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Yr3 Met 3B > 1. Diabetes Aetiology > Flashcards

1. Diabetes Aetiology Flashcards

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1
Q

Roughly how many people are diagnosed with Diabetes per year?

A. 3 Million
B. 4.1 Million
C. 5.3 Million
D. 7 Million

A

A. 3 Million

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2
Q

Diabetes accounts for what percentage of adult cases?

A. 3%
B. 4%
C. 5%
D. 6%

A

C. 5 (4.9)%

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3
Q

T2DM Accounts for how many cases in the UK?

A. 55-65%
B. 65-75%
C. 75-85%
D. 85-95%

A

D. 85-95%

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4
Q

What are some “osmotic” symptoms of Diabetes?

A
  1. Polydipsia
  2. Polyuria
  3. Nocturia
  4. Pruritis
  5. Fatigue
  6. Weight Loss
  7. Blurred Vision
  8. UTI/Genitourinary
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5
Q

What are two main ways of diagnosing Diabetes instantly?

A
  1. Incidental Finding

2. Screening someone at high risk

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6
Q

Name two main Acute Emergencies resulting from Diabetes?

A
  1. Hyperosmolar Hyperglycemic Syndrome

2. DKA

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7
Q

What type of complications can Diabetic Patients present with systematically?

A
  1. Skin infections (Staph Skin Abscesses, Oral/Genital Candidiasis)
  2. Foot (Ulcer/Neuropathic Pain)
  3. Eyes (Retinopathy)
  4. Acute MI/Stroke
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8
Q

What are the Main Clinical ways of diagnosing Diabetes?

A
  1. Fasting Plasma Glucose (FPG) [Not Capillary Glucose]
  2. Random Plasma Glucose (RPG)
  3. 75 g Oral Glucose Tolerance Test (OGTT)
  4. HbA1c
  • No symptoms: Needs Two of above or One abnormal OGTT
  • Symptoms: Needs One of above
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9
Q

How is the OGTT done?

A
  1. Patient fasts for 9+ hours
  2. Check their FPG
  3. GIve 75g Glucose (Lucozade)
  4. Check 2 Hour PG
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10
Q

What is the HbA1c test?

A

Measures for Average glucose control over 3 months

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11
Q

What is the normal range for HbA1c?

A

<42 mmol/mol

Though it can vary between individuals depending on Age/Co-morbidities

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12
Q

What is the normal range for HbA1c for those with well controlled Diabetes?

A

<53 mmol/mol

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13
Q

Generally, what is the Glucose levels of a Normal individual undergoing a FPG?

A

<6 mmol/L

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14
Q

Generally, what is the 2 hr PG of a Normal individual undergoing a 2 HR PG?

A

<7.8 mmol/L

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15
Q

Generally, what is the 2 hr PG of a Normal individual undergoing a RPG?

A

<7.8 mmol/L

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16
Q

Generally, what is the Glucose levels of a Diabetic individual undergoing a FPG?

A

> 7 mmol/L

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17
Q

Generally, what is the Glucose levels of a Diabetic individual undergoing a 2 HR PG?

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A

> 11.1 mmol/L

18
Q

Generally, what is the Glucose levels of a Diabetic individual undergoing an RPG?

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A

> 11.1 mmol/L

19
Q

For those with an impaired Glucose Tolerance (IGT), what is their HbA1c levels?

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A

42-47 mmol/mol

20
Q

List 5 differences between T1 and T2DM

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A

Type 1 is

  1. Ketosis Prone
  2. Insulin Deficient
  3. Autoimmune (GAD/ICA Abs)
  4. Acute Onset
  5. Non-Obese associated
21
Q

List 5 Secondary Causes of Diabetes

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A
  1. Gestational Diabetes
  2. Pancreatic Disease
  3. Endocrine Disease
  4. Genetic Defects of Beta cell function
  5. Genetic Defects of Insulin action
  6. Genetic Syndromes
  7. Infections
  8. Drugs
22
Q

List 5 Diseases of the Exocrine Pancreas

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A
  1. Acute/Chronic Pancreatitis
  2. Trauma/Pancreatectomy
  3. Neoplasia
  4. Cystic Fibrosis
  5. Haemochromatosis /Thalassemia (Iron Overload)
  6. Fibrocalculous Pancreatopathy
23
Q

List 6 Endocrine Diseases that could cause Secondary Diabetes

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A
  1. Acromegaly
  2. Cushing’s
  3. Conn’s
  4. Phaechromocytoma
  5. Hyperthyroidism
  6. Glucagonoma
24
Q

List 5 Drugs that can induce Diabetes

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A
  1. Glucocorticoids
  2. Beta Blockers
  3. Thiazide Diuretics
  4. Tacrolimus
  5. Atypical Antipsychotics
25
How does Tacrolimus cause Diabetes?
1. Used in Transplantation | 2. Causes NODAT (New Onset Diabetes after Transplantation)
26
Give three examples of Atypical Antipsychotics that can cause diabetes
1. Olanzapine 2. Risperidone 3. Clozapine
27
**Give Four Examples of Genetic Defects of Beta Cell function
1. Chr 20 (HNF-4A) 2. Chr 7 (Glucokinase) 3. Chr 12 (HNF-1A) 4. Mitochondrial DNA
28
Give Four Examples of Genetic Defects in Insulin Action
1. Type A Insulin Resistance 2. Leprechaunism (Insulin res) 3. Rabson-Mendenhall Syndrome (Severe insulin res) 4. Lipoatrophic Diabetes (Lack of adipose and issues with fat/glucose metabolism)
29
Give 10 Examples of Genetic Syndromes associated with Diabetes
1. Down's 2. Klinefelter's 3. Turner's 4. Wolfram's (DIDMOAD) 5. Friedrich's Ataxia 6. Huntington's Chorea 7. Lawrence-Moon-Biedl 8. Prada Willi 9. Myotonic Dystrophy 10. Porphyria
30
What is the acronym for the characteristics of Wolfram's syndrome?
Diabetes Insipidus Diabetes Mellitus (Childhood-onset) Optic Atrophy Deafness
31
What types of infections can cause Diabetes?
1. Congenital Rubella | 2. CMV
32
T2DM is described as a Heterogeneous syndrome? What does this mean?
It is a condition characterised by multiple aetiologies: - Environmental (Obesity) - Diabetogenic Genes
33
How does Hyperglycemia exacerbate T2DM?
1. "Glucose Toxicity" 2. High glucose will impair Beta cell function --> Less insulin 3. Lowering Glucose can make Beta cells work less hard
34
What is described as a thrifty gene?
Genes favouring Fat Storage/Insulin resistance Helping us in times of famine
35
Is there a link between T2DM and Dementia?
Amyloid Peptides can be deposited in the Islets later in the disease Potentially
36
What criteria are needed to diagnose Metabolic Syndrome?
1. Central Obesity (BMI>30) 2. Abdo Waist Circum (Above 88/102 in Europe) (Above 80/90 in South Asia) PLUS ANY TWO FROM: 3. Low HDL 4. High TGs 5. High BP 6. High Fasting Glucose
37
Who should be screened for T2DM?
1. Overweight 2. Family History people 3. History of Gest. Diabetes 4. Ethnic Minorities (South Asia/Afro-Carib) 5. Vascular Disease (CHD, PVD) 6. Steroid/AntiPsychotic/Transplant patients 7. Foot ulcers/Candida
38
How is T1DM characterised?
1. Pancreatic Beta Cell Destruction | 2. ICA/GAD Antibody positive
39
What is LADA?
Latent Autoimmune Diabetes in Adults - Non-Acute - ICA/GAD +
40
What is the concordance rate of T1DM in Monozygotic Twins?
30-50%
41
What are some environmental factors for those with T1DM?
1. Puberty 2. Seasons 3. European 4. 5-7 year peak age of onset
42
What is the Pathogenic Sequence of T1DM?
1. Genetic Susceptibility (HLA genes on Chr6) 2. Environmental Insults (Cocksackie/Parvovirus) 3. Insulitis (Infiltration of T-lymphocytes) 4. Activation of Autoimmunity 5. Immune attack on Beta Cells (ICA/GAD Abs) 6. Diabetes Mellitus (90% Beta cell destruction)

Yr3 Met 3B (13 decks)

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