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Clinical Pathology > Diabetes > Flashcards

Flashcards in Diabetes Deck (27):
1

What is diabetes?

- A medical condition with high blood glucose levels
- Diabetic people also often have high BP and high cholesterol levels.

- a condition in which the blood glucose level drifts up: chronic hyperglycaemia

2

Where are the breakdown products of food and drink refined to glucose?

In the Liver

3

Where is 'fuel' stored?

In the liver and muscles as glucose and in fat cells.

4

Using the analogy of a car, what are the issues with to little or too much fuel?

To little - stalling
Too much - uneven engine performance

5

What is a normal blood glucose level?

5 mmol/l

6

Glucose is released from where in response to insulin?

The liver

7

Glucose is taken up to where in response to insulin?

Muscle tissue

8

What are the signs are symptoms of diabetes?

- Symptoms: thirst, polyuria, weight loss, tiredness
- Signs: dry mouth, weight loss, glycosuria, hyperglycaemia

9

How common is diabetes?

- Leeds 4% population
- Rising fast
- Associated with the rise in obesity and a reduction in physical activity
- High prevalence in certain ethnic groups: Asians, Afro-Caribbeans

10

How is diabetes diagnosed?

- Typical symptoms and high RANDOM blood glucose
- Fasting blood glucose >7mmol/l
- 75g OGTT
- HbA1c; 48 mmol/mol (6.5%)

11

What is the oral glucose tolerance test?

- Fasting, then 75g oral glucose load
- Blood glucose: fasting and at intervals
- Fasting: normal 7mmol/l
- 2-hour post-glucose load: diabetic >11 mmol/l

12

What is 'borderline' diabetes?

- Impaired fasting glucose: 6-7mmol/l
- Impaired glucose tolerance: two-hour glucose levels of 7.8 -11.0 mmol/l, 140 to 199 mg/dl on the 75-g oral GTT

13

What investigations are neccessary in diabetes?

- HbA1c
- Renal function
- Liver function
- Lipids
- Thyroid function

14

What are the features of type 1 diabetes?

- Autoimmune destruction of the insulin producing islet beta cells
- Insulin deficient: insulin dependent
- Usually young, but can be ANY age.

15

What autoantibodies may be present in TiDM?

- ICA
- IA2
- GAD

16

What is latent autoimmune diabetes in adults(LADA)?

- Older patients, often female
- Medical or family history of related conditions: type 1 diabetes, thyroid, PA, Addison’s, coeliac, vitiligo
- Presents often as ‘type 2’ diabetes
- Progressive deterioration in control, increasing therapy

17

What autoantibodies may be present in LADA?

- GAD
- ICA
- tTG
- TPO

18

What are the features of type 2 diabetes?

- Insulin resistant/deficient
- Not absolutely insulin dependent
- Strong family history
- Often obese or overweight
- Usually hypertensive and hyperlipidaemic

19

What are the features of TIIDM variant 'ketosis-prone type 2'?

- Often obese, ethnic minority
- Ketosis when physically stressed with intercurrent illness
- Temporarily requites insulin
- Not insulin dependent

20

Which pancreatic disorders can cause secondary diabetes?

- Chronic or acute pancreatitis
- Calcific, tropical pancreatitis
- Pancreatectomy
- Pancreatic cancer
- Cystic fibrosis
- Haemochromatosis

21

Which drugs can induce diabetes?

- Diuretics
- Steroids
- Antipsychotics e.g. Olanzapine
- Psychiatric drugs: weight gain

22

Diabetes may be comorbid in which endocrine disorders?

- Acromegaly: high growth hormone levels cause diabetes
- Cushing’s syndrome: high cortisol levels cause diabetes
- Phaeochromocytoma

23

What are the ethnic variants of diabetes?

- J type diabetes: ‘Jamaican’ diabetes, Afro-Caribbeans
- Flatbush diabetes: US Afro-Americans
- MRDM: malnutrition- related diabetes, tropical diabetes
- Chronic calcific pancreatitis: secondary diabetes
- Z type diabetes

24

What are the features if J typr Jamaican diabetes?

- Ketosis prone
- Not particularly obese
- On and off insulin therapy
- Variable insulin requirements
- Also called Flatbush diabetes

25

Which genetic syndromes are associated with genetic syndromes?

- Friedreich’s ataxia
- Dystrophia myotonica: a genetic diabetes syndrome

26

What is gestational diabetes?

- Diabetes appears during pregnancy
- Diabetes resolves after pregnancy
- At risk of diabetes in later pregnancy
- At risk of diabetes in future
- Pregnancy in the known diabetic case
- Diabetes arising or diagnosed in pregnancy

27

What is maturity onset diabetes in the young?

- Autosomal dominant pattern
- 1-2% of diabetic cases
- Onset under 25
- Insulin not required initially
- Glucokinase, HNF 1A, HNF 4A

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