Diabetes Flashcards
Main pathophysiological features of diabetes
Glucose is not correctly transported in muscles and adipose tissue
Fat is not correctly stored in adipose tissue
Consequences of diabetes
Hyperglycaemia
Cardiovascular, renal, retinal and neurological complications
Pathophysiology of late stage diabetes
Lipids and amino acids are burned instead of glucose which causes ketosis
Consequences of late stage diabetes
Ketosis
Acidosis
Protein wasting
Exhaustion
Difference between type 1 and type 2 diabetes
Type 1 - inability to secrete insulin
Type 2- relative insulin deficiency (strong genetic component)
Symptoms of late stage type 2 diabetes
- Obesity
- Slow healing
- Frequent infection
- Pain in joints or numbness
- Cardiovascular issues, atherosclerosis
Dietary management of type 2 diabetes
Dietary fibre, slow digested starch, no bread, avoid fruits
Consequences of hyperglycaemia
It can lead to build up of CO2 in the blood causing acidosis
Names and tests that can be seen with diabetes
BMs= blood glucose levels
BSL= blood sugar level
Glucose= dextrose
mMolar= mmol/L
Post prandial= after a meal
FPG= Fasting Plasma Glucose test
OGT (T)= Oral Glucose Tolerance test
What is an oral glucose tolerance test (OGT)
Patient fasts for 8-12 hours or overnight and are given a large glucose load
Then blood glucose levels are taken at intervals to see their tolerance
What is a fasting plasma glucose test (FPG)
Blood glucose test that is taken after a patient has fasted for 8-12 hours
Tests for diagnosing diabetes
- Glycosuria- glucose in urine
- Blood glucose levels
- Oral glucose tolerance
- Glycated haemoglobin
- Insulin levels
When is it likely for an oral glucose tolerance test to be done?
When it is likely the patient has diabetes or is suspected of gestational diabetes in pregnancy
What is glycated haemoglobin (HbA1c) ?
The amount of haemoglobin that a patient has with glucose attached to it
Units= mmol/mol
What are the prediabetic states for patients at risk of having diabetes?
- Impaired fasting glucose
High BSL <7mM and FPG 6.1-6.9mM - Impaired glucose tolerance
Elevated OGT < 11.1mM
Symptoms of type 2 diabetes: the Three Polys
Three Polys
1. Polydipsia- Thirsty excessively
2. Polyuria- Dilute urine often
3. Polyphagia- excessive eating/hungry
Symptoms of type 2 diabetes. The 4 Ts
Thirsty
Toilet
Tired
Thinner
Type 1 diabetes specific symptoms
- Weight loss- catabolism
- Weakness and fatigue
- Short history (2-3 weeks of symptoms)
- Diabetic Ketoacidosis (DKA)
How can the risks of developing diabetes due to pre-diabetic state be reduced?
- Reduction of weight by 5-10%
- Diet
- More exercise
What is the onset of type 1 diabetes
Mid-teens to early adulthood after a trigger
In type 1 diabetes, how do genetics play a part?
Environmental modifiers to genetic components trigger the autoimmune destruction of the pancreas
Symptoms of DKA
- Vomiting
- Abdominal pain
- Changes in conciousness
What is Latent Autoimmune Diabetes in Adults (LADA)
- Subtype of type 1 (Type 1.5)
- Diagnosed by presence of DM and pancreatic auto-antibodies
Treatment for LADA
- Preserving islet cell function
- Eventually insulin will be required
Onset of type 2 diabetes
Later in life; >40
What is Maturity Onset Diabetes of the Young (MODY)
- Type 2 diabetes
- Rare inherited type of diabetes, problem of insulin secretion
- Occurs <25
Risks of gestational diabetes
- Increases the chance of stillbirth
- Increases birthweight (macrosomia)
- Mothers are at risk of developing type 2
Drugs that cause extrinsic diabetes or destabilise diabetic patients
- Corticosteroids
- Protease inhibitor (HIV)
- Thiazides (BP)
- Beta-blockers (BP)
- Antipsychotics
What is diabetes insipidus
- The patient lacks the secretion of vasopressin
- Produce large volumes of urine because they can’t concentrate their urine
- Excessive urination and extreme thirst
- Normal blood glucose and insulin levels
What causes diabetes insipidus
ADH deficiency or renal insensitivity to ADH
Tests for diabetes insipidus
- Blood glucose bicarbonate
- Calcium levels
- Electrolytes (high sodium, hypernatremia)
- Urinalysis- Dilute urine
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SSRIs