Diabetes: Aetiology, Diagnosis and Presentation Flashcards
(21 cards)
Symptoms of Diabetes:
Describe the difference between the onset of symptoms for Type 1 and Type 2 Diabetes [1]
Type 1: Acute
Type 2: Subacute / nonspecific symptoms (e.g. tiredness)
State 6 classical symptoms of diabetes
polyuria
polydipsia
nocturia
weight loss
fatigue
blurred vision
pruritis
recurrent urinary or genitourinary infections
Name 4 complications associated with untreated diabetes
skin infections – staphylococcal skin abcesses, oral or genital candidiasis
foot problems – ulcers or neuropathic pain
retinopathy – perhaps found on routine eye test
acute myocardial infarct / stroke – diagnosed whilst in hospital
State 4 methods for diagnosing diabetes [4]
Fasting plasma glucose (FPG) (note NOT a capillary glucose [ie. a fingerprick test])
Random plasma glucose (RPG)
75 gram oral glucose tolerance test (OGTT)
Haemoglobin A1c (HbA1c, glycated haemoglobin)
NOTE: One diagnostic test is enough to diagnose diabetes **w/ sympto
What HbA1c scores indicate:
normal range [1]
well controlled diabetes [1]
Normal range < 42 mmol/mol
Well controlled diabetes: < 53 mmol/mol indicates
If Ptx has diabetic symptoms, how many diagnostic tests do they require for a diagnosis ? [1]
If Ptx has no diabetic symptoms, how many diagnostic tests do they require for a diagnosis ? [1]
Symptoms: one test
No symptoms: two tests
A:
Impaired glucose tolerance can only be diagnosed using which diagonostic test?
FPG
2 hr PG
RPG
HbA1c
Impaired glucose tolerance can only be diagnosed using which diagonostic test?
FPG
2 hr PG
RPG
HbA1c
Which HLA is associated with DMT1? [2]
HLA DR3 & DR4
Describe what pancreatic diabetes is [1]
Name 4 causes of pancreatic diabetes
Severe disease of pancreas causes damage to B cells:
Acute / Chronic Pancreatitis
Trauma / Pancreatectomy
Neoplasia
Cystic fibrosis
Haemochromatosis / Thalassaemia – due to iron overload
Name 6 endocrine diseases known to cause diabetes [6]
Acromegaly (excess growth hormone)
Cushing’s syndrome (excess cortisol)
Glucagonoma (excess glucagon)
Phaechromocytoma (excess adrenaline)
Hyperthyroidism (excess thyroid hormone)
Conn’s syndrome (excess aldosterone hormone)
State 5 causes of drug induced diabetes [5]
Glucocorticoids
b-blockers
Thiazide diuretics
Tacrolimus (used in transplantation – may cause “New Onset Diabetes after Transplantation” [NODAT])
Atypical anti-psychotics – eg. olanzapine, risperidone, clozapine
Name two congenital viral infections that may cause diabetes [2]
Congenital rubella
Cytomegalovirus
DMT2 is caused by a combination of which two physiological factors? [2]
Insulin resistance AND B-cell failure
Insulin resistance AND B-cell failure are exacerbated by hyperglycaemia:
What is this concept called? [1]
Explain the pathophysiology [2]
Glucose toxicity:
High levels of glucose lead to poorer b-cell function leading to reduced insulin secretion
therefore lowering glucose may actually help b-cell function
Why is abdominal / visceral adiposity is not good for risk of diabetes? [1]
pro-inflammatory cytokines from adipocytes contribute to insulin resistance (they antangoise effect of insulin)
Describe how alpha and beta cell mass changes in diabetic patients [2]
b-cell mass is relatively preserved (50% at autopsies) - but function declines
a-cell population increased
Which factors contribute to metabolic syndrome? [6]
- BMI > 30 kg/m2 , or:
- Abdominal Waist Circumference – ethnic specific
- Low HDL Concentration
- Blood pressure
- Fasting glucose
- Triglyceride
Which antibodies are commonly positive in DMT1? [2]
Usually islet cell [ICA] and glutamic acid decarboxylase [GAD] antibodies positive
Serum C‑peptide is a measure of insulin production. It is low with low i
Possible non-genetic contributors to DMT1? [4]
