Flashcards in Diabetes Deck (18):
How does DM present?
polydipsia, (dehydration), polyuria (esp. night), rapid weight loss, lack of appetite, TATT, vision blur, thrush
How to diagnose DM?
fasting glucose > 7mM
oral glucose > 11.1mM after 2 hours
HbA1c > 6.5%
Symptoms: 1 abnormal test, Asymptomatic: 2 abnormal test
Describe type 1 DM
autoimmune beta cell destruction
normally young people with genetic predisposition
environmental as well
How to detect type 1 DM? What is the treatment?
elevated venous plasma glucose
presence of ketones (breakdown product of fat) measured using 'ketostik' - absolute lack of insulin
treatment: exogenous insulin through subcutaneous injection given several times a day
What is type 2 DM?
when insulin receptors do not work (don't bind) OR not enough insulin is produced by body
develops later on in life due to lifestyle choices
type 2 DM symptoms
polyuria, polydipsia, weight loss
no urinary ketones
may be asymptomatic at early stages
Symptoms of hyperglycaemia
polyuria, polydipsia, blurring of vision, urogenital infections, (weight loss)
Symptoms of inadequate energy utilisation
tiredness, weakness, lethargy, weight loss
How do you manage diabetes?
change of diet (less fat & high sugars) & lifestyle (more exercise)
insulin injections as tablets won't work - body enzymes break it down by liver - inject to blood
How to monitor type 2 diabetes?
look for vascular risk factors - BP, lipids, smoking, exercise, diet
surveillance for chronic complications (eyes, diabetes foot)
How do you monitor type 1 diabetes
What happens if treatment is not effective?
gradual worsening of symptoms
inadequate energy utilisation - ketones instead of glucose
worsening / onset of complications of diabetes - CV risks
acute complications of diabetes
1. diabetic ketoacidosis (type 1) - blood become acidic due to fat metabolism producing ketones
2. hyperosmolar non-ketotic syndrome (type 2) - high blood sugar cause dehydration
acute complications of hyPOglycaemia
coma - brain needs glucose ONLY
chronic macrovascular complications of DM
large vessel disease:
1. cerebrovascular, cardiovascular, peripheral vascular disease
2. stroke, heart attack, intermittent claudication, gangrene
chronic MICROvascular complications of DM
1. retinopathy, nephropathy, neuropathy
2. blindness, need for renal replacement therapy, erectile dysfunction, foot ulceration, diarrhoea, constipation, painful peripheral neuropathy
Why does diabetes develop?
inability to produce insulin (beta cells)
insulin doesn't bind to receptors (resistance)