CLASSIFICATION AND EPIDEMIOLOGY OF DIABETES

Question 1

TYPE I DIABETES USUALLY APPEARS BEFORE THE AGE OF?

Answer 1

40

Question 2

WHEN DID DIABETES MORTALITY START DECREASING?

Answer 2

EARLY 20TH CENTURY

Question 3

EXAMPLES OF DIABETES MANAGEMENT PRE INSULIN DISCOVERY?

Answer 3

OATMEAL, MILK DIET, POTATO THERAPY, THE RICE CURE, OPIUM, INJECTIBLE PANCREATIC EXTRACT, LOCK AND KEY STRATEGY (STARVING ONESELF)

Question 4

OUTCOMES FOR DIABETEC PEOPLE BEFORE 1922?

Answer 4

CHILDREN RARELY LIVED A YEAR PAST DIAGNOSIS, UNTREATED DIABETICS FACED BLINDNESS, LOSS OF LIMBS, KIDNEY FAILURE, STROKE, HEART ATTACK AND DEATH

Question 5

WHERE DOES THE NAME ‘INSULIN’ COME FROM?

Answer 5

FROM LATIN ‘INSULA’, MEANING ISLAND, REFERRING TO INSULIN PRODUCING ISLETS OF LANGERHANS IN THE PANCREAS

Question 6

1910 ENGLISH PHYSIOLOGIST E.A. SHARPEY-SHAFER STUDIED THE PANCREAS AND DISCOVERED:

Answer 6

THAT THERE IS A SUBSTANCE THAT WOULD NORMALLY BE PRODUCED IN NON DIABETIC PEOPLE MISSING IN THOSE WITH DIABETES

Question 7

WHO AND WHEN DISCOVERED INSULIN?

Answer 7

FREDERICK BANTING AND CHARLES BEST IN 1922, (CANADA)

Question 8

BEFORE BEING CALLED T1D AND T2D WHAT WERE THESE DISEASES CALLED?

Answer 8

T1D: INSULIN-DEPENDANT DIABETES
T2D: NON-INSULIN DIABETES MELLITUS

Question 9

OTHER TYPES OF DIABETES EXCEPT FOR I AND II (BY CAUSE)?

Answer 9

GESTATIONAL, DISEASES OF THE PANCREAS LEADING TO DIABETES, ENDOCRINOPATHIES THAT LEAD TO DIABETES (CUSHING’S, ACROMEGALY..), STEROIDS CAN BRING DIABETES, GEN DISORDERS (DOWN’S, TURNER’S, PW)

Question 10

CAUSES OF T1D?

Answer 10

IMMUNE MEDIATED (ABSOLUTE INSULIN DEFFICINECY) OR IDIOPATHIC

Question 11

T2D DIABETES METABOLIC CAUSES?

Answer 11

CAN RANGE FROM PREDOMINANTELY INSULIN RESISTANCE TO RELATIVE INSULIN DEFICIENCY

Question 12

WHICH TYPE OF DIABETES HAS A HLA ASSOCIATION?

Answer 12

TYPE I

Question 13

FAMILY HISTORY OF DIABETES IS MORE COMMON IN WHICH TYPE?

Answer 13

TYPE II

Question 14

IN HOW MANY PERCENT OF CASES IS THERE FAMILY HISTORY IN T1D VS T2D?

Answer 14

<20% IN T1D

CCA 60% IN T2D

Question 15

GENETIC LOCUS OF T2D IS ON CHROMOSOME?

Answer 15

6

Question 16

2 TYPES OF ‘PRE-DIABETES’?

Answer 16

IMPAIRED GLUCOSE TOLERANCE AND IMPAIRED FASTING GLUCOSE

Question 17

GLUCOSE REMAINS STUCK TO HEMOGLOBIN FOR UP TO HOW MANY DAYS?

Answer 17

120

Question 18

CRITERIA FOR DIABETES DIAGNOSIS:
FASTING GLUCOSE?
2 HRS POST OGTT?
HbA1C?
RANDOM PLASMA GLUCOSE + DIABETES SYMPTOMS?

Answer 18

> 7mmol/L
11.1 mmol/L
6.5% (48mmol)
11.1 mmol/L

Question 19

HOW IS ‘FAST’ DEFINED?

Answer 19

NO CALORIC INTAKE FOR AT LEAST 8 HRS

Question 20

WHAT AMOUNT OF GLUCOSE IS GIVEN IN OGTT?

Answer 20

75g

Question 21

PROS AND CONS OF HbA1C MEASUREMENTS?

Answer 21

PROS: STABLE, REPRODUCTIBLE, NO FASTING REQUIRED, TIME AVERAGED
CONS: INFLUENCED BY MANY FACTORS, NOT RELIABLE IN CONDITIONS LIKE PREGNANCY, MALIGNANCY, ANEMIA, SICKLE CELL, DYSLIPIDEMIA..

Question 22

PROS AND CONS OF GLUCOSE MEASUREMENTS?

Answer 22

PROS: CHEAP, QUICK, ALLOWS INTERNATIONAL COMPARISON, USED FOR LONGER SO THERE’S MANY DATA ON IT, DIABETES IS A PRIMARILY ‘GLUCOSE DISEASE’

CONS: NEED TO FAST, GLUCOSE LEVELS AREN’T OVERLY STABLE..

Question 23

2 EXAMPLES OF TOOLS FOR DIABETES RISK ASSESSMENT IN THE UK?

Answer 23

1) LEICESTER RISK ASSESSMENT SCORE

2) DIABETES UK SCORE

Question 24

WHICH LEICESTER RISK ASSESSMENT SCORE MEANS SOMEONE IS AT HIGH RISK OF DIABETES?

Answer 24

25-47

Question 25

WHAT KIND OF INFO DO TOOLS FOR DIABETES RISK ASSESSMENT IN THE UK ASK FOR?

Answer 25

AGE, SEX, ETHNICITY, BMI, BP, WAIST SIZE..

Question 26

DIABETES, HIB/AIDS, MALARIA AND TUBERCULOSIS, WHICH IS THE CAUSE OF MOST DEATHS PER YEAR?

Answer 26

DIABETES (MORE THAN ALL OTHER 3 COMBINED)

Question 27

NUMBER OF PEOPLE UNDER 20 Y.O. LIVING WITH T1D?

Answer 27

1.1 MILLION

Question 28

NUMBER AND PERCENTAGE OF ADULTS (20-79 Y.O.) LIVING WITH DIABETES?

Answer 28

463 MILLION, I.E. 9.3%

Question 29

SCREENING FOR DIABETES; UK GUIDELINES:

Answer 29

• FOR INDIVIDUALS AGED 40-74 WITHOUT AN EXISTING DIAGNOSIS OF DIABETES OR CVD
• DIABETES RISK ASSESSMENT USING A VALIDATED TOOL
• IN CASE THE RISK TURNS OUT TO BE HIGH; FASTING PLASMA GLUCOSE OR HbA1C TEST

Question 30

THE NUMBER OF ADULTS LIVING WITH DIABETES HAS TRIPLED SINCE?

Answer 30

1975

Question 31

% OF PEOPLE LIVING WITH DIABETES UNAWARE OF IT?

Answer 31

50.1%

Question 32

WHICH CONTINENT IS MOST CONCERNING IN TERMS OF PREDICTED INCREASE IN DIABETES RATES?

Answer 32

AFRICA

Question 33

WHICH CONTINENT HAS THE HIGHEST NUMBER OF CHILDREN AND ADOLESCENTS WITH T1D?

Answer 33

EUROPE

Question 34

1 IN HOW MANY PEOPLE IN UK HOSPITALS HAVE DIABETES?

Answer 34

1/6

Question 35

% OF NHS BUDGET THAT GOES TOWARDS DIABETES MANAGEMENT?

Answer 35

10%

Question 36

CURRENT PREDICTION IS THAT PERCENTAGE OF OBESE ADULTS BY 2034 WILL BE?

Answer 36

> 70%

Question 37

NUMBER OF PEOPLE DIAGNOSED WITH DIABETES IN THE UK?

Answer 37

3.7 MILLION

Question 38

NUMBER OF PEOPLE UNAWARE THEY HAVE DIABETES IN THE UK?

Answer 38

1 MILLION

Question 39

HOW MANY HRS DO PEOPLE WITH DIABETES SPEND WITH A HCP PER YEAR?

Answer 39

3

Question 40

ALPHABET STRATEGY (‘A SAFETY CHECKLIST’) FOR DIABETES MANAGEMENT:

Answer 40

Advice on lifestyle
Blood pressure (aim for < 140/80)
Cholesterol and chronic kidney disease prevention
Diabetes control (HbA1C)
Eyes (yearly check)
Feet (yearly check)
Guardian drugs (aspirin, ACE inhibitors)