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Endocrinology > What is DM? > Flashcards

What is DM? Flashcards

1
Q

What is DM?

A

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

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2
Q

What at symptoms of hyperglycaemia?

A 
thirst
Urinating a lot 
blurred vision 
tiredness
Weight loss 
Infections
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3
Q

What are the long term microvascular complications of DM?

A

Retinopathy
Neuropathy
Nephropathy

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4
Q

What are the long term macrovascular complications of DM?

A

Stroke
MI
PVD

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5
Q

How is someones long term glucose controlled monitored?

A

Measure HbA1c

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6
Q

What is the diagnostic value for HbA1c for DM?

A

> 48 mmol/mol

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7
Q

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

A

> 7.0 mmol/mol

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8
Q

What is the diagnostic value for random glucose in DM?

A

> 11.1 mmol/mol

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9
Q

What is the diagnosis criteria for DM?

A

One diagnostic lab glucose plus symptoms

Two diagnostic lab glucose or HbA1c without glucose

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10
Q

What does HbA1c measure?

A

The level of glycosylated haemoglobin in the blood

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11
Q

What does HbA1c give an indication of?

A

Blood glucose over the past 8-12 weeks

Glucose control in the body

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12
Q

When can HbA1c not be used?

A 
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
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13
Q

What are the 2 types of DM?

A

Type I

Type II

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14
Q

Which is the only hormone that lowers BG?

A

Insulin

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15
Q

What is there a destruction of in Type I?

A

Beta cells

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16
Q

What type of condition is type I?

A

Autoimmune

17
Q

When will most people have presented with Type I?

A

By the age of 30

18
Q

What occurs in type I DM?

A

There is loss of insulin production by beta cells

19
Q

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

A

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

20
Q

Is there any mechanism to switch off gluconeogenesis?

A

No

21
Q

What is the clinical presentation of type I DM?

A 
Thirst 
Tiredness
Polyuria 
Weight loss 
Blurred vision 
Abdominal pain
22
Q

What may be seen on examination in type I DM?

A 
Ketones on bereath 
Dehydration 
Increased RR 
Tachycardia 
Low grade infection - thrush
23
Q

How does type II DM develop time wise?

A

Over a period of time

24
Q

When does Type II diabetes occur?

A

When insulin production cannot overcome insulin receptor resistance

25
Q

Which is more genetically determined type I or type II?

A

Type II

26
Q

What are the typical symptoms of type II DM?

A 
Thirst 
Tiredness 
Polyuria 
Sometimes weight loss 
Blurred vision
27
Q

What are signs of type II DM?

A

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

28
Q

What are the risk factors for type II DM?

A 
Overweight 
FH 
Previous history with gestational DM 
Inactive lifestyle 
Lack of exercise 
Previous high blood glucose
29
Q

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

A

MODY
Secondary
Gestational

30
Q

What can cause secondary DM?

A

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

31
Q

What causes gestational DM?

A

Increasing insulin resistance in pregnancy

32
Q

What does gestational diabetes increase the risk of?

A

Type 2 later in life

33
Q

When does gestational DM usually occur?

A

In 2nd/3rd trimester

34
Q

What are the babies like in gestational DM?

A

Big babies

35
Q

What type of inheritance is MODY?

A

Autosomal dominant

Endocrinology (19 decks)

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