Case 5 Flashcards
What is Type-1 diabetes characterised by
Insulin deficiency
Auto-immune condition
Destruction of ß-cells in pancreas
What is Type-2 diabetes characterised by
Insulin resistance
Associated with obesity
Most common in certain racial groups
Interplay between genes and environemtn
What is the mode of action fo insulin
Binds to the insulin receptor on the CSM
Intracellular cascade to translocate GLUT4 to the CSM
Glucose is transported into the cell through these transporters
How do you distinguish between Type-1 and 2 diabetes
Measure the insuling levels (type 1 is low 2 is high)
Send a blood sample to the lab that will test for antibodies
What is considered an abnormal blood glucose level and should be investigated further
Fasting >7mmol/L
Random measurement > 11.1 mmol/L
What would show up for Type 1 diabetics in urinalysis
Ketones in the urine
Who should be screened for type 2 diabetes
Overweight individuals Vascular disease sufferers Hypertension Over 40 Previous gestational diabetes Pre-diabetic states
What is HbAC1
This is an indicator of how much glucose is in the blood as the maount fo glucose on its surface can be measured
What reading on HbAC1 is diagnostic of chronic hyperglycaemia
48mmol/mol
How does the impaired glucose tolerance drink work
It’s a drink containing 75% glucose
Blood tests are at 120 minutes and diagnosed as having ‘impaired glucose tolerance’ if blood glucose levels 7.8mmol/l
What level constitutes impaired fasting glycaemia
6.1mmol/L
What are typical diabetic symptoms
Thirst increased urination Tiredness Weight loss Blurred vision
How does Type 1 diabetes present differently to type 2
Much more acute rapid symptom onset
Generally young patients
Clear marked symptoms as opposed to mild symptoms
Mostly no family history
Most present as an emergency instead of complications
What is secondary diabetes
This is after medication, particularly steroids
Can also affect after pancreas conditions or rare endocrine conditions
Is diabetes attributed to one or many genes
It is described as polygenic as it can be attributed to many genes
What may there be a history of in Type 1 diabetes
Other autoimmune diseases such as thyroid disease or inflammatory bowel disease
What are examples of monogenic diabetes and how do these affect patients
Neonatal diabetes and Maturity Onset Diabetes of the Young (MODY)
Strong family history and onset before 25
Often diagnosed with Type 1 diabetes but don’t need to be treated with insulin in general
What are the risk factors for pregnant women of gestational diabetes
Overweight or obese
History of gestational diabetes
Large baby in previous pregnancies
When does gestational diabetes resolve
After delivery of the baby
How does gestational diabetes occur
Some hormones released during pregnancy interfere and cause insulin resistance
What cardiovascular problems can diabetes lead to
Increased risk of Stroke CVD Hypertension PVD Absent foot pulses
What else can diabetes lead to beyond cardiovascular disease
Retinopathy
Nephropathy
Erectile dysfunction
Neuropathy
How do insulin and glucagon react after a meal
Insulin rises and glucagon drops in a response to blood glucose rising
What is ATP important for
Muscle contraction Active transport Biosynthesis Cellular Processes Adaptive thermogenesis