Clinical presentation & diagnosis Flashcards
Diabetes- Common symptoms —> Reasons
- Polyuria –> osmotic diuresis when blood
glucose exceeds renal threshold - Polydipsia – due to resulting fluid & electrolyte loss
- Weight loss – due to fluid depletion & breakdown of fat & muscle
- Fatigue – due to body’s inability to get glucose from blood into cells to meet energy
- Blurred vision - due to glucose induced
changes in refraction
Describe DKA
- MEDICAL EMERGENCY
- intercurrent illness in a diagnosed Type 1
Symptoms of DKA
- Hyperventilation,
- nausea & vomiting ,
3 .dehydration - weakness,
- ketone breath,
- reduced consciousness,
↑ blood glucose → osmotic diuresis & dehydration →
hypotension
↑ ketone bodies → metabolic acidosis (“air hunger” +
ketone breath)
Clinical manifestations - Type 2
- Chronic skin infections —> because of impaired phagocyte function
- Pruritis & Candida infection of vagina
- retinopathy,
- neuropathy,
- foot ulcers, nephropathy
Describe Hyperosmolar non-ketotic syndrome [HONK]:
- MEDICAL EMERGENCY
- Present in TYPE 2 patiants
- Similar symptoms to DKA except there no ketosis or acidosis due to remaining insulin to prevent heptic ketogenesis bbut not enough to prevent glycogenolysis
What is the normal blood glucose levels?
3.4 - 5.8 mmol/l
What is the WHO diagnostic criteria for DIabetes for those with symptoms ?
1.Random plasma glucose ≥ 11.1 mmol/l
Fasting venous plasma glucose ≥ 7.0 mmol/l
Plasma glucose ≥ 11.1 mmol/l 2hrs after 75g anhydrous
glucose in an oral glucose tolerance test (GTT)
What is the WHO diagnostic criteria for DIabetes for those with no symptoms ?
Two separate measurements of either random ≥ 11.1
mmol/l or fasting ≥ 7.0 mmol/l
If fasting or random are not diagnostic, the GTT value
should be used
What is Hba1 and how is it used diagnostically in diabetes?
- HBa1 is glycated haemoglobin
- used to measure glucose levels
- Used to test for type 2 diabetes - should be >48mmol/ml
