Session 1-diabetes

Question 1

What are the 3 symptoms of type 1 diabetes?

Answer 1

Polyuria (excess urine)
Poldipsia (thirst and drinking)-due to Polyuria
Weight loss due to fats and proteins being metabolised because insulin Is absent

Question 2

what does a lack of insulin cause?

Answer 2

• decreased uptake of glucose into adipose tissue and skeletal muscle
• decreased storage of glucose as glycogen in muscle and liver
• increased gluconeogenesis in liver

Question 3

what is it called when glucose appears in urine?

Answer 3

glucosuria

Question 4

which type of diabetes is common in young people?

Answer 4

type 1

Question 5

which type is characterised by a slow progressive loss of beta cells?

Answer 5

type 2

Question 6

which type is fatal if not treated?

Answer 6

type 1

Question 7

which type my not initially need to be treated with insulin but will do eventually?

Answer 7

type 2

Question 8

what leads to high amounts of ketone bodies?

Answer 8

high rate of beta oxidation of fats in the liver with the low insulin ratio (e.g. acetone may be smelt on patients breath)

Question 9

what are the symptoms of ketoacidosis (high levels of ketone bodies when body cannot produce enough insulin)?

Answer 9

hyperventilation,nausea,vomiting,dehydration,abdominal pain

Question 10

where do you test for ketones?

Answer 10

urine

Question 11

how can diabetics become hypoglycaemic?

Answer 11

insulin treatment with increased exercise, missed meals, overdose.

Question 12

what are the symptoms of hypoglycaemia?

Answer 12

sweating,anxiety,confusion,drowziness,coma

Question 13

which enzyme metabolises glucose?

Answer 13

aldose reductase

Question 14

what is the equation for glucose metabolisation?

Answer 14

glucose + NADPH + H+ —–> sorbitol + NADP+

Question 15

how does sorbitol accumulate and what is the effect of this?

Answer 15

depletion of NADPH leads to increased disulphide bond formation and protein alteration-causes osmotic damage to cells

Question 16

what effect does glycosylation have on the body?

Answer 16

-addition of functional group to proteins changing their net charge, 3d structure and function

Question 17

how can you check whether blood glucose control has been effective?

Answer 17

glucose attaches to Hb forming glycosylated Hb (HBA1C)

-Poorly controlled diabetes have a HbA1c value of above 10%

Question 18

what are the macrovascular (large blood vessel diseases) complications of diabetes?

Answer 18

increased stroke risk, MI and poor circulation to peripheral parts of the body

Question 19

what is diabetic eye disease?

Answer 19

• changes in lens due to osmotic effect of glucose (glaucoma) and cataracts (cloudy eye)
• RETINOPATHY-damage to blood vessels in retina leading to blindness
• bleeding in eye

Question 20

what is diabetic kidney disease?(nephropathy)

Answer 20

• damage of gomeruli, poor blood supply due to change in vessels, or damage from urinary tract
• sign of neuropathy is increased protein in urine (microalbuminuria)

Question 21

what are the problems associated with poor blood supply to the peripheral parts of the body? (peripheral neuropathy)

Answer 21

loss of sensation, foot problems (gangrene-death of tissue due to obstructed circulation or bacterial infection)

Question 22

why does polyuria occur in type 1 diabetes?

Answer 22

excess glucose means kidney has to filter more..meaning its hard for the kidney to reabsorb all the glucose.

• Therefore lots of glucose gets left in the nephron (lowers WP) and so less water gets reabsorbed and more moves into the nephron.
• Lots of urine excreted via the collecting duct

Question 23

what 4 tests can be done to determine presence of diabetes?

Answer 23

random plasma glucose concn (urine stick) >11.1 mmol=diabetes
fasting plasma glucose concn >7mmol=diabetes
OR
Plasma glucose concn >11.1mmol 2 hours after 75g anhydrous glucose in OGTT (oral glucose tolerance test)
OR
TYPE 2 elevated HbA1c>6.5%

Question 24

Name 3 non insulin therapies of type 2 diabetes.

Answer 24

BAGS
B-biguanides-e.g. Metformin (prevents carb digestion)
AG-alpha glucosidase inhibitors (suppress glucose production in liver)
S-sulphonylureas (increase insulin production by beta cells)

Question 25

To be diagnosed with diabetes, what do you need to have in terms of symptoms and tests?

Answer 25

• symptoms and 1 abnormal test OR

- if asymptotic (no symptoms) then 2 abnormal tests

Question 26

What type of diabetes is the HbA1c test used for?

Answer 26

2

Question 27

What is the normal range for venous plasma glucose concentration?

Answer 27

3.3-3.6 mmol/l

Question 28

What is diabetes insipidus?

Answer 28

Uncommon condition-kidneys unable to conserve water as they filter blood