Diabetes Flashcards
Cost to NHS?
14 billion
How much money for prescription for diabetes?
1 in every 8
Clinical diagnosis?
Equal or more 11.1 mmol/l and symptoms
HbA1c value?
More than 48mmol/mol
75g glucose tolerance test?
Fasting- more than 7mmol/l
2 hour > 11.1 mmol/l
What causes problem?
Deposition of amyloid derived from islet amyloid polypeptide polymers.
Abnormal beta cells
Insulin resistance
Fetal programming epigenetic factors?
Intrauterine growth retardation
And maternal hyperglycaemia results in reduced beta cell mass
Ectopic fat makes?
Free fatty acids- insulin resistance and atherogenic lipid
Cytokines- insulin resistance, inflammation
Procoagulant factors PAI1
What percent of diabetes is attributed to preventable factors?
96
How does Cataract happen?
Increased generation of polyols from glucose
1% reduction in glucose hba1c means?
19% reduction in cataract risk
Glycosylation of connective tissue?
Addition of carbohydrate group. Cheiroarthopathy, limited joint mobility.
Atherosclerotic lesion process?
- Dyslipoporteinaemia
- Inflammation
- Thrombosis
Treatment for dyslipaemia?
Statins
Screening of kidneys?
Urine albumin
BP
ACE inhibitors and ARBs
Best obesity surgery?
Roux en y bypass
T2D education programmes?
Desmond
Treatment for hypertension?
Aspirin
Treatment for eyes?
Retinal photography
Laser treatment
For kidneys treatment?
Meausre urine albumin
Control bp
Ace inhibitors and arbs
HbAic goal
6.5-7.5
Bp goal
120-140/80
Ldl goal
<2 mmol/l
Non HDL cholestrol?
<2.78
How prevalence of diabetes type 2 in UK?
4.6 million
Impaired glucose tolerance levels?
Between 7 and 11.1 mmol/l
Impaired fasting glucose levels?
6-6.9mmol/l
What may be causing diabetes?
Islet amyloid polypeptide IAPP is secreted from pancreatic islet B cells and coverted to amyloid deposits in t2d
Other possible aerological factors causing diabetes?
Age
Ectopic fat in pancreas
Change in gut microbiota
Glucotoxicity and lipotoxicity
What are the problems with t2D?
Hyperglycaemia Dysregulation of lipid metabolism High levels of proinflammatory cytokines High levels of free radicals Increased susceptibility of infections
Fractures in diabetes?
Increased x2
If you reduce hba1c by 1% then micro vascular complications go down by?
37
Type 2 diabetes education programmes?
Desmond
Treatment for hypertension?
Aspirin
