54 - diabetes Flashcards

1
Q

normal blood glucose level

A

5mmol/l

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2
Q

hyperglycaemia when

A

> 11mmol/l

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3
Q

Diabetes - symptoms

A

thirst, polyuria, weight loss, tiredness

signs: dry mouth, weight loss, glycosuria, hyperglycaemia

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4
Q

Diabetes - who?

A

ethnic groups - asians, afro-caribbeans

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5
Q

Diabetes - diagnosis

A

Fasting blood glucose >7mmol/l
75g OGTT
HbA1c 48 mmol/mol (6.5%)

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6
Q

GTT stands for… OGTT…. IVGTT…

A

Glucose tolerance test
Oral GTT
IV GTT

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7
Q

GTT process

A

Fasting
then 75 glucose load

Fasting 7mmol/l

2 hour post-glucose load: diabetic >11mmol/l

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8
Q

Borderline diabetes

A

6-7mmol/l at fasting

Impaired glucose tolerance = 7.8 - 11.0mmol/l

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9
Q

Diabetes - investigations

A
HbA1c
Renal function
Liver function
Lipids
Thyroid function
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10
Q

Type One Diabetes - what is it?

A

Autoimmune destruction of the insulin producing islet beta cells

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11
Q

Type One Diabetes - who?

A

Usually young but can be any age

Autoantibody test: ICA, IA2, GAD

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12
Q

LADA - stands for

A

latent autoimmune diabetes in adults

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13
Q

LADA - who?

A

older patients, often female

FH of: T1DM, thyroid, PA, addison’s, coeliac, vitiligo

T2DM who progresses out of control

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14
Q

LADA - autoantibodies

A

GAD, ICA, tTG, TPO

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15
Q

Type 2 Diabetes - what is it

A

insulin resistance/deficient

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16
Q

Type 2 Diabetes - who

A

not absolutely insulin dependent

strong FH

often obese
hypertensive, hyperlipidaemic

17
Q

Type 2 Diabetes - variant: ketosis-prone type 2

A

Often obese, ethnic minority

Ketosis when physically stressed with intercurrent illness and temporarily needs insulin

18
Q

Diabetes secondary to pancreatic disorders - what disorders

A
chronic/acute pancreatitis
calcific, tropical pancreatitis
pancreatectomy
pancreatic cancer
CF
haemochromatosis
19
Q

Haemochromatosis reminder

A

Hereditary iron overload storage disorder

20
Q

Drug induced diabetes

A

Diuretics
Steroids
Antipsychotics e.g. Olanzapine
Psychiatric drugs: weight gain

21
Q

Endocrine disorders -

A

Acromegaly
Cushing’s syndrome
Phaeochromocytoma

22
Q

Acromegaly

A

High growth hormone levels cause diabetes

23
Q

Cushing’s syndrome is

A

High cortisol levels cause diabetes

24
Q

Ethnic variants of diabetes

A

J type: Jamaican, afro-caribbeans

Flatbush: US afro-american

MRDM - malnutrition-related diabetes, tropical diabetes

Chronic calcific pancreatitis: 2° diabetes

Z type diabetes

25
Q

J type Jamaican diabetes

A

Ketosis prone
not particularly obese
On and off insulin therapy

Variable insulin req.
Also called flatbush diabetes

26
Q

Genetic syndromes

A

Friedreich’s ataxia

Dystrophia myotonica

27
Q

Gestational diabetes

A

diabetes appears during preg but resolves.

At risk of diabetes in later pregnancy w/ risk of diabetes in future

28
Q

MODY stands for

A

maturity onset diabetes in the young

29
Q

MODY genetics

A

AD pattern

1-2% of diabetic cases

30
Q

MODY who?

A

under 25

31
Q

MODY - treatment

A

insulin not req. initially

32
Q

MODY - pathogenesis

A

Glucokinase probs
HNF 1A
HNF 4A