Diabetes and hypoglycaemia Flashcards Preview

T IoD biochemistry > Diabetes and hypoglycaemia > Flashcards

Flashcards in Diabetes and hypoglycaemia Deck (28):
1

what is the problem in type I diabetes?

A pancreatic beta cell deficiency

2

what is the problem in type II diabetes?

Insulin resistance or a beta cell secretory defect of insulin

3

what is MODY?

maturity onset diabetes of the young

4

what is the age of onset of MODY?

under 25

5

how many parents are affected in MODY?

1

6

Is there insulin treatment given for MODY?

Not for the initial few years

7

what is the inheritance pattern for MODY?

autosomal dominant

8

what genes are involved in MODY?

NF1A
HNF4A
glucokinase
HNF1B
IPF1
NeuroD1

9

who are the at risk groups for gestational diabetes?

- obese
- previous GD
- previous baby birthweight >4.5kg
- fh of diabetes
- south Asian, black or African Caribbean or middle eastern

10

what is the fasting plasma glucose above in gestational diabetes?

5.6

11

what is the 2 hour plasma glucose above in gestational diabetes?

7.8

12

what is the fasting glucose in diabetes?

Above 7.00mmol/l

13

what is the random glucose above in diabetes?

11.1

14

what are advantages of HBA1C testing?

- standardised
- better index of overall glycaemic exposure
- less pre-analytical instability
- no need for fasting
- relatively unaffected by acute changes

15

what factors affect HBA1c levels?

- abnormal haemoglobin
- altered life span of RBC
- a recent blood transfusion
- anaemia
- ethnicity
- aging

16

when is HBA1c not appropriate for diagnosing diabetes?

- All young people
- suspected type 1
- symptoms under 2 months duration
- acutely ill
- medications that increase glucose such as steroids
- acute pancreatic damage
- pregnancy

17

what are clinical features of HONK?

- insidious onset
- vomiting
- confusion
- hypercoaguable state
- venous thrombosis

18

what is the biochemical diagnosis for HONK?

- hyperglycaemia
- high serum osmolality
- no acidosis or ketonaemia

19

what prevents ketone production in HONK?

Its due to insulin deficiency, but there is a small amount still that stops ketone production

20

what causes HONK?

- high sugar drinks
- intercurrent infection
- MI
- initial diagnosis
- medications such as glucocorticoids

21

what is the management for HONK?

- rehydration
- prophylactic heparin
- gentle insulin regime
- broad spectrum antibiotics

22

what are the microvascular complications of diabetes?

- nephropathy
- retinopathy
- neuropathy

23

what are the macrovascular complications of diabetes?

- heart
- head
- legs (peripheral vascular disease)

24

what are the three stages of diabetic retinopathy?

1. background retinopathy
2. diabetic maculopathy
3. proliferative retinopathy

25

what three things make up whipples triad?

1. symptoms of hypoglycaemia at time of low glucose
2. symptoms relieved by glucose
3. low plasma glucose

26

what are causes of hypoglycaemia with hyperinsulinaemia?

- islet cell tumour
- sulphonylureas

27

what causes hypoglycaemia with no hyperinsulinaemia?

- endocrine deficiency
- starvation
- IGF2 secreting tumour

28

what causes of hypoglycaemia will cause a raised C peptide?

Endogenous insulin
Sulphonylureas