54 Diabetes Flashcards
What is the normal level of blood glucose?
5mmol/l.
Simply, what does insulin do?
Stops release of glucose from liver by increasing glycogen formation.
Increases glucose uptake into the tissues.
Define hypo and hyperglycaemia.
Hypo: less than 4mmol/l
Hyper: over 11mmol/l.
Define a syndrome:
Collection of symptoms and signs due to more than one cause.
What are the symptoms and signs of diabetes? (7).
Thirst. Tiredness. Polyuria. Weight loss. Dry mouth. Glycosuria. Hyperglycaemia.
What are the diagnostic criteria for diabetes? (4)
Symptoms and:
Fasting blood glucose > 7mmol/l.
OGTT >11mmol/l.
HbA1c >48mmol/mol.
How is a oral glucose tolerance test (OGTT) carried out?
Fasting.
75g oral glucose load.
Measure blood glucose 2hrs after.
What are the diagnostic criteria for borderline diabetes? (2).
Impaired fasting glucose: 6-7mmol/l.
Impaired OGTT response: 7.8-11mmol/mol.
What is type 1 diabetes due to?
Lymphocyte infiltration and autoimmune destruction of insulin producing beta islet cells of pancreas.
Which autoantibodies are present in type 1 diabetes? (3).
ICA.
IA2.
GAD.
What is latent autoimmune diabetes in adults (LADA)?
Who gets it?
Type 2 with islet destruction over time.
Older females.
Which conditions are associated in the PMH/FH with LADA? (6).
Type 1 diabetes. Thyroid. Psoriatic arthritis. Addison’s. Coeliac. Vitiligo.
Which autoantibodies are seen in LADA? (4).
GAD.
ICA.
tTG.
TPO.
What is the typical presentation of type 2 diabetes? (5).
Insulin resistant.
Strong family history.
Obese.
Hypertensive + hyperlipidaemic.
What is ketosis prone type 2 diabetes?
Temporary ketosis when stressed with illness.
Temporarily requires insulin.
Which pancreatic disorders may diabetes be secondary to? (5).
Pancreatitis (acute or chronic). Pancreatectomy. Pancreatic cancer. Cystic fibrosis. Haemochromatosis.
Which drugs may induce diabetes? (4).
Diuretics.
Steroids.
Anti-psychotics: olanzapine.
Which endocrine disorders may cause diabetes? (3).
Acromegaly (too much IGF-1).
Cushing’s (cortisol increases glucose levels).
Pheochromocytoma (less insulin).
What is MRDM?
Malnutrition related diabetes.
What is J type/Flatbrush diabetes? (3).
Ketosis prone.
On and off insulin therapy.
Not particularly obese.
Which genetic syndromes can cause diabetes? (2).
Friedrich’s ataxia.
Dystrophia myotonica.
Describe the diagnostic criteria for gestational diabetes: (2).
Appears during pregnancy.
Resolves after pregnancy.
Are women with gestational diabetes at increased risk of diabetes in the future?
Yes.
Describe mature onset diabetes in the young: (3).
Autosomal dominant.
Starts under 25y/o.
Insulin not required initially.
Name the genes implicated in mature onset diabetes in the young: (3).
Glucokinase.
HNF 1A.
HNF 4A.
