Flashcards in Diabetes Deck (37):
What is Diabetes Mellitus?
Deficiency of insulin and resistance to effects of insulin
What is Diabetes Insipidus?
Deficiency of anti-diuretic hormone
What is insulin?
Peptide hormone, 51 amino acids, produced in ß-cells in pancreas
What does insulin regulate?
Glucose uptake and metabolism
What cells require insulin to absorb glucose?
Skeletal muscle cells and fat cells
What does not require insulin to absorb glucose?
Neurons and a variety of other cells
Why do skeletal and fat cells require glucose but neurons and others don't?
Can accumulate large carbohydrate reserves
What is the action of Insulin?
Uptake glucose and amino acids by cells, glycogen synthesis
What is the control release of insulin?
Mainly direct feedback, ß-cells absorb glucose by GLUT2
Some autonomic control
Released from cholecystokinin
What are the acute consequences of insulin deficiency?
Hyperglycaemia, ketosis, acidosis, hyperosmolar state
What are the chronic consequences of insulin deficiency?
Cardiovascular disease, nephropathy, neuropathy, retinopathy
What is Diabetes Mellitus Type 1?
Autoimmune destruction of ß-cells, trigged by infection, susceptible on HLA gene
When does Diabetes Mellitus Type 1 typically start?
Childhood, though can start in adult
What is Diabetes Mellitus type 2?
Insulin resistance, ß-cells response to glucose delayed/absent
What is Diabetes Mellitus 2 associated with?
What is Gestational Diabetes?
Genetic, insulin resistance triggered by hormonal changed
When is Gestational Diabetes resolved?
What are the risk factors of Gestational Diabetes?
Maternal age, family history of DM2, African/North American, previous gestational diabetes, previous baby over 4kg, smoking
What are the dangers to the mother with Gestational Diabetes?
Risk of DM2, hypertension, pre-eclampsia, obstructed labour
What are the dangers to the child with Gestational Diabetes?
Risk of DM2, risk of obesity, mactosomia, neonatal hypoglycaemia, neonatal jaundice, respiratory distress
What conditions can lead to Secondary Diabetes Mellitus?
Chronic pancreatitis, cystic fibrosis, pancreatic surgery, haemachromatosis
What drug related conditions can lead to Secondary Diabetes?
Endocrine - Cushings
Drug therapy - Corticosteriods
What are the symptoms for Diabetes Mellitus Type 1?
Polyuria, polydipsia, hunger, weight loss
What is Polyuria?
Increased urine output and polydipsia (increased thirst)
What is the biochemical diagnosis of Diabetes Mellitus?
Fasting glucose - 7mmol
Oral glucose - 11.1mmol
Random glucose- 11.1mmol
What happens in an acute presentation of Diabetes Mellitus? (K)
Ketoacidosis - Breakdown of fat and protein released ketones and acids in to blood
What can Acute Ketoacidosis result in?
Come and death
What is Acute Hyperosmolar Nonketotic state and what can it lead to?
Sever dehydration, DM2, coma and death
What is Acute Hypoglycaemia and what can it lead to?
Insulin overdose, coma and death
What is Acute Diabetic foot and what can it lead to?
Can lead to generalised sepsis and death
What is Chronic Macrovascular Diabetes Mellitus?
Ischaemic heart disease, stroke, peripheral vascular disease
What is Chronic Microvascular Diabetes Melitus?
Retinopathy, neuropathy, nephropathy
What other chronic eye condition can happen to Diabetes Mellitus patients?
What is Diabetic Retinopathy?
Proliferation of blood vessels in retina, macular oedema
What can happen with Hyperglycaemia to the eye?
What is Diabetic Neuropathy?
Microangiopathy of vasa nervosum, numbness, pain, weakness