Endocrinology

Question 1

What are the goals of management for diabetes?

Answer 1

1. Relieve symptoms of hyperglycaemia
2. Prevent or delay long term complications
3. Avoid adverse effects of treatment (hypoglycaemia)
4. Assist psychological adjustment and improve QOL

Question 2

What are the complications of diabetes (acute and chronic?

Answer 2

Acute:

1. Diabetic ketoacidosis
2. Hyperglycaemia
3. Hypoglycaemia
4. Diabetic coma

Chronic:

1. Macrovascular disease: coronary artery disease, stroke, peripheral vascular disease, diabetic foot ulcers
2. Microvascular disease: diabetic nephropathy, neuropathy, retinopathy
3. Abnormal immune response: respiratory infections, restrictive lung disease

Question 3

What is diabetic ketoacidosis and how does it present?

Answer 3

Diabetic ketoacidosis (DKA) is characterised by a rapid onset of the following triad:
1. hyperglycaemia
2. ketonaemia
3. acidaemia
It is characterised by absolute insulin deficiency and occurs when the liver utilises fatty acid and creates ketones.

Presentation:

1. polyuria, polydipsia, polyphagia,
2. weakness, weight loss
3. tachycardia, dry mucous membranes, poor skin turgor, hypotension
4. shock in extreme cases