Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Chemistry > L.2+3 Diabetes > Flashcards

L.2+3 Diabetes Flashcards

(117 cards)

Start Studying
1
Q

What is Diabetes Mellitus?

A

A metabolic disorder of multiple aetiologies characterised by chronic hyperglycaemia with disturbances of carbohydrate, fat, and protein metabolism resulting from defects in insulin secretion, action, or both.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can cause Diabetes Mellitus?

A
  • Pancreatic insufficiency (insulin secretion)
  • Insulin resistance (insulin action)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the characteristic symptoms of Diabetes Mellitus?

A
  • Polydipsia (frequent thirst)
  • Polyphagia (frequent hunger)
  • Polyuria (frequent urination)
  • Glucosuria (glucose in urine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the types of Diabetes Mellitus?

A
  • Type 1 DM
  • Type 2 DM
  • Gestational DM
  • Other types (e.g. drug-associated / disease-associated)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Fill in the blank: Diabetes Mellitus is characterised by chronic _______.

A

[hyperglycaemia]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

True or False: Insulin resistance is a cause of Diabetes Mellitus.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fill in the blank: One symptom of Diabetes Mellitus is _______.

A

[polydipsia]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the four main symptoms of Diabetes Mellitus?

A
  • Polydipsia
  • Polyphagia
  • Polyuria
  • Glucosuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Fill in the blank: Type 1 DM and Type 2 DM are types of _______.

A

[Diabetes Mellitus]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Type 1 DM?

A

A chronic autoimmune disease where the body’s immune system mistakenly attacks and destroys the insulin-producing β-cells in the pancreas.

Specifically affects the islets of Langerhans.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What leads to high blood sugar levels in Type 1 DM?

A

Destruction of β-cells leads to little to no insulin production, resulting in hyperglycemia.

Cells are starved of energy despite glucose being present in the blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the risk factors for Type 1 DM?

A
  • Underlying genetic risk associated with specific HLA alleles DR and DQ
  • Environmental factors such as certain viruses (e.g., coxsackievirus, enteroviruses, rubella, mumps virus)

Genetic predisposition accounts for 40% of familial aggregation of T1D.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What percentage of people with diabetes are affected by Type 1 DM?

A

Accounts for 10% of people with diabetes.

It is one of the most frequent chronic diseases in children.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are classic symptoms of new-onset diabetes in Type 1 DM?

A
  • Polyuria
  • Polydipsia
  • Lethargy
  • Weight loss

Patients may also present with severe hypoglycemia or DKA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some chronic complications of Type 1 DM?

A
  • Skin disorders
  • Diabetic retinopathy
  • Diabetic neuropathy
  • Kidney disease

These complications can arise over time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Type 2 DM?

A

A chronic metabolic disorder where the body’s cells become resistant to insulin and/or the pancreas doesn’t make enough insulin.

Insulin resistance occurs when cells don’t respond properly to insulin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What results from insulin resistance and beta-cell dysfunction in Type 2 DM?

A
  • Elevated blood glucose levels (hyperglycemia)
  • Long-term damage to organs if not managed

This can lead to serious health complications.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the risk factors for Type 2 DM?

A
  • Age > 45 years
  • Overweight/obesity
  • Prediabetes/gestational diabetes
  • Strong genetic component (30-70% risk)

Increasing prevalence in children/adolescents due to rising obesity and inactivity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What percentage of all diabetes cases does Type 2 DM account for?

A

Accounts for 90% of all diabetes cases.

Estimated 462 million individuals globally affected by T2DM.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What did the Scottish Diabetes Survey 2021 report about diabetes prevalence?

A

Reported that 6% of the population had diabetes.

Population size similar to Ireland.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are common symptoms that can develop in Type 2 DM?

A
  • Increased thirst
  • Increased urination
  • Lack of energy and fatigue
  • Bacterial and fungal infections
  • Delayed wound healing

Symptoms can be asymptomatic for months or years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Diabetic Ketoacidosis characterized by?

A

Uncontrolled hyperglycemia, metabolic acidosis, and increased body ketone concentration

It is a life-threatening complication of diabetes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

In which type of diabetes is Diabetic Ketoacidosis most commonly seen?

A

Type-1 diabetes mellitus

It can rarely occur in patients with type-2 diabetes mellitus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What percentage of children with Type-1 Diabetes Mellitus experience Diabetic Ketoacidosis?

A

Approximately 25%

This highlights the severity of the condition in pediatric patients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the typical onset time for Diabetic Ketoacidosis?
Hours to days ## Footnote The onset is rapid, which requires prompt medical intervention.
26
List three symptoms of Diabetic Ketoacidosis.
* Hyperglycemia * Dehydration * GI symptoms (vomiting, abdominal pain) * Metabolic acidosis
27
What are the key pathophysiological processes involved in Diabetic Ketoacidosis?
Insulin deficiency and increased counter-regulatory hormones lead to: * Increased gluconeogenesis * Accelerated glycogenolysis * Impaired glucose utilization
28
What happens to free fatty acids during Diabetic Ketoacidosis?
They are released into circulation from adipose tissue (lipolysis) and undergo hepatic fatty acid oxidation to ketone bodies ## Footnote This process results in ketonemia and metabolic acidosis.
29
What is the second acute complication of diabetes mentioned?
Hyperosmolar non-ketotic coma
30
What is the third acute complication of diabetes mentioned?
Hypoglycaemia
31
What is Hyperosmolar Non-Ketotic Coma also known as?
Hyperosmolar hyperglycaemic syndrome (HHS) ## Footnote HHS is a serious and potentially fatal complication of type 2 diabetes.
32
What is the onset period for Hyperosmolar Non-Ketotic Coma?
Days to weeks
33
List the main symptoms of Hyperosmolar Non-Ketotic Coma.
* Hyperglycaemia * Severe dehydration * Neurological symptoms can occur
34
What are the most common precipitating factors for Hyperosmolar Non-Ketotic Coma?
* Infections * Dehydration * Medications * Surgery/trauma
35
True or False: The pathophysiology of HHS is similar to that of DKA.
True
36
What is the hallmark of both Hyperosmolar Non-Ketotic Coma and Diabetic Ketoacidosis (DKA)?
Deficiency of insulin
37
What effect does a deficiency of insulin have on glucose utilization?
Decreases glucose utilization by peripheral tissue
38
Fill in the blank: The hyperglycaemic state increases the _____ gradient, causing free water to be drawn out of the extravascular space.
osmotic
39
What leads to excessive urination in Hyperosmolar Non-Ketotic Coma?
Increased osmotic gradient due to hyperglycaemia
40
What condition results from excessive urination in Hyperosmolar Non-Ketotic Coma?
Volume depletion and haemoconcentration
41
Why is ketosis absent in Hyperosmolar Non-Ketotic Coma?
Presence of some insulin inhibits hormone-sensitive lipase-mediated adipose tissue breakdown
42
What is hypoglycaemia?
Usually occurs in newly diagnosed diabetics who have trouble getting competent with glycaemic control when starting insulin or sulfonylurea therapy.
43
What are common causes of hypoglycaemia?
* Take too large a dose * Delay/skip meals * Exercise
44
What are the symptoms of mild hypoglycaemia?
Minimal or no symptoms
45
What are the symptoms of severe hypoglycaemia?
Neurological impairment
46
What are chronic complications of diabetes?
* Macrovascular * Microvascular
47
What do macrovascular complications involve?
Complications involving large blood vessels (arteries)
48
What causes accelerated atherosclerosis in macrovascular complications?
Due to hyperglycemia, dyslipidemia, and hypertension
49
What is associated with increased cardiovascular morbidity and mortality?
Macrovascular complications
50
What do microvascular complications involve?
Complications involving small blood vessels (capillaries, arterioles)
51
What is the effect of chronic hyperglycemia on small blood vessels?
Damages the endothelium, leading to thickened basement membranes, decreased perfusion, and hypoxia in tissues
52
Which tissues are affected by microvascular complications?
* Eyes * Kidneys * Nerves
53
What is the grey-top blood type used for in diabetes investigation?
Contains 2 chemicals: sodium fluoride and potassium-oxalate
54
What is the role of sodium fluoride in the grey-top blood type?
Inhibits enzyme involved in glycolysis cycle
55
What is the role of potassium-oxalate in the grey-top blood type?
Weak anti-coagulant
56
Why is patient fasting status important in diabetes investigation?
For interpretation of results
57
What are the two fasting statuses important for interpretation?
* Fasting * Random
58
What does the GOD-PAP method stand for?
Glucose oxidase - peroxidase (with phenol and aminoantipyrine) ## Footnote This method is used for measuring glucose levels.
59
What type of assay is a colourimetric enzymatic assay?
Requires enzyme reaction for colour change ## Footnote This method is used to measure glucose concentration.
60
What are the two steps in the enzyme method for measuring glucose?
1. Glucose Oxidase → glucose oxidised to gluconic acid + forms H2O2 2. Peroxidase uses H2O2 to produce a colour change ## Footnote The colour intensity correlates with glucose concentration.
61
List the types of blood tests for diabetes mellitus (DM).
* Random glucose * Fasting glucose * Oral glucose tolerance test * HbA1c ## Footnote These tests help diagnose diabetes and monitor glucose levels.
62
What is pre-diabetes?
Metabolic intermediate stage between normal glucose homeostasis and DM ## Footnote It indicates increased blood glucose but not within diagnostic criteria for DM.
63
Why is the term 'pre-diabetes' discouraged?
To avoid stigma associated with the word diabetes ## Footnote It is considered a risk state, not a clinical condition or disease.
64
What is required to determine pre-diabetes?
Fasting blood glucose test or Oral Glucose Tolerance Test (OGTT) ## Footnote Random glucose samples cannot determine pre-diabetes.
65
Define gestational diabetes.
Any degree of glucose intolerance seen during pregnancy ## Footnote It develops for the first time during pregnancy.
66
What happens to insulin production during pregnancy?
Insulin production usually increases ## Footnote Some women may not produce enough insulin to meet increased demand, leading to hyperglycaemia.
67
What are risk factors for gestational diabetes?
* BMI >30kg/m2 * Previous macrosomic baby * Previous gestational diabetes * Family history of diabetes * Ethnicity with high prevalence of diabetes (e.g., South Asians, African-Caribbeans) ## Footnote These factors increase the likelihood of developing gestational diabetes.
68
What is the purpose of a screening test?
Used to detect diseases at an early stage ## Footnote Particularly for asymptomatic individuals at higher risk.
69
What is the purpose of a diagnostic test?
Used to determine the presence or absence of disease ## Footnote It establishes a diagnosis for symptomatic individuals or those with a positive screening test.
70
When is risk screening for GDM done during pregnancy?
At the first ante-natal appointment (8-12 weeks) ## Footnote Individuals with one or more risk factors are offered GDM screening.
71
What is an Oral Glucose Tolerance Test (OGTT)?
A dynamic test used for screening GDM ## Footnote It evaluates how the body processes glucose over time.
72
What is a dynamic blood test?
Involves taking multiple blood samples at specific intervals after a challenge ## Footnote It assesses how the body responds to substances like glucose over time.
73
What is the purpose of the Oral Glucose Tolerance Test (OGTT)?
Assess the capacity for postprandial metabolism of glucose under controlled conditions ## Footnote Most often for the diagnosis of Gestational Diabetes Mellitus (GDM)
74
What patient conditions should preclude the performance of an OGTT?
Patient is febrile, acutely ill, or within 6 weeks ## Footnote These conditions can alter glucose metabolism.
75
How many days of normal diet are recommended before an OGTT?
At least 3 days ## Footnote Carbohydrate intake should be 150g/24 hours.
76
What is the recommended fasting period before an OGTT?
8-14 hours ## Footnote Water may be consumed during this fasting period.
77
What type of tubes are used for glucose samples in OGTT?
Sodium fluoride - grey top tubes
78
What is the glucose load administered during the OGTT?
75g anhydrous glucose in 250-300mL water ## Footnote The glucose must be consumed over the course of 5 minutes.
79
What is the duration of rest required for the patient during the OGTT?
Duration of the test ## Footnote Patient should not smoke during this time.
80
When is the 2-hour sample taken during the OGTT?
At time = 2hr (T2)
81
What is an advantage of the OGTT?
Shows the body’s response to glucose ## Footnote Includes both a fasting and postprandial sample.
82
What are some disadvantages of the OGTT?
* Patient has to fast * 2-hour duration for the patient * Nausea post-glucose load * Poor reproducibility * Pre-analytical / analytical variability
83
What fasting plasma glucose level indicates gestational diabetes?
5.1 mmol/litre or above
84
What 2-hour plasma glucose level indicates gestational diabetes?
8.5 mmol/litre or above
85
What is a complication of gestational diabetes?
* Macrosomia * Birth trauma * Foetal morbidity
86
What does HbA1c stand for?
Glycated haemoglobin
87
How is HbA1c formed?
When glucose attaches to haemoglobin in red blood cells through a non-enzymatic chemical reaction
88
What is a schiff base?
A compound formed when an amine group reacts with a carbonyl group, resulting in a double bond between nitrogen and carbon
89
What is the role of the N-terminal amino group of the β-chain of haemoglobin in HbA1c formation?
It reacts with the carbonyl group of glucose to form a schiff base
90
What happens in the Amadori rearrangement?
The schiff base undergoes rearrangement to form a more stable compound, HbA1c
91
What is required for measuring HbA1c?
EDTA-anticoagulated blood
92
Why is EDTA used in HbA1c measurement?
It maintains the red cell physiological state by preventing glycolysis
93
Which methods are commonly used to measure HbA1c?
* High-Performance Liquid Chromatography (HPLC) * Capillary Zone Electrophoresis (CZE)
94
What is the recommended cut-off point for diagnosing diabetes using HbA1c?
48mmol/mol (6.5%)
95
Does a HbA1c level of less than 48mmol/mol (6.5%) exclude diabetes?
No, it does not exclude diabetes diagnosed using glucose tests
96
What is the approximate lifespan of red blood cells?
≈ 120 days
97
Why is HbA1c considered a stable irreversible component?
Once formed, it stays in red blood cells for the duration of their lifespan
98
What does the percentage of HbA1c in blood indicate?
The amount of time in hyperglycaemic state over ≈ 120 days
99
What is a key advantage of monitoring HbA1c?
It provides a retrospective indication of glycaemic control
100
Is HbA1c suitable for monitoring diabetic patients with altered RBC survival?
No, it is not suitable for patients with conditions that affect RBC survival (e.g. anaemias)
101
List some advantages of using HbA1c for monitoring diabetes
* No fasting required * Glycaemic control over ~120 days * Preanalytical stability * Not affected by stress/illness
102
List some disadvantages of using HbA1c for monitoring diabetes
* High cost * Limited availability * Comparatively poor sensitivity for diagnosis of DM * Cannot be used for patients with conditions that affect RBC survival (anaemia)
103
What does the presence of C-peptide in blood indicate?
The pancreas is producing insulin ## Footnote C-peptide presence helps distinguish between endogenous and exogenous insulin.
104
What is the significance of elevated C-peptide levels when insulin is elevated?
Insulin is endogenous ## Footnote Elevated C-peptide indicates that the insulin produced is from the body rather than injected.
105
What does a decrease in C-peptide levels indicate when insulin is elevated?
Insulin is exogenous ## Footnote Decreased C-peptide suggests that the insulin is not produced by the body but is from an external source.
106
What percentage of T1DM patients experience diabetic nephropathy?
35-45% ## Footnote Diabetic nephropathy is a chronic kidney disease that can progress to end-stage renal failure.
107
Define microalbuminuria.
Excretion of 30-300mg/g albumin in urine over 24 hours ## Footnote Normal excretion is < 25mg/g in 24 hours.
108
What is the significance of microalbuminuria in diabetic patients?
Signals breakdown in kidney's ability to prevent protein loss ## Footnote Early identification can prevent long-term consequences.
109
What test is used to calculate microalbumin levels?
Albumin:Creatinine Ratio Test (ACR) ## Footnote ACR is critical for assessing kidney function in diabetes.
110
Name some other tests performed for diabetes investigation.
* Ketone levels * pH of blood * Serum osmolality ## Footnote These tests help assess the metabolic state of the patient.
111
What does diabetic autoantibody testing involve?
Testing for anti-Islet cell antibodies ## Footnote It helps in understanding the autoimmune aspect of diabetes.
112
What is point of care testing (POCT) in diabetes management?
Patients monitor their own diabetic control using manual tests ## Footnote This includes various devices and tests for glucose and ketones.
113
What is the purpose of urinary dipsticks in diabetes testing?
To test for glucose, ketones, protein, and more ## Footnote Urinary dipsticks are a screening tool for diabetes management.
114
What is the function of a glucometer?
Takes capillary glucose readings ## Footnote Essential for monitoring T1DM and can be used for T2DM with certain medications.
115
What are the methodologies for glucose detection in glucometers?
* Enzymatic * Chemical * Photoelectric ## Footnote These methods vary in technology and application.
116
What is a continuous glucose monitoring device?
Uses a portable subcutaneous glucose sensor ## Footnote It is valuable for T1DM patients with frequent or unrecognized hypoglycemia.
117
True or False: Continuous glucose monitoring devices are inexpensive and require minimal patient input.
False ## Footnote They are expensive and require intensive patient input.

Clinical Chemistry (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions