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Block 8 Ellen > Clinical diabetes > Flashcards

Clinical diabetes Flashcards

1
Q

symptoms of diabetes

A

polyuria
polydipsia
fatigue

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2
Q

what is polyuria

A

excessive passing of urine

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3
Q

what is polydipsia

A

thirst

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4
Q

what is diabetes insipidus

A

polyuria even with restricted fluid intake, patients have excessive thirst ADH deficiency

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5
Q

what is polyuria in diabetes insipidus caused by

A

osmotic diuresis

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6
Q

more prevalent type of diabetes

A

type 2

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7
Q

in which type is insulin required to sustain life

A

type 1

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8
Q

which is an autoimmune condition

A

type 1

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9
Q

which has more genetic linkage

A

type 2

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10
Q

MODY=

A

maturity onset diabetes of the young

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11
Q

LADA=

A

late autoimmune diabetes in adults

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12
Q

what happens in type 1 diabetes

A

autoimmune condition where immune system seeks out and destroys insulin producing beta cells

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13
Q

what is the main attacking cell in type 1

A

CD8+ T cells

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14
Q

what is required to activate the autoimmune response

A

combo of environmental triggers and genetic predisposition

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15
Q

phase one of type 1 diabetes

A

Beta cell death (happens naturally)

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16
Q

Phase 2 of type 1 diabetes

A

priming of autoreactive B and T cells

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17
Q

what is the movement of primed/ differentiated B and T cells to islets in pancreas called

A

insulitis

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18
Q

phase 3 of type 1

A

destruction of Beta cells

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19
Q

what increases in CD8+ T cells

A

the potential to kill beta cells by apoptosis

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20
Q

what does an increased number of antibodies to islets antigens correlate to

A

an increased risk of disease

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21
Q

in genetically susceptible individuals with 3 antibodies against islets antigens what is the prognosis

A

they will get type 1 diabetes

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22
Q

what is the strongest genetic association for type 1 diabetes

A

Major histocompatibility complex (MHC)

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23
Q

outside of MHC what are the most common genetic association (2)

A 
Immunoregulatory genes (PTPN22) 
CD25
24
Q

2 environmental factors causing type 1

A

Bystander activation

molecular mimicry

25
Q

what is bystander activation

A

immune response to infection causes damage to healthy tissue leading to release of islet antigens

26
Q

what is molecular mimicry

A

viral proteins resembles beta cell proteins, immune system attacks both as consequence

27
Q

consequence of severe insulin deficiency

A

ketoacidosis develops rapidly (especially in children)

28
Q

what is type 2 diabetes often detected via

A

routine screenings

29
Q

what is type 2 often associated with at diagnosis

A

high bloop pressure and/or cholesterol levels

30
Q

who do you inherit type 2 diabetes from

A

from mother

31
Q

what 2 things happen in type 2

A

beta cells don’t produce enough insulin to regulate blood glucose levels
Also develops insulin resistance

32
Q

how do Free fatty acids result in insulin resistance

A

they result in fat oxidation in the mitochondria and cellular stress, when mitochondria are stressed–> increased IL-6 and TNF production

33
Q

how do Free fatty acids ceraminde intakes affect insulin

A

FFA take in ceramide which can act on PKB/AKt impeding effective responses to insulin and movement of GLUT4 to plasma membrane

34
Q

in type 1 diabetes after 40 years what is found in the blood

A

measurable C peptide

35
Q

what is the measurable C peptide in type 1 diabetes called

A

beta cell insulin microsecretors

36
Q

diagnosis of LADA

A

elevated pancreatic autoantibodies

37
Q

risk factor for LADA

A

Metabolic syndromes

38
Q

what can diabetic complications be split into

A

macrovascular and microvascular

39
Q

Macrovascular=

A

large blood vessels

40
Q

4 macrovascular

A

stroke
heart disease and hypertension
peripheral vascular disease
foot problems

41
Q

microvascular=

A

small blood vessels

42
Q

4 microvascular

A

diabetic eye disease
renal disease
neuropathy
foot problems

43
Q

diabetes most common problem=

A

heart attack

44
Q

diabetic nephropathy=

A

diabetic kidney disease

45
Q

what happens in diabetic nephropathy

A

raised glucose alters chemical composition of kidney causing glomerulus to malfunction resulting in leakage of protein into urine

46
Q

after prolonged raised blood glucose levels what can happen to the kidneys

A

scar formation—> kidney failure

47
Q

what is diabetic neuropathy

A

family of nerve disorders caused by diabetes

48
Q

diabetic foot syndrome results from

A

peripheral nerve damage and associated peripheral artery disease (PAD)

49
Q

3 consequences of diabetic foot

A

infections
ulceration
increased risk of amputation

50
Q

diabetic retinopathy=

A

damage to blood vessels in retina can leak blood into eye

51
Q

HbA1c=

A

glycated haemoglobin

52
Q

C-peptide vs HbA1c

A

HbA1c is a more realistic measure as RBC only glycated if serum glucose remain consistently high

53
Q

HbA1c levels normal range

A

4-6

54
Q

HbA1c levels good=

A

6.5-7

55
Q

HbA1c levels acceptable=

A

7.1-8.0

56
Q

> 8 HbA1c=

A

poor

57
Q

when is the most important time to regulate blood glucose levels

A

at diagnosis

Block 8 Ellen (14 decks)

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