Case 5- Diabetes

Question 1

What is HbA1c an indicator of?

Answer 1

Glucose levels over the past 3 months- HbA1cis a form of glucylated haemoglobin that will appear higher in someone with diabetes

Question 2

What is the HbA1c concentration that is indicative of diabetes?

Answer 2

greater than or equal to 48mmol/mol

Question 3

What is the HbA1c concentration range that is indicative of pre-diabetes?

Answer 3

42-27mmol/mol

Question 4

What are the diagnostic measures used in diabetes?

Answer 4

HbA1c and fasting plasma glucose (or glucose levels 2h after 75g glucose load)

Question 5

What levels of plasma glucose after fasting indicate diabetes and pre diabetes?

Answer 5

Diabetes: greater than or equal to 7mmol/L

Pre diabetes- less than 7

Question 6

What levels of plasma glucose 2h after a 75g glucose load indicate diabetes and pre diabetes?

Answer 6

Diabetes: greater than or equal to 11.1 mmol/L

Pre-diabetes: greater than or equal to 7.8mmol/L and lower than 11.1

Question 7

What causes diabetic ketoacidosis?

Answer 7

This occurs in uncontrolled diabetes- a decrease in glucose uptake in fat cells increases lipolysis- this leads to an increase in free fatty acids (FFA). These are converted to ketones (these are acidic) in the liver which then subsequently causes acidosis.