Diabetes

Question 1

What does mellitus mean

Answer 1

sweet- high sugar content (hyperglycaemia)

Question 2

what is insipidus

Answer 2

excessive thirst and urination - rare

Question 3

what is diabetes?

Answer 3

inappropriate glucose homeostasis, hyperglycaemia, insulin insufficiency to meet regulation.

Question 4

what type of diabetes is absolute insulin deficiency?

Answer 4

type 1

Question 5

Type 2 is what type of insulin deficinecy

Answer 5

relative

Question 6

what is the failure of insulin synthesis, release or activity known as?

Answer 6

MODY

Question 7

HbA1c would score what if diabetic

Answer 7

> 48m/m

Question 8

fasting glucose score would be what if diabetic

Answer 8

> 7m/mol

Question 9

what would the random glucose score be in someone with diabetes

Answer 9

> 11.1m/mol

Question 10

what is the score for 2hr glucose OGTT

Answer 10

> 11.1

Question 11

what antibodies are usually present in type 1 diabetes

Answer 11

Anti GAD and anti- islet cell antibodies

Question 12

what is insulinitis

Answer 12

lymphocyte infiltration

Question 13

When does type 1 usually present

Answer 13

childhood/ peri puberty

Question 14

what onset is type 1

Answer 14

acute +severe WEIGHT LOSS

Question 15

does type 1 require insulin?

Answer 15

HELL YEAH

Question 16

when does type 2 present

Answer 16

middle aged/ obese

Question 17

how do you manage type 2 diabetes?

Answer 17

diet and tablets

Question 18

what are complications of type 2 diabtes

Answer 18

neuropathy, retinopathy

Question 19

whom does monogenic diabetes most commonly affect?

Answer 19

children

Question 20

what would the antibodies be in monogenic diabetes

Answer 20

negative- GAD and C peptide positive

Question 21

what does HbA1c show?

Answer 21

glucose control measure over 2-3 months

Question 22

what microvascular complications can occur?

Answer 22

retinopathy, neuropathy, nephropathy

Question 23

What macrovascular complications

Answer 23

heart disease and stroke

Question 24

risk factors for type 2

Answer 24

previous MI and stroke, pregnancy, obesity, age, medications- antipsychotics

Question 25

what is the classic presentation of type 1 diabetes?

Answer 25

polyuria, WL, polydipsia

Question 26

Are cystic fibrosis patients likely to develop diabetes?

Answer 26

yes- >25%

Question 27

What is prominent in bardet beadle syndrome

Answer 27

polydactyly, hypogonadal, visual/hearing impairment, DIABETES

Question 28

In LADA are antibodies positive or negative?

Answer 28

positive (where MODY is negative)

Question 29

What autoimmune conditions are associated with diabetes

Answer 29

coeliac, thyroid, anemia, IgA deficiency, Addisons

Question 30

what are key elements of type 2 diabetes

Answer 30

insulin resistance and b cell dysfunction

Question 31

describe the concept of insulin resistance

Answer 31

the receptor is not as responsive to insulin molecule and therefore less glucose enters cell, resulting in a build up of glucose in the blood

Question 32

what factors cause insulin resistance

Answer 32

BUILD UP OF FAT, INFLAMMATORY, reduction In glycogen synthesis due to reduced glucose transport

Question 33

truew or flase, at time of diabetes presentation, b cell function is already approx. half depleted

Answer 33

truuueee

Question 34

which body shape is worse for diabetes, apple or pear

Answer 34

apple

Question 35

what factors make up the metabolic syndrome

Answer 35

high BP, high triglycerides, low HDL, insulin resistance

Question 36

what kind of lifestlyr advice can you give

Answer 36

WL, exercise, smoking cessation and improve diet

Question 37

name a biguanide

Answer 37

metformin

Question 38

what type of anti hyperglycaemic agents is glicazide/ glipizide

Answer 38

sulphylureas

Question 39

What is pioglitazone

Answer 39

a thiazolidiones

Question 40

what is the usual starting dose of metformin

Answer 40

500mg OD

Question 41

What do the class biguanides do?

Answer 41

insulin sensitizers

Question 42

does metformin cause hypos?

Answer 42

nooo

Question 43

true or false, metformin can cause micro and macrovascular problems

Answer 43

FlALSE FALSE FALSE

Question 44

IS METFORMIN SAFE IN PREGNANCY?

Answer 44

yes

Question 45

are GI side effects common in metformin?

Answer 45

Yes-25%

Question 46

Should you be weary with MI/strokes in patients taking metformin?

Answer 46

yeah

Question 47

what should you do if eGFR is less than 30ml/min?

Answer 47

stop metformin

Question 48

what do sulphonylureas do?

Answer 48

secrete insulin by acting of potassium channel

Question 49

does sulphonylureas prevent micro and macrovascualar problems?

Answer 49

No- prevents microvascualr complications but NOT macrovascular

Question 50

what is one of the biggest risks of sulphonylureas?

Answer 50

hypo attacks in older people

Question 51

when should you totally avoid sulphonylureas?

Answer 51

in severe renal or hep[atic disease

Question 52

thiazolinedione does ewhat?

Answer 52

transcripts genes that are insulin sensitive

Question 53

What happens to your weight in TZDs?

Answer 53

you put weight on!

Question 54

Patients with heart failure should not get TZDs

Answer 54

true- risk of fluid retention

Question 55

does TZDs prevent against macrovascular complications?

Answer 55

Yes

Question 56

True or flase- there si not a risk of hip fracture when taking plioglitazone

Answer 56

false!- 20% risk

Question 57

what is the incretin pathway?

Answer 57

where glucose is absorbed better orally than iv

Question 58

what are 2 incretins?

Answer 58

GIP form K cells and GLP-1 from L cells

Question 59

what do GLP1 receptor agonists do?

Answer 59

suppress glucagon, promote insulin secretion, decrease gastric emptying, reduce apetite WL

Question 60

why are DPP4 good?

Answer 60

becase they keep weight newutral and supress glucagon

Question 61

what normally happens to sugar oin the body

Answer 61

sugar is completely reabsorbed

Question 62

what doo SGLT2 inhibitors do?

Answer 62

decrease uptake of sugar

Question 63

what are downsides to SGLT2 inhibitors

Answer 63

increase thrush, increase UTI?

Question 64

when is insulin used?

Answer 64

basically as a last resort

Question 65

How should you treat hypertension in patients that have diabetes?

Answer 65

NO ASPIRIN, statins, fibrates,