Diabetes Flashcards Preview

Endocrine > Diabetes > Flashcards

Flashcards in Diabetes Deck (47):
1

Define the bascis of diabetes.

A group of metabolic diseases characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action or both

2

What are the 4 criteria of which any can be used to diagnose diabetes?

HbA1c 48mmol/mol +
Fasting glucose - 7mmol/L+ 2hr glucose in OGTT 11.1mmol/L+
Random glucose 11.1mmol/L+

3

What are the 4 main types of Diabetes?

Type 1
Type 2
Other specific types
Gestational Diabetes

4

What are the 2 cardinal symptoms of diabetes?

Polydipsia (excessive thirst)
Polyuria

5

Give a list of other syptoms that can occur with any diabetes in general?

Thrush (candidal or other infection)
Blurred vision
Weakness fatigue

6

What are the 3 main microvascular complications in diabetes?

Nephropathy
Retinopathy
Neuropathy

7

Define gestational diabetes.

any degree of glucose intolerance arising or diagnosed during pregnancy

8

Which autoantibodies are normally present in T1DM?

anti-GAD and /or anti-islet cell antibodies

9

What is type 2 DM?

A diagnosis of exclusion - not type 1 and not some other specific type

10

Does autoimmune destruction to the beta-cells occur in type 2 DM?

No
It is not an AI disease

11

Give 5 specific types of diabetes? Not incding T1, T2 or gestational diabetes

LADA
MODY
Drug induced
NND
Endocrine disease
Wolfram syndrome

12

How does type 1 DM usually present?

Pre-school or peri-puberty
Usually lean
Acute onset of severe symptoms
Often severe weight loss
ketonuria with/wo metabolic acidosis
No evidence of complications

13

What is the basis pathogenesis of T1DM?

Interaction between genes imparting susceptibility and resistance --> Variable insulinitis and beta-cell sensitivity to injury -->
Pre-diabetes --> Overt diabetes

14

What is your risk of havin T1DM if both of your parents have it?

~30%

15

Briefly describe the management of type 1 DM.

BG and ketone monitoring
Insulin
CHO estimation
Dieticia and DSN contact
Annual review assessment
Record severe hypoglycaemia episodes and DKA

16

What is the typical presentation of T2DM?

Middle aged/ elderly
Usually obese
Pre-diagnosis duration of ~6-10 years
Insidious onset
Ketonuria – minimal or absent
Evidence of microvascular disease/complications at diagnosis in 20-50 %

17

Give the risk factors for the development of T2DM.

Obesity
FH
Age
Ethnicity (Asian, African, Afro-Carribean)
PMH - MI or CVA
Antipsychotics
IGT/IFG

18

What is a diagnosis of the "metabolic syndrome" made on?

Need insulin resistance and T2DM plus 2 of the following to have the metabolic syndrome:
Micralbuminuria
Obesity (BMI >30 or WHR 1.7, HD <1.0

19

What are the basic steps of treatment for T2DM?

Therapeutic lifestyle change
Monotherapy
Combination therapy (w/o insulin)
Combination therapy (with insulin)

20

What does LADA stand for?

Latent autoimmune diabetes of adults

21

When should you suspect LADA?

AGe 25-40
Usually non-bese
Associated AI conditions
Male preponderance
Auto-antibody positive

22

What does MODY stand for?

Maturity onset diabetes of the young

23

What kind of inheritance does MODY express?

Autosomal dominant inheritance - rare

24

What are the 2 main types of MODY?

Glucokinase and transcripton factors

25

Which class of diabetic drugs works really well in MODY?

Sulphonylureas

26

When is neonatal diabetes diagnosed and what is required?

Within the first 3 months of life and insulin treatment is required

27

What are the 3 macrovascular complications of diabetes?

CVA
MI
PVD

28

The microvascular diabetic complication of retinopathy can present with what?

Retinopathy
Cataract
Glaucoma

29

What is the scale used to measure diabetic retinopathy?

Mid non-proliferative
Moderate non-proliferative
severe non-proliferative
Proliferative
Maculopathy

30

What are some further complications caused by the diabetic complication of nephropathy?

Development of HTN
Relentless decline in renal functtio
reduction in GFR
accelerated vascular disease

31

Which anti-hypertensive drug is particularly good at treating diabetic nephropathy?

ACE Inhibitors

32

What are the symptoms of peripheral neuropathy?

Numbness
tingling
burning
sharp pain or cramps
sensitivity to touch
loss of balance and coordination

33

What can diabetic neuropathy lead to?

infections
ulcers
deformities (charcot foot, rocker bottom foot)
amputations

34

What is the treatment for diabetic peripheral neuropathy?

Simple analgesia
tricyclic antidepressanes
gabapentin
Duloxetin (SSRI)
Stronger opiods (Tramadol)
topical capsaicin cream

35

What other complications can diabetes lead to?

Erectile dysfunction or vaginal dryness
Psychiatric – depression, eating disorder, bi-polar, schizophrenia

36

What is the target blood pressure for diabetics?

130/80

37

What other measures besides diabetic drugs can help in controlling diabetes?

simvastatin 40 mg or atorvastatin 10 mg for T2DM regardless of baseline cholesterol

38

Is low dose aspirin recommended for primary prevention of CV disease in diabetics?

No but can be used for 2y prevention

39

Why is diabetes monitored?

Guide treatment decisions
reduce risk of compications
Avoid hypo/hyper/DKA
Safe in society
Empower patients

40

What is HbA1c?

Glycated haemoglobin formed by non-enzymatic glycation of haemoglobin on exposure to glucose

41

What does HbA1c measure?

Average blood glucose over a period of time

42

What HbA1c needs to be reached before diabetes can be diagnosed?

>48mmol/mol (6.5%)

43

What is the targert HbA1c for diabetics?

53mmol/mol

44

For T1 and T2 DM how many times a day should they be monitoring their blood glucse via home BG monitoring machine?

T1 - 4-8 times a day
T2 - 1-4 times a day

45

What are the targets for home blood glucose monitoring before and after meals?

before - 4-7mmol/mol
1-2 hours after beginning of meal <10mmol/mol

46

What is the main purpose of bllod ketone monitoring at home?

Identifies early stages of ketone body formation when the patient often has no symptoms allowing preventative action to be carried out

47

Patients in DKA are at high risk of what?

Thromboembolism