Diabetes Flashcards

1
Q

What is diabetes mellitus?

A
  • Insulin dependence - Resistance to the effects of insulin.
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2
Q

What is diabetes insipidus?

A
  • Deficiency of antidiuretic hormone.
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3
Q

What is diabetes mellitus type 1?

A
  • Autoimmune destruction of B-cells - probably triggered by a viral infection such as coxsackie or rubella. - Susceptibility partly dependant on HLA gene subtypes (HLA-DR3/4) - Classically starts in childhood though adult onset is not rare.
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4
Q

What is diabetes mellitus type 2?

A
  • Peripheral insulin resistance. - B-cells response to glucose delayed or absent. - Insulin concentrations normal or high. - Strong association with lifestyle (obesity)
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5
Q

What is gestational diabetes?

A
  • Genetic predisposition - Insulin resistance, probably triggered by hormonal changes of pregnancy and is resolved with delivery. - Risk factors - maternal age, family history of DM type 2, African/north American native, smoking, previous GF, previous baby over 4kg. - Danger to mother - risk of DM type 2 in later life, hypertension, pre-eclampsia, obstructed labour. - Danger to child - risk of DM type 2 in later life, risk of obesity in later life, macrosomia, neonatal hypoglycaemia, neonatal jaundice, respiratory distress syndrome.
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6
Q

What are the causes of secondary diabetes mellitus?

A
  • Chronic pancreatitis - Haemochromatosis - Cystic fibrosis - Pancreatic surgery - Endocrine disease (Cushings syndrome) - Drug therapy (corticosteroids)
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7
Q

What are the symptoms of DM type 1?

A
  • Polyuria - Polydipsia - Hunger - Weight loss
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8
Q

How do you diagnose DM?

A
  • Fasting plasma glucose level at or above 7.0mmol - Plasma glucose at or above 11.1mmol - 1-2hours after glucose load.
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9
Q

What are the acute presentations of DM?

A
  • Ketacidosis - rapid breakdown of fat and protein release ketones (including acetone), can lead to coma/death. - Hyperasmolar nonketotic state - severe dehydration, DM type 2, can lead to coma/death. - Hypoglycaemia - insulin overdose, generally accidental. - Diabetic foot - can lead to generalised sepsis or death.
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10
Q

What is the chronic presentation of DM?

A
  • Macrovascular - ischaemic heart disease, stroke, peripheral vascular disease. - Microvascular - Retinopathy, neuropathy, nephropathy. - Cataracts.
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11
Q

What is diabetic retinopathy?

A
  • Proliferation of blood vessels in the retina - retinal haemorrhages. - Muscular oedema - fluid exudation into retina.
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12
Q

What is diabetic neuropathy?

A
  • Microangiopathy of vasa nervosum - peripheral numbness or tingling, occasional neuropathic pain, muscle weakness, autonomic neuropathy (V+D, constipation, impotence, incontinence, anorgasmia, postural hypotension). - Microangiopathy of glomerulus capillaries - pathology (nodular and diffuse glomerulosclerosis) and clinical (chronic renal failure or nephrotic syndrome hypertension).
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