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PA3305 > 9.6- Glucose Tests > Flashcards

9.6- Glucose Tests Flashcards

1
Q

first line tests for glucose metabolism (3)

A
  • glucose
  • keytones
  • plasma glycalated haemoglobin (HbA1c)
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2
Q

what are the 4 types of diabetes

A

type 1- Primary insulin dependednt

type 2- non insulin dependent

type 3- secondary diabetes (pancreatic autoimune, genetic, endocrine)

type 4- gestational

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3
Q

diagnosis of DM (any plasma, fasting, 2hrs post meal, borderline)

A

any glucose- >11.1mmol/L
fasting- >7mmol/L
2hrs post- >11.1mmol/l

borderline- 6.7-11.1mmol/l

need to repeat twice

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4
Q

What is the glucose tolerence test and when should it be normal

A

drink 50-100g glucose

2 hours should be <7.8mmol/l (DM will stay high)

-must be fasting

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5
Q

what antibodies can you test for for early type 1 (2)

A
  • Serum islet cell antibodies

- Serum glutamic acid decarboxylase antibody

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6
Q

What antibodies can you test for for early type 2

A

serum insulin antibody

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7
Q

what can cause false pos on glucose dipstick

A

preg

high vit C

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8
Q

ketosis and insulin compared in type 1+2

A

type 1- common ketosis, low/absent insulin

type 2- in stress ketosis, present insulin

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9
Q

What is MODY- and what is the defect

A 
in youth (5%)
-looks like type 1

–Glucokinase def

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10
Q

What is NIDDM-Y- when is it found + def

A

in youth, looks like type II

  • -Usually in obese/overweight females
  • -absence of glutamic acid decarboxalase antibodies
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11
Q

What is LADA and test to find it

A

Looks like type II but needs insulin

–Serum glutamic acid decarboxylase antibodies usually present (100% specific)

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12
Q

diabetic ketosis lab work

A
  1. blood glucose
  2. Plasma glu/bicarbonate/potassium (pot will be high)
  3. Plama sod/choride (elevated = signs of dehydration)
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13
Q

3 tx of diabetic keto acidosis

A
  1. FLuids
  2. Insulin
  3. Potassium
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14
Q

3 tx of diabetic keto acidosis

A
  1. FLuids
  2. Insulin
  3. Potassium
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15
Q

What are the 3 types of diabetic comas

A
  1. diabetic ketoacidotic coma (DKA)
  2. Hyperosmolar non ketotic coma (HONK)
  3. Lactic acidodic coma (LA)
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16
Q

DKA vs HONK vs LA- glucose, keytones, acid, dehydration, hyperventilate

A

DKA- high glu, ketones, acid, dehydration, hyperventilated (type 1)

HONK- Very high glu, no keytones/acidosis/hyperventilate (type 2)

LA- variable byt very acidic

17
Q

risk factors for type II

A
  • overweight
  • high blood pressue
  • babies over 3.5kg
  • gestationa diates
  • impaired glu tolerence
18
Q

what two tests are done to assess long term damage in type 2 DM

A

Glycalated Hb- every 2-4m

Urine albumin- yearly

19
Q

What blood marker gives us a estimation on long term exposure to high glu

A

HbA1c

20
Q

what is the test to determine if execise fructose causes type II

A

Serum fructosamine

21
Q

what is type 3 diabetes due to and what to measure

A

obesity/pituitary causes

  1. Pituitary-measure GH, adrencorticotrophic hormine

Thyroid- TSH

Adrenal- cortisol

22
Q

what do u need normal at preg to avoiid teratogenic probs

A

need normal glu at time of conception

23
Q

Type 4 DM lab test and when is it abnormal

A

oral glu tolerence 24-28w

50g given, a plasma glu >8mmol at 1 hour is considered abnormal

24
Q

Risk to neonate in type 4 diabetes

A
  • born big
  • hypoglucemia after birth
  • jaundice, bilirubin increased
  • low calc
  • breathing probs
25
Q

type 4 risks for offspring

A

Obesity as teen

Early onset of DM and diseases of aging

26
Q

What is normal healthy glucose and hypoglucermia

A

healthy= 3.5-5mmol/l

hypo- plasma <2.5mmol/l

27
Q

acute symptoms of hypoglycemia

A
  • sweating
  • slurred speech
  • nausea
  • impaired judgement
  • confussion etc
28
Q

Causes of fasting hypoglycaemia

A
  • cancers such as insulinoma
  • organ failures
  • endocrine diseases
29
Q

Causes of episodic/reactive hypoglycaemia

A

Gastrointestinal sugery
alcohol
med error

30
Q

causes of hypoglycaemia in DM

A
  • insufficient carbs
  • excess insulin
  • strenuous ex
  • excess alcohol
31
Q

what effect does ethanol metabolism have on DM

A
  1. primes pancrease to secrete insulin
  2. Inhibits gluconeogenesis
  3. Inhibits energy from alanine from mm
  4. inhibits counter hormones
  5. NADH/NAD ratio blocks metabolism
32
Q

how is insulin made

A

-pre insulin is metabolized to proinsulin which is metabolized to insulin + C peptide

33
Q

lab tests for hypoglucaemia

A

Blood glu
plasma ketones
plasma insulin
plasma proinsulin/c peptide

34
Q

What % of neonates have hypoglycaemia

A

normal- about 10%%

small for gestational age- 25% have it

PA3305 (8 decks)

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