Session 10 Lecture 2 Flashcards
(30 cards)
What is diabetes mellitus?
Group of metabolic disorders characterised by chronic hyperglycaemia due to insulin deficiency, insulin resistance or both.
What is hyperglycaemia?
Elevated blood glucose concentration
What are the aim types of diabetes?
Two main types - type 1 and type 2
Why does type 1 diabetes occur?
Characterised by the progressive loss of all or most of the pancreatic beta cells.
What is the cause of type 2 diabetes?
Characterised by the slow progressive loss of B-cells along with disorders of insulin secretion and tissue resistance to insulin.
Describe the process of how type 2 diabetes progresses?
Insulin resistance, then insulin production failure, impaired glucose tolerance eventually lose all insulin production
Describe the process of how type 1 diabetes progresses?
HLA markers and antibodies, develop impaired glucose tolerance
What are the genetic markers that make you more pre-disposed to type 1 diabetes?
HLA DR3 and HLA DR4.
What are the symptoms of type 1 diabetes?
Triad of symptoms
- Polyuria
- Thirst
- Weight loss
Why do you get polyuria with type 1 diabetes?
Large quantities of glucose in the blood and not all it resorbed in the kidney. This means less water is reabsorbed so the extra water and glucose are excreted as urine.
Why do you get increase thirst with type 1 diabetes?
Due to excess water loss and the osmotic effects of glucose on thirst centres
Why do you get weight loss in type 1 diabetes?
Fat and protein are metabolised by tissues because insulin is absent
How is type 1 diabetes diagnosed?
Measuring plasma glucose levels. Glucose will be found in the urine.
Why is blood glucose elevated when there is a lack of insulin?
Lack of insulin causes decrease uptake of glucose in adipose tissue and skeletal muscle, decreased storage as glycogen and increased gluconeogenesis.
What happens if you don’t treat someone who has type 1 diabetes?
The individual will progress to a life threatening crisis - diabetic ketoacidosis.
What are the features of keto-acidosis?
Prostration, hyperventilation, nausea, vomiting, dehydration, abdominal pain.
How do you treat a patient with type 1 diabetes?
Insulin injections
What are the symptoms of someone who has type 2 diabetes?
Very variable - might have triad
More likely to present with lack of energy, persistent infections, slow healing and vision problems
How do we treat someone with type 2 diabetes?
Sometimes managed by diet, oral hypoglycaemic drugs such as sulphonylureas.
What so oral hypoglycaemic drugs such as sulphonylureas, do?
Increase insulin release from the remaining beta cells and reduce insulin resistance and particularly metformin that reduces gluconeogenesis.
How can type 2 diabetes be prevented?
Maintain a healthy body weight and do regular exercise. Healthy diet.
What do long term diabetics suffer from?
Number of microvascular and microvascular complications
What makes any potential complications worse?
Worse when an individual’s blood glucose is poorly controlled
Give some examples of microvascular complications that occur in a long term diabetic?
Increased risk of stroke
Increased risk of MI
Poor circulation to the periphery esp feets
