Diabetes Flashcards
4 mode of action of hypoglycaemic agents in treating Type 2 diabetes
- inc agent secretion
- inc sensitivity of of tiss. to insulin
- dec glycogenesis
- dec. hydrolysis of carbohydrates into glu
4 common clinical biochem test in diabetes diagnosis/management & why
- HbA1C > assess glycemic control
- Lipid (chloesterol) > assess risk of microvascular disease (coronary heart disease & stroke)
- Urinary albumin (microalbuminuria) > predict nephropathy disease & monitor development of proteinuria
- Urea/creatinine (GFR) > monitor decline in urine function
role of HDL-c & LDL
- LDL: carries cholesterol to cells & organs
- HDL: return cholesterol to liver
microalbumineuria
- small amounts of albumin in urine
- note detectable by dipstick
- earliest sign of diabetic renal disease
characteristics of hyperosmolar non-ketotic coma (HONK)
- Hi glu & no acidosis or ketones
- inc creat/urea
- inc hypotenstion w/ dehydration
Describe diabetes insipidus in terms urine
- Hi vol: urinate 10-20L/day
- urine NOT SWEET
- LOW urine OSMOLALITY
IDF defines Metabolic Syndrome (MS) as*
- Central obesity (consider ETHNICITY)
- and the following 2
• Raised TG
• Lowered HDL
• Hypertension
• Raised fasting glucose
Diagnosis of Metabolic Syndrome*
\+ gestational diabetes \+ 2 of the following: • Impaired glucose tolerance • obesity • hypertension • Dyslipidemia • Microalbinuria
BMI equ & interpret
BMI = weight (kg) / Height (m^2)
• Normal: 20-25
• Overweight: 25-30
• Obese = 30
Type 1 diabetes symptoms
- polyuria; frequent urination, increased urine vol)
- polydipsia: thirsty
- polyphagia: hungry
- weight loss
- fatigue
4 complications of diabetes & give e.g in each
- Microvascular disease: e.g.retinopathy & nephropathy
- Macrovascular disease: e.g. Coronary <3 disease & Cerebrovascular disease
- Neuropathy: don’t feel pain
- Acute complications: DKA, hyperosmolar coma
Whats autophagy
- auto = self + phagy = eat
- self degradation of cells
- discovered by Professor Yoshinori
4 common tests to measure plasma glucose
- Fasting level w/ glucometer
- Glucose tolerance test GTT
- Non-Fasting or random w/ glucometer
- HbA1c (it represents chronic hyperglycemia)
fatsing Glucose level of normal & diabetes mellitus (DM)
normal: 3.5 - 5.5 mM (or less than <7.8mM)
DM: 7
Glucose threshold lvls b/w normal & DM person:
- fasting glucose result
- & oral glucose tolerance test (OGTT)
- Normal: (a) 3.5-5.5 (b) <7.0
- DM: (a) >7.0 (b) >11.1
who are peple @ high risk of developing diabetes
- Indigenous Aus , NZ , Asians, pacific islanders
- > 45yrs w/ obesity or hypertension
- Those with CAD
Describe the HbAc1 (glycated Hb) test
- Hb + Glucose bound by covalent bond
- fasting not required
- av blood glucose for 1- months
> for blood glu control & dx diabetes - <6% low risk for developing disease associated w diabetes
Does HbA1c requires a chromogenic substrate? Why?
no bc Hb is red & visible in visible range
If a patient is anemic, would that affect his HbA1c result? Why?
yes, may affect binding of sugar on Hb?
I say no bc measuring HbA1c as a percentage out of total Hb present?
If HbA1C results can be reduced via drugs such as _ or , the prevalence of diabetic complications will be too.
a) DCCT or UKPDS
b) reduced
other causes of hyperglycemia
- Post prandial: sampling after a meal
- Stress => cortisol + adrenaline => make glucose
- gestational diabetes (in pregnancy)
- acromygly (growth hormone)
Diabetics have an increased prevalence of abnormalities in their lipids or__.
dyslipidemias
The major classes of cholesterol in fasting state are —–.
In fasting state, we expect don’t see which cholesterol? ——-
a) VLDL, LDL (bad), HDL(good)
b) chylomicron
The most common lipid abnormality are predominantly
High Tg and low HDL
