18. Diabetes Mellitus 1

Question 1

How is diabetes diagnosed?

Answer 1

1. Random plasma glucose of >11.1mmol/L with osmotic symptoms
2. 2 hour glucose load >11.1
3. Fasting plasma glucose >7
4. HbA1C >48mmol

Question 2

How is blood glucose most accurately taken to be sent to the lab?

Answer 2

Most accurate in venous blood

Special tube with fluoride

Question 3

What is HbA1C?

Answer 3

Shows average blood concentration of glucose over past months
Glycosylation of Hb

Question 4

How is pre-diabetes diagnosed?

Answer 4

Fasting plasma glucose: 6.1-6.9

2 hour glucose load 7.8-11

Question 5

What can c-protein be used for?

Answer 5

Has a longer half life than insulin so can be used to show secretory function

Question 6

Which organs don’t require insulin?

Answer 6

Brain
Renal tubules
RBCs

Question 7

What causes blurred vision in diabetics?

Answer 7

Deposition of glucose within lens

Question 8

What are the causes of diabetes other than type 1 and 2?

Answer 8

AD conditions impairing secretion
Diseases or surgery involving the pancreas
Endinocrinopathies which increase counter hormones
Drugs

Question 9

What autoantibodies might be present in type 1 diabetes?

Answer 9

anti-GAD
anti-IA2
anti-insulin
Islet cell antibodies
anti-zinc transporter 8

Question 10

What genes are associated with type 1 diabetes?

Answer 10

HLA-DR3 and 4

Question 11

What other disease should be screened for when someone is diagnosed with type 1 diabetes?

Answer 11

Coeliac disease

Question 12

What is metabolic syndrome?

Answer 12

Insulin resistance
Abdominal obesity
Abnormal lipids
Hypertension

Question 13

Why does type 2 diabetes not caused DKA?

Answer 13

Always have a low circulating level of insulin

Question 14

What are the signs of insulin resistance on examination?

Answer 14

Acanthosis nigricans
Skin tags
Hypertension
High TAGs, low HDL