Diabetes

Question 1

definition diabetes, criteria for diagnosis

Answer 1

= chronic metabolic disorder with increased blood sugar (hyperglycemia) resulting from impaired insulin secretion/action

fasting blood glucose > 7 mmol/l (normal = 4)

Question 2

classification diabetes

Answer 2

T1: aka IDDM or juvenile onset
T2: aka NIDDM or adult-onset
Gestational: occurs during some pregnancies

other rare forms caused by single gene mutations

Question 3

characteristic/etiology T1 vs T2

Answer 3

T1:

• 5-10% cases
• incidence rising
• not usually associated with diabetes
• lack of beta cells, thus insulin secretion
• no treatment = ketoacidosis = death
• require exogenous insulin for survival
  etiology: autoimmune disease involving destruction of beta cells by T lymphocytes. both genetic and acquired factors
• greatest risk factor: alleles of MHC

T2D
-usually obesity
-insulin resistance, decreased response to insulin in target tissues and defects in glucose-stimulated insulin secretion
-basal insulin increased early in disease
-slower onset, less severe
etiology:
- genetic and acquired factors
- 400 genes linked to risk
- genetic susceptibility had little effect in absence of enviro stress
-loss function beta cells and insulin resistance

Question 4

major complications diabetes (short and long term)

Answer 4

1. glucosuria
2. polyuria
3. polydipsia
4. polyphagia
5. ketoacidosis

long term

1. neuropathy- loss sensation in periphery
2. CVD
3. microvasculature disease- lead to amputation
4. nephropathy
5. retinopathy- blindness

Question 5

mechanism of hyperglycemia in diabetes

Answer 5

no insulin secretion, or insulin resistance