagon secretion by alpha cells
  • increased hepatic glucose production
  • vascular insulin resistance
  • neurotransmitter dysfunction
  • inflammation
  • decreased glucose uptake
  • increased glucose reabsorption
  • increased lipolysis
26
Q

Why is there IFG

A

Hepatic insulin resistance leads to continuous glucose output from the liver

27
Q

Why is there IGT

A

Muscle insulin resistance and impaired post-prandial insulin releaze

Leads to poor cellular glucose uptake

28
Q

Normal fasting glucose level

A

<6.1 mmol/mol

29
Q

Normal Post prandial glucose

A

<7.8mmol/mol

30
Q

Normal random glucose

A

<11.1

31
Q

Normal urine dip glucose

A

Negative

32
Q

Impaired fasting glucose

A

6.2-6.9

33
Q

Impaired glucose tolerance fasting, post prandial, random glucose, urine dio

A

<7,
7.8-11.1,
<1.1
Positive

34
Q

Diabetes fasting glucose

A

> 7

35
Q

Diabetes post prandial

A

> 11.1

36
Q

Diabetes randim glucose

A

> 11.1

37
Q

Is urine dip glucose reliable

A

No doesn’t make a differential diagnosis

38
Q

How is post prandial glucose tested

A

Oral glucose tolerance test, taken 2 hours after a 75g oral load

39
Q

What is t2d

A

Metabolic disorder associated with hyperglycaemia caused by impaired insulin secretion and insulin resistance

40
Q

What contributes to t2d

A

Peripheral organs (liver, muscle, kidney) become insulin resistant

Leads to reduced glucose uptake, excessive glucose reabsorption in kidney, jncreased gluconeogenesis

41
Q

Micro vascular complications associated with t2d

A

Several hyperglycaemia leads to neuropathy, retinopathy

42
Q

Macro vascular complications of t2d

A

Myocardial infarction
Peripheral vascular damage
Stroke

Result of hypertension, hyperglycaemia, inflammation

43
Q

HbA1C diagnosis criteria for t2d

A

More than 6.5%

44
Q

Urinating more often

A

High blood glucose levels cause body to try and remove excess glucose via urination
Kidneys filter out water

45
Q

GLUT1 distribution

A

Erythrocytes, endothelium

46
Q

GLUT2 distribution

A

Pancreatic beta cells,
Kidney
Small intestine
Liver

47
Q

GLUT3 distribution

A

Neurons
Placenta

48
Q

GLUT4 distribution

A

Skeletal muscle
Adipose tissues

49
Q

Which receptor is glucose dependent

A

GLUT4

50
Q

Receptor affinity for glucose

A

1- borderline
2- low
3&4- high

51
Q

Glucose input into cells

A

Pancreatic beta cells secrete insulin

Binds to insulin receptor, activating it which initiates translocation of transporter to cell membrane

Glucose can enter cell

CSI (4 decks)

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