Flashcards in Diabetes Deck (35):
What is Diabetes mellitus ?
Disorder of metabolism characterised by hyperglycaemia
What glucose levels are used for the cut off for the diagnosis of DM ? (3)
1. Fasting glucose levels > 7mmol/l
2. OGTT/Random glucose > 11.1mmol/l
3.Hb1ac > 48mmol/l
What is the normal value for the FF:
a) fasting glucose
b) OGTT/Random glucose
A) less than 6.1 mmol/l
B) less than 7.8 mmol/l
What is impaired fasting glycaemia ?
Impaired fasting glycaemia is when an individual has fasting glucose levels above the normal range but below the diagnostic range for diabetes
State the value for impaired fasting glycaemia
Greater than 6.1mmol/l but less than 7 mmol/l
What is impaired glucose tolerance ?
Impaired glucose tolerance is a stage of impaired glucose seen in any disorder of hyperglycaemia but it is not diabetes
State the fasting glucose values for impaired glucose tolerance
Less than 7 mmol/l (6.1-7)
State the random/OGTT values for impaired glucose tolerance
Greater than 7.8 mmol/l but Less than 11.1mmol/l (7.8-11.1mmol/l)
What are the 4 main types of diabetes ?
1.T1DM 2.T2DM 3. Gestational diabetes 4.MODY
When does T1DM occur ?
T1DM occurs when the pancreas fails to produce enough insulin,i.e, insulin deficiency. This is due to autoimmune destruction of the pancreatic islet B cells
What does T2DM begin with and progress to ?
T2DM begins with insulin resistance and progresses to a decrease in insulin secretion
What is insulin resistance ?
When cells fail to respond to insulin properly lead to IFG and IGT
What is gestational diabetes ?
Gestational diabetes occurs during pregnancy with no previous history or diagnosis of diabetes
What is MODY ?
Maturity onset diabetes in the young is a autosomal dominant form of type 2 diabetes that occur in young patients with a positive family history of diabetes
State the 6 groups into which the secondary causes of diabetes can be grouped into ?
1.drugs 2.pancreatic 3.genetitic syndrome and defects 4. Endocrine causes 5. Wolfam's. Syndrome 6. others
State the secondary causes of diabetes for drugs ? (5)
2. Anti-HIVs (anti-retrovirals protease inhibitors
State the secondary causes of diabetes for pancreatic ? (4) 😭
1. Chronic pancreatitis
2. Surgical removal of the pancreas (pancreatomy)
3. Trauma and destruction (haemochromatomasis and CF)
4. Pancreatic cancer
D+C can cause diabetes via inhibition of enzyme release
State the secondary causes of diabetes for genetic syndromes (3) and defects
DKT: 1. Downs 2. Kleinfeiters 3.Turners
4. Genetic defects in B-cell and insulin function
State the endocrine secondary causes of diabetes
Secondary cause of diabetes
State the other secondary causes of diabetes (4)
3. Congenital dystrophy
4. Glycogen storage Diseases
What must T1DM patients have ?
What are the 3 clinical presentations of T1DM ?
1. Mainly occurs in young patients, i.e, adolescents peak age 13, but can occur at any age
2. Associated with LADA
3. There may be a family history or concurrent autoimmune disease
What are 3 signs and symptoms of T1DM and when do these all occur ?
1. Severe polyuria and polydysia due to PERSISTENT hyperglycaemia
2. Weight loss
3. Ketosis ( KETOACODOSIS and ketonuria on urine -dipstick)
These all occur over weeks
What are the 5 clinical presentations of T2DM ?
1. Asymptomatic but there my be a complication e.g MI
2. Increases with age (i.e older patients), obesity and lack of physical activity
3. Family history is more common
4. Occurs more frequently in patients with hypertension and dyslipidaemia
State 2 differences between T1DM and T2DM ?
1. In T2DM, patients may present with complications FIRST
2. Ketoacidosis and osmotic symptoms such as polyuria and polydypsia
Are less common patients with T2DM
Describe the dietary treatment for diabetes including what they should do generally
1.Reduce fat intake, specifically saturated fats. Fat=35% of total intake with Sats + Trans < 10%
2. Protein: 1g/1kg
3. CHO: 40-60% of total intake
4. Salt: less than 6g a day. Diabetic hypertensive patients should have less than 3g/day
Generally, pick foods with low GI, increase fruit fibre, veg. Some alcohol is allowed
State the 4 ways in which diabetic control can be evaluated
1. Urine glucose testing
2. Self-monitored blood glucose testing
3. Measurement of Hb1AC
4. Continuous blood glucose monitoring
When is it best to do urine testing ?
In the morning
What are the 3 things you need to know about Urine testing ?
1. Identifies high urine glucose and ketones.
2.However, does not give you an idea of current blood glucose levels (as urine glucose lags behind that of blood glucose
3. It Does not give you an idea about whether glucose is too low, i.e hypoglycaemia goes unmarked
State 2 features of self monitored blood glucose testing
1. Best and immediate indication of blood glucose levels
2. Monitors hypoglycaemia and hyperglycaemia
State the target for Hb A1C
Less than 48mmol/l
State the 2 features of Hb A1C
1. Gives indication of long-term glycaemic control
2. Ideally than once a year
What is the indication for continuous glucose monitoring ?
It is offered to people with poor-hypoglycaemic awareness