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3006 Clin. Biochem > Diabetes > Flashcards

Diabetes Flashcards

1
Q

4 mode of action of hypoglycaemic agents in treating Type 2 diabetes

A
  1. inc agent secretion
  2. inc sensitivity of of tiss. to insulin
  3. dec glycogenesis
  4. dec. hydrolysis of carbohydrates into glu
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2
Q

4 common clinical biochem test in diabetes diagnosis/management & why

A
  1. HbA1C > assess glycemic control
  2. Lipid (chloesterol) > assess risk of microvascular disease (coronary heart disease & stroke)
  3. Urinary albumin (microalbuminuria) > predict nephropathy disease & monitor development of proteinuria
  4. Urea/creatinine (GFR) > monitor decline in urine function
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3
Q

role of HDL-c & LDL

A
  • LDL: carries cholesterol to cells & organs

- HDL: return cholesterol to liver

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4
Q

microalbumineuria

A
  • small amounts of albumin in urine
  • note detectable by dipstick
  • earliest sign of diabetic renal disease
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5
Q

characteristics of hyperosmolar non-ketotic coma (HONK)

A
  • Hi glu & no acidosis or ketones
  • inc creat/urea
  • inc hypotenstion w/ dehydration
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6
Q

Describe diabetes insipidus in terms urine

A
  • Hi vol: urinate 10-20L/day
  • urine NOT SWEET
  • LOW urine OSMOLALITY
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7
Q

IDF defines Metabolic Syndrome (MS) as*

A
  • Central obesity (consider ETHNICITY)
  • and the following 2
    • Raised TG
    • Lowered HDL
    • Hypertension
    • Raised fasting glucose
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8
Q

Diagnosis of Metabolic Syndrome*

A 
\+ gestational diabetes
\+ 2 of the following:
• Impaired glucose tolerance
• obesity 
• hypertension
• Dyslipidemia
• Microalbinuria
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9
Q

BMI equ & interpret

A

BMI = weight (kg) / Height (m^2)
• Normal: 20-25
• Overweight: 25-30
• Obese = 30

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10
Q

Type 1 diabetes symptoms

A
  • polyuria; frequent urination, increased urine vol)
  • polydipsia: thirsty
  • polyphagia: hungry
  • weight loss
  • fatigue
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11
Q

4 complications of diabetes & give e.g in each

A
  1. Microvascular disease: e.g.retinopathy & nephropathy
  2. Macrovascular disease: e.g. Coronary <3 disease & Cerebrovascular disease
  3. Neuropathy: don’t feel pain
  4. Acute complications: DKA, hyperosmolar coma
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12
Q

Whats autophagy

A
  • auto = self + phagy = eat
  • self degradation of cells
  • discovered by Professor Yoshinori
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13
Q

4 common tests to measure plasma glucose

A
  1. Fasting level w/ glucometer
  2. Glucose tolerance test GTT
  3. Non-Fasting or random w/ glucometer
  4. HbA1c (it represents chronic hyperglycemia)
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14
Q

fatsing Glucose level of normal & diabetes mellitus (DM)

A

normal: 3.5 - 5.5 mM (or less than <7.8mM)
DM: 7

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15
Q

Glucose threshold lvls b/w normal & DM person:

  • fasting glucose result
  • & oral glucose tolerance test (OGTT)
A
  • Normal: (a) 3.5-5.5 (b) <7.0

- DM: (a) >7.0 (b) >11.1

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16
Q

who are peple @ high risk of developing diabetes

A
  • Indigenous Aus , NZ , Asians, pacific islanders
  • > 45yrs w/ obesity or hypertension
  • Those with CAD
17
Q

Describe the HbAc1 (glycated Hb) test

A
  • 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
18
Q

Does HbA1c requires a chromogenic substrate? Why?

A

no bc Hb is red & visible in visible range

19
Q

If a patient is anemic, would that affect his HbA1c result? Why?

A

yes, may affect binding of sugar on Hb?

I say no bc measuring HbA1c as a percentage out of total Hb present?

20
Q

If HbA1C results can be reduced via drugs such as _ or , the prevalence of diabetic complications will be too.

A

a) DCCT or UKPDS

b) reduced

21
Q

other causes of hyperglycemia

A
  • Post prandial: sampling after a meal
  • Stress => cortisol + adrenaline => make glucose
  • gestational diabetes (in pregnancy)
  • acromygly (growth hormone)
22
Q

Diabetics have an increased prevalence of abnormalities in their lipids or__.

A

dyslipidemias

23
Q

The major classes of cholesterol in fasting state are —–.

In fasting state, we expect don’t see which cholesterol? ——-

A

a) VLDL, LDL (bad), HDL(good)

b) chylomicron

24
Q

The most common lipid abnormality are predominantly

A

High Tg and low HDL

25
Q

2 artheogenic cholesterols

A

LDL & VLDL

26
Q

Diagnosis of microalbuminuria, requires —- measurements with ≥_ in abnormal range (because __).

A

3x
≥2
it varies too much

27
Q

Acute diabetic problems that need immediate medical attention. (Occurs in Type 1 or 2?)

A
  • hyperglycaemia (type 1 &2)
  • diabetic ketoacidosis: w/out insulin left w lipolysis fir energy (type 1)
  • hyperosmolar coma: high glucose but w/out increased ketones and acidosis (Type 2)
28
Q

diabetic ketoacidosis is most likely due to

A
  • A Kussmall breathing pattern
  • Low plasma bicarbonate
  • Mobilization of fatty acids from adipose tissue
  • Increased 3-hydroxybutyrate and acetoacetate synthesis
29
Q

4 results expect to see in ketoacidosis

A
  • ↑ Triglycerides often also seen.
  • ↑ urea and creatinine (↓GFR)
  • ↑ Plasma glucose (10-40 mmol/L)
  • Acidosis and ↑ Potassium in blood (Hyperkalemia)
  • Ketones in plasma (acetoacetate, hydroxybutyrate) & Acidosis
30
Q

Function of hypoglycemic agents:

a) Sulphonylurea drug
b) Thiazolidinedione drug
c) Metformin
d) Alpha-glucosidase inhibitor

A

a) Sulphonylurea drug> inc insulin secretion
b) Thiazolidinedione drug> inc tiss sensitivity to insulin
c) Metformin > dec production & absorption of glu
d) Alpha-glucosidase inhibitor > inhibit enzyme - hydrolyse carbohydrates

3006 Clin. Biochem (13 decks)

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