Diabetes

Question 1

Pathogenesis

Answer 1

Chronic metabolic disorder, chronic hyperglycaemia by insulin resis

1: AID of b-cells in p, prod insulin, 5% cases, Cd8 rec b cell foreign, destroy via cytokines and nitric oxide = releases immunogenic proteins inc b cell destr
Factors: Hist,age smoke, activity, non-hisp-w

2: 90, cell no ins response, bc not enough insulin, org no response, bc lose function bc high ins demand = inc hyperglycaemia
RF: Hist, PA, gluco+lipotox inc bc damage
inc dysfunction… less common -> GDM in pregnancy 5, not enough insulin, t2 risk, 2nd chronic pancreas related disorder

Question 2

Acute and chronic complications

Answer 2

1: Poor control - DKA - higher in t1 = lack insulin = no g use = ketone buildup, fruity breath, tiredness and nausea HHS mc in T2,
cause hyperglycaemia, dehydration and chronic fatigue, acute hyperglycaemia by ins buildup = dec in glucose levels: sweating, confsusion, seizure, no mange = inc chronic comp

2: MVC 3 :
1 = nephropathy - affects kidney vessels, GFR builds up proteins and albumin in urine
2 retinopathy - damage retina capillarus
3 Neuropathy - Muscle weakness, severe paralysis
MVC - inc CVD,CHD, severe.. gangrene

Question 3

Manage and T

Answer 3

High QOL, reduce comps and ensure BG control
1 - Insulin inj, b cell therapy, screening, education
2 - diet, med egs. Biguaniles = inc ins sensitivity, sulphaners - stims ins secretion, alphaglucosidase inhibitors = slows carb absorption
Monitor BG, bcells inhibitors for hypertension