What is DM?

Question 1

What is DM?

Answer 1

Group of metabolic diseases of multiple aetiologies characterised by hyperglycaemia together with disturbances of carbohydrates, fat, and protein metabolism resulting from defects in insulin secretion, insulin action or both

Question 2

What at symptoms of hyperglycaemia?

Answer 2

thirst
Urinating a lot 
blurred vision 
tiredness
Weight loss 
Infections

Question 3

What are the long term microvascular complications of DM?

Answer 3

Retinopathy
Neuropathy
Nephropathy

Question 4

What are the long term macrovascular complications of DM?

Answer 4

Stroke
MI
PVD

Question 5

How is someones long term glucose controlled monitored?

Answer 5

Measure HbA1c

Question 6

What is the diagnostic value for HbA1c for DM?

Answer 6

> 48 mmol/mol

Question 7

What is the diagnostic value for fasting glucose test in DM?

Answer 7

> 7.0 mmol/mol

Question 8

What is the diagnostic value for random glucose in DM?

Answer 8

> 11.1 mmol/mol

Question 9

What is the diagnosis criteria for DM?

Answer 9

One diagnostic lab glucose plus symptoms

Two diagnostic lab glucose or HbA1c without glucose

Question 10

What does HbA1c measure?

Answer 10

The level of glycosylated haemoglobin in the blood

Question 11

What does HbA1c give an indication of?

Answer 11

Blood glucose over the past 8-12 weeks

Glucose control in the body

Question 12

When can HbA1c not be used?

Answer 12

In all children and young people 
Pregnancy 
Short duration of DM symptoms 
Patients at high risk of DM who are acutely unwell 
Acute pancreatic damage or surgery 
Renal failure 
HIV patients
Patients taking medications which may cause rapid glucose rise

Question 13

What are the 2 types of DM?

Answer 13

Type I

Type II

Question 14

Which is the only hormone that lowers BG?

Answer 14

Insulin

Question 15

What is there a destruction of in Type I?

Answer 15

Beta cells

Question 16

What type of condition is type I?

Answer 16

Autoimmune

Question 17

When will most people have presented with Type I?

Answer 17

By the age of 30

Question 18

What occurs in type I DM?

Answer 18

There is loss of insulin production by beta cells

Question 19

What is the result of glucose not being taken up by tissues?

Answer 19

The tissue will send out help signals to produce more and more glucose

Question 20

Is there any mechanism to switch off gluconeogenesis?

Answer 20

No

Question 21

What is the clinical presentation of type I DM?

Answer 21

Thirst 
Tiredness
Polyuria 
Weight loss 
Blurred vision 
Abdominal pain

Question 22

What may be seen on examination in type I DM?

Answer 22

Ketones on bereath 
Dehydration 
Increased RR 
Tachycardia 
Low grade infection - thrush

Question 23

How does type II DM develop time wise?

Answer 23

Over a period of time

Question 24

When does Type II diabetes occur?

Answer 24

When insulin production cannot overcome insulin receptor resistance

Question 25

Which is more genetically determined type I or type II?

Answer 25

Type II

Question 26

What are the typical symptoms of type II DM?

Answer 26

``` Thirst Tiredness Polyuria Sometimes weight loss Blurred vision ```

Question 27

What are signs of type II DM?

Answer 27

Not ketotic Usually overweight but not always Low grade infection e.g thrush

Question 28

What are the risk factors for type II DM?

Answer 28

``` Overweight FH Previous history with gestational DM Inactive lifestyle Lack of exercise Previous high blood glucose ```

Question 29

What are the other types of DM apart from type I and II?

Answer 29

MODY Secondary Gestational

Question 30

What can cause secondary DM?

Answer 30

Drug therapy e.g corticosteroids Pancreatic destruction Recognised genetic syndrome Rare endocrine disorders e.g cushings

Question 31

What causes gestational DM?

Answer 31

Increasing insulin resistance in pregnancy

Question 32

What does gestational diabetes increase the risk of?

Answer 32

Type 2 later in life

Question 33

When does gestational DM usually occur?

Answer 33

In 2nd/3rd trimester

Question 34

What are the babies like in gestational DM?

Answer 34

Big babies

Question 35

What type of inheritance is MODY?

Answer 35

Autosomal dominant