Diabetes Mellitus Flashcards
(26 cards)
What is the difference between diabetes mellitus and insipidus
Mellitus is an abnormality in glucose regulation
Insipidus is an abnormality in renal function - water
Mellitus - pee is sweet
Insipidus - it isn’t
What percentage of diabetes mellitus patients are each type
10% is type 1
85% is type 2
5% is neither - monogenic diabetes
What is diabetes mellitus
A series of metabolic conditions sharing the major characteristics of hyperglycaemia
What are the risks of chronic hyperglycaemia
Macrovascular diseases such as stokes and MIs
Microvascular complications such as obliteration of vessels and atherosclerosis
What can be used to test for diabetes mellitus
Random plasma glucose
GTT
HbA1C
When would a random blood glucose diagnose a patient as diabetic
> 11.1mmol/L on 2 occasions
Describe glucose tolerance test (GTT)
Fixed glucose load is given to the patient and the sugar level is assessed afterwards
What is HbA1C
Also called glycosylated haemoglobin
A measure of what the blood glucose has been like for the past few weeks
What is impaired fasting glucose
A pre-diabetic state
When will a GTT diagnose diabetes
Before test (mmol/L)
Fasting plasma glucose >7
2 hour plasma glucose
FPG >11.1
Describe type 1 diabetes mellitus
Caused by an autoimmune destruction of pancreatic B cells leading to a lack of insulin
How will a patient with type 1 diabetes present
With hyperglycaemia and ketoacidosis
Low C-Peptide levels indicating low insulin secretion
GAD, ICA and IAA antibodies present
What causes ketoacidosis
Inability to make insulin so patient’s don’t have the ability to move glucose into cells for metabolism
Therefore will metabolise fat within cells rather than glucose to maintain energy
Will result in ketones being produced which are acidic
Describe the typical adult onset of type 1 diabetes
Will often be LADA - latent autoimmune diabetes in adults
GAD associated
Less weight loss and ketoacidosis
Syptoms will develop over a longer period of time
What are the symptoms of type 1 diabetes
Polyuria - pee a lot
Polydipsia - will be thirsty a lot
Tiredness
What patients are most likely to have type 2 diabetes
Patients who are obese and inactive
Usually over the age of 40
Describe ketoacidosis in type 2 diabetes
Patients rarely become ketoacidotic as the rate of insulin problem develops very slowly
In most cases the patients hyperglycaemia will present with problems or complications of the disease will arise before ketoacidosis is going to happen
If left long enough patient would run out of insulin and develop ketoacidosis
Describe type 2 diabetes
A heterogenous group of hyperglycaemic disorders with multiple different mechanisms
Patient is unable to produce an adequate insulin response to a sugar load and the insulin response doesn’t properly interact with cell receptors to allow glucose to move into cells
Patient often over-secretes insulin for a normal amount of response
What metabolic changes happen in type 2 diabetes
Inadequate release or response to incretins
Increased absorption of glucose from GI tract
Defect in insulin synthesis, secretion and action
Collectively termed insulin resistance
What are the effects of type 2 diabetes (7)
Impaired glucose tolerance Hyperinsulinanaemia Hypertension Obesity with abdominal distribution Dislipidaemia (High LDL, low HDL) Procoagulant epithelial markers Early and accelerated atherosclerosis
Describe the onset of type 2 diabetes
Gradual over many years
Symptoms develop gradually and may be thought of as ageing
May present with unusual infections such as oral candidiasis, MI or stroke
What is medication induced diabetes
Medicine which interferes with the secretion of insulin or glucagon
Which medicines can cause medication induced diabetes
Corticosteroids Immune suppressants Cancer medication Antipsychotics Antivirals
Which diseases can cause diabetes
Cushing’s disease
Phaeochromocytoma (adrenal tumour)
Acromegaly
Pregnancy - gestational diabetes
