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BDS2 BAMS Endocrinology > 4. Diabetes > Flashcards

4. Diabetes Flashcards

1
Q

Types of diabetes (2)

A

Diabetes mellitus

Diabetes insipidus

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2
Q

Definition of diabetes mellitus

A

Abnormality of glucose regulation

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3
Q

Definition of diabetes insipidus

A

Abnormality of renal function (water)

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4
Q

Diabetes diagnosis involves (2)

A

Two random plasma glucose tests

Results > 11.1mmol

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5
Q

Glucose tolerance test process (3)

A

Fasting test
75g glucose load
Test after 2hrs

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6
Q

Glucose tolerance test result groups before test (3)

A

<6.1 - normal
6.1-7.0 - impaired fasting plasma glucose
>7.0 - diabetes

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7
Q

Glucose tolerance test result groups after two hours (3)

A

<7.8 - normal
7.8-11.1 - impaired glucose tolerance
>11.1 - diabates

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8
Q

Types of diabetes mellitus (2)

A

Type 1 - insulin deficient

Type 2 - insulin resistant

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9
Q

Definition of type 1 diabetes (2)

A

Autoimmune disease

Involves immune-mediated destruction of pancreatic B cells by auto-antibodies

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10
Q

Uncontrolled type 1 DM can lead to (2)

A

Hyperglycaemia

Ketoacidosis

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11
Q

Circulating antibodies present in type 1 DM (3)

A

GAD
ICA
IAA

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12
Q

Process of ketoacidosis (2)

A

Glucose cannot be metabolised correctly by cells
Fat is metabolised for energy, causing a build-up of acidic ketones
Leads to ketoacidosis

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13
Q

Definition of hypoglycaemia

A

Low blood glucose levels

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14
Q

Prevention of ketoacidosis

A

Insulin

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15
Q

Prevention of hypoglycaemia

A

Glucose

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16
Q

Type 1 DM involves (2)

A 
Genetic influences (familial clustering, HLA)
Environmental trigger
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17
Q

Types of type 1 DM (2)

A

Child/adolescent onset

Adult/latent onset - LADA (latent autoimmune diabetes in adults)

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18
Q

Features of early onset type 1 DM (3)

A

Peak incidence - 10-14yrs
Higher ICA, IAA
More severe decompensation

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19
Q

Features of adult/latent onset type 1 DM (4)

A

GAD associated
Less weight loss, less ketoacidosis
‘Non-obses’ type 2
Variable period until insulin required

20
Q

Type 1 DM symptoms (3)

A

Polyuria
Polydipsia
Tiredness

21
Q

Acute presentation of type 1 DM (2)

A

Hyperglycaemia with diabetic symptoms

Ketoacidosis

22
Q

Definition of impaired glucose tolerance - IGT (2)

A

Peak secretion of insulin is lower than normal, but high enough to metabolise some/all glucose ingested

23
Q

Type 2 DM diagnosis

A

Exclude Type 1 DM

24
Q

Most common type of DM

A

Type 2 - 90%

25
Q

Predisposing factors of type 2 DM (2)

A

Obesity

Inactivity

26
Q

Types of type 2 DM (2)

A

Classic (>40yrs old)

MODY - mature onset diabetes in young

27
Q

Type 2 and ketoacidosis

A

Type 2 do not often suffer from ketoacidosis

28
Q

Links with type 2 DM (2)

A

Risk - genetic and lifestyle

Strong FH link

29
Q

Metabolic disorders involved in type 2 DM (4)

A

Defect in insulin resistance
Defect in insulin secretion
Basal hepatic glucose output increased
Insulin stimulated muscle glucose uptake is reduced

30
Q

Effects of type 2 DM include metabolic syndromes (7)

A 
IGT
Hyperinsulinaemia
HTN
Obesity with abdominal distribution
Dyslipidaemia
Procoagulant epithelial markers
Early and accelerated atherosclerosis
31
Q

Complications of type 2 DM

A

Retinal damage

32
Q

Symptoms of type 2 DM (6)

A 
Rarely acute presentation
Polyuria
Polydipsia
Tiredness
Unusual infections
Diabetic complications
33
Q

Typical presentation of type 1 DM (6)

A 
Younger
Thin
Often FH of type 1
Often FH of autoimmune disease
Diabetic symptoms
Easily get ketosis
34
Q

Typical presentation of type 2 DM (6)

A 
Older
Obese
Strong FH
Often diabetic symptoms
Present with complications
Rarely get ketosis
35
Q

Diabetes management (7)

A 
Education
Setting glucose target levels
Drugs
Insulin
Nutrition
Exercise
Monitoring
36
Q

Insulin regimes (2)

A

Basal bolus - more infections, better control

Split-mixed - fewer injections, poorer control

37
Q

Type 1 DM management (2)

A

SC insulin administration

Target sugar 4-7mmol/l

38
Q

Type 2 DM management (5)

A 
Weight loss
Diet restriction
Diet pills
Surgery
Oral hypoglycaemic agents
39
Q

Types of oral hypoglycaemic agents (2)

A 
Insulin secretagogues (sulphonylureas)
Insulin sensitisers (biguanides)
40
Q

Complications of diabetes can be (2)

A

Acute

Chronic

41
Q

Acute complications of diabetes

A

Hypoglycaemia

42
Q

Chronic complications of diabetes (3)

A

CV risk
Infection risk
Neuropathy

43
Q

Other complications of diabetes (2)

A 
Large vessel (atheroma)
Small vessel (poor wound healing)
44
Q

Diabetic eye disease includes (3)

A

Cataracts
Maculopathy
Proliferative retinopathy

45
Q

Treatment of diabetic eye disease

A

Laser treatment

46
Q

Diabetic neuropathy includes (3)

A

General sensation
Motor neuropathy
Autoimmune regulation

BDS2 BAMS Endocrinology (5 decks)

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