9. Causes and diagnosis of blood glucose disorders Flashcards
What is the leading cause of blindness in working-age adults?
Diabetic retinopathy is the leading cause of blindness in working-age adults.
What is the leading cause of end-stage renal disease?
Diabetic nephropathy is the leading cause of end-stage renal disease.
What is the percentage increase in cardiovascular mortality and stroke in diabetic patients?
Diabetic patients have a 2 to 4 fold increase in cardiovascular mortality and stroke.
What is the leading cause of non-traumatic lower extremity amputations?
Diabetic neuropathy is the leading cause of non-traumatic lower extremity amputations.
What percentage of diabetic patients die from cardiovascular events?
8/10 diabetic patients die from cardiovascular events.
What is the mechanism of action of glucose in relation to cardiovascular mortality?
Glucose is a continuous risk factor for cardiovascular mortality.
What is the relative risk of all-cause mortality in individuals with high fasting glucose levels?
The relative risk of all-cause mortality increases with higher fasting glucose levels.
What is the prevalence of type 2 diabetes in Hungary in 2014?
94% of diabetic patients in Hungary in 2014 had type 2 diabetes.
What is the relationship between fasting blood glucose levels and cardiovascular mortality in men?
Fasting blood glucose levels predict cardiovascular mortality in men.
What is the prevalence of type 2 diabetes in people aged 70 and above according to the 2011 census and data by the National Health Insurance Fund?
10%.
What is the mechanism for diagnosing diabetes based on classical symptoms?
Classical symptoms of diabetes (polyuria, polydypsia, weight loss) + fasting glucose ≥ 7,0 mmol/l (after 10 hours fasting).
What is the laboratory criteria for diagnosing diabetes mellitus?
Random glucose value ≥ 11,1 mmol /l or fasting glucose value ≥ 7,0 mmol /l or 2-hour OGTT value ≥ 11,1 mmol /l.
What is the difference between impaired fasting glucose (IFG) and impaired glucose tolerance (IGT)?
IFG is fasting glucose between 6.1 and 7.0 mmol/l, while IGT is postprandial glucose between 7.8 and 11.1 mmol/l.
What is the ratio of lower limb amputations among type 2 diabetic patients in 2014?
0.50%.
What are the diagnostic criteria for diabetes mellitus II?
One classic symptom or severe metabolic abnormality + one glucose value falling into the diabetic range.
What are the diagnostic criteria for diabetes mellitus III?
Either 2 out of the three, but not measured on the same day: Venous blood plasma, laboratory testing, or OGTT.
What is OGTT?
Oral Glucose Tolerance Test.
What is the diagnostic importance of OGTT?
Only fasting and 120 minute postprandial glucose values are of diagnostic importance.
What are the frequent mistakes during OGTT?
Urinalysis left out, presence of ketonuria, and diagnosis made based on blood glucose level measured with test strip.
What is the medical history for diagnosing diabetes mellitus?
Asking about classical symptoms and other autoimmune diseases for type 1 diabetes mellitus, and frequently part of metabolic syndrome and CVD for type 2 diabetes mellitus.
Does age play a definitive role in the classification of diabetes mellitus?
No.
What are the different types of diabetes mellitus?
There are four types of diabetes mellitus: Type 1, Type 2, Gestational diabetes mellitus (GDM), and Other specific types.
What is Type 1 diabetes mellitus?
Type 1 diabetes mellitus is characterized by beta cell destruction and absolute insulin deficiency. It can be caused by an autoimmune mechanism (1A) or idiopathic (1B).
What is Type 2 diabetes mellitus?
Type 2 diabetes mellitus is characterized by insulin resistance and relative insulin deficiency.
What are the characteristics of Type 1 diabetes mellitus?
The characteristics of Type 1 diabetes mellitus include classical clinical symptoms, ketonuria, lack of obesity, low C-peptide level, presence of autoantibodies, presence of other organ-specific autoimmune disorders (thyroid, coeliac, Addison), family history of T1DM, and predisposing HLA haplotypes.
What are some factors that may increase the risk of developing type 1 diabetes?
Presence of other organ-specific autoimmune disorders, family history of T1DM, predisposing HLA haplotypes.
What are some markers of beta cell dysfunction in type 1 diabetes?
C-peptide deficiency, missing first-phase insulin release (IVGTT).
What are some autoantibodies that may be present in type 1 diabetes?
GADA, ICA, IAA.
What is insulitis?
Beta cell injury caused by inflammation of the islets of Langerhans in the pancreas.
What is the incidence of type 1 diabetes in Hungary?
The incidence ranges from 0 to 14 per 100,000 people depending on the year.
What is the correlation between vitamin D and the risk of type 1 diabetes?
There is a North-South gradient in the incidence of type 1 diabetes and a correlation between type 1 diabetes incidence and the number of hours spent exposed to sunlight.
What are some cardiovascular outcomes in patients with type 1 diabetes compared to matched controls?
Total mortality is 29% lower and CV mortality is 42% lower in patients with type 1 diabetes.
What are some former names for type 2 diabetes mellitus?
Adult onset diabetes, NIDDM (non-insulin dependent diabetes mellitus).
What is the Swedish National Diabetes Register?
A database that collects data on diabetes patients in Sweden.
What are some markers of beta cell dysfunction in type 2 diabetes?
Reduced insulin secretion and increased insulin resistance.
What is insulin resistance?
Insulin resistance is when the normal amount of insulin produces a subnormal reaction.
What are the causes of insulin resistance?
Causes of insulin resistance include obesity (25%, visceral, adipocytokines), passive lifestyle (25%), genetics (50%, ethnic differences), age, and nutrition (CH↑, fat↓, cytokine production ↓).
What are the risk factors for type 2 diabetes mellitus?
Risk factors for type 2 diabetes mellitus include positive family history, being overweight, old age, sedentary lifestyle, pregnancy, and GDM.
What is the percentage of type 2 diabetic patients who are overweight or obese?
90% of type 2 diabetic patients are overweight or obese.
What is the “thrifty gene” hypothesis?
The “thrifty gene” hypothesis suggests that certain genes that were advantageous for survival during times of food scarcity may now contribute to the pandemic of obesity.
What is the “thrifty gene” hypothesis?
The hypothesis that certain genes that were advantageous for survival during times of food scarcity may now contribute to the development of obesity and type 2 diabetes in modern times.
What is the prevalence of obesity and diabetes in the USA according to the 2000 data?
No data, 26.0% for obesity and No data, 9.0% for diabetes.
What is the Whitehall II study?
A study that investigated the relationship between social and economic status and health outcomes, including the development of type 2 diabetes.
What is the necessity of early intervention in type 2 diabetes?
There is a progressive decrease in beta cell function before diagnosis, making early intervention necessary to preserve beta cell function.
What is HOMA?
HOMA is a method used to estimate beta cell function based on fasting glucose and insulin levels.
What is the focus of the Whitehall II study?
The study focuses on the relationship between pre-diagnosis type 2 diabetes and postprandial blood sugar levels, insulin sensitivity, and insulin secretion.
What is LADA?
LADA stands for Latent Autoimmune Diabetes of Adults, which is a slowly progressing type 1 diabetes mellitus that is initially manageable with diet but requires insulin treatment later on.
What are the criteria for diagnosing LADA?
The criteria for diagnosing LADA include diagnosis during adulthood (>30 years), absence of obesity in type 2 diabetic patients, negative family history for T2DM, slow progression, low C-peptide level, and antibody positivity.
What is the role of individualized diets in managing diabetes?
Individualized diets can play a crucial role in managing diabetes by helping patients maintain healthy blood sugar levels and manage their weight.
What are the limitations of lifestyle changes in managing diabetes?
People are fallible, and lifestyle changes can be challenging to maintain in the long term, which can limit their effectiveness in managing diabetes.
