Diabetes Mellitus Flashcards Preview

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Flashcards in Diabetes Mellitus Deck (21)
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Where is insulin produced?

produced in ß-cells of the islets of Langerhans of pancreas; they also produce glucagon and pancreatic polypeptide
- auto-immune destruction of B-cells
- may be triggered by viral infection (dependent on HLA gene subtype)


What is diabetes mellitus?

- deficiency of insulin
- resistance to effects of insulin


What is diabetes insipidus?

- deficiency of antidiuretic


What are the acute consequences of insulin deficiency?

- hyperglycaemia (to much glucose in the blood steam)
- ketosis (produced by break down of fat, makes you sick and in high concentrations can kill you )
- acidosis
- hyperosmolar state


What are the chronic consequences of insulin deficiency?

- cardiovascular disease
- nephropathy
- neuropathy
- retinopathy


In type 2 diabetes what are the causes of it?

- peripheral insulin resistance
- B-cells response to glocise delayed or absent


What is gestational diabetes?

- triggered by hormonal changes in pregnancy
- genetic predisposition
- resolves with delivery


What are the risk factors for gestational diabetes?

- maternal age (as you get older)
- family history of DM type 2
- African or North American native
- previous gestational diabetes
- previous baby over 4kg
- smoking


What are the dangers of gestational diabetes?

- greater risk of DM type 2 in later in life
- hypertension
- pre-eclampsia or eclampsia
- obstructed labour
- risk of DM type 2 later in life
- risk of obestity later in life
- macrosomia
- neonatal hypoglycaemia
- neonatal jaundice
- respiratory distress syndrome


What can secondary diabetes mellitus?

- chronic pancreatitis
- cystic fibrosis
- pancreatic surgery
- haemachromatosis ( inherited iron deficiency)
- endocrine disease eg. Crushing syndrome
- Drug therapy eg. steroids


What are the symptoms of diabetes mellitus type 1 ?

- polyuria
- polydipsia
- hunger
- weight loss
- can be seen in type 2 but often camouflaged by other symptoms


Why do we get polyuria in type 1 diabetes?

- normal for glucose to be secreted into the urine
- high concentrations lead to glycosuria
- gycouria leads to osmotic polyuria
- polyuria leads to polydipsia


What are the diagnosistic test results for diabetes mellitus?

- fasting plasma glucose level at or above 7.0 mmol/l

- plasma glucose at or above 11.1mmol/l two hours after a 75 g oral glucose load

- random plasma glucose at or above 11.1 mmol/l


What is ketoacidosis?

- rapid breakdown of fat and protein releases ketones and acids into bloodstream
- normally in type 1
- can lead to coma and death


What is hyperosmolar nonketotic state?

- severe dehydration
- seen in type 2
- can lead to coma and death


What can diabetic foot lead to ?

generalised sepsis and death


What is hypoglycaemia?

- insulin overdose, generally accidental
- it can present in misleading ways. brain not being given enough glucose, confusion - can lead to brain damage
- can lead to coma and death


What are the chronical presentations of diabetes?

- ischaemic heart disease
- stroke
- peripheral vascular disease
- retinopathy
- neuropathy
- cataract


What is diabetic retinopathy?

- proliferation of blood vessels in the retina
- retinal haemorrhages
- fluid exudation into retina
- can cause them to go blind


What is diabetic neuropathy?

- peripheral numbness or tingling
- occasional neuropathic pain
- muscle weakness
- autonomic neuropathy ( vomiting, diarrhoea, constipation, male impotence, incontinence, anorgasmia, postural hypotension)
- damage to kidney as glomerulus cant filter out all of the glucose


- Infections can occur in diabetic patients. such as more likely to get?

- osteomyelitis
- septicaemia
- post op infections
- rectal abscess
- pyelonephritis (infections in the kidney)