diabetes Flashcards
List two blood tests and their values which are diagnostic of diabetes.
a random venous plasma glucose concentration ≥ 11.1 mmol/l or.
a fasting plasma glucose concentration ≥ 7.0 mmol/l (whole blood ≥ 6.1 mmol/l) or.
two hour plasma glucose concentration ≥ 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT).
What two lifestyle advices would you give the patient
exercise, eat less times, decrease carb intake
common causes of type 1 and 2 diabetes?
Type 1 = cause = autoimmune destruction/cancer/cystic fibrosis/pancreatic disease (alcohol) of B cells in pancreas
* Organ specific autoimmune disease, e.g. hashimotos, graves, addison’s, pernicious anaemia (loss of B12)
* Linked to family history
Type 2 = they haven’t lost all the function
* Insulin resistant = receptors don’t behave the same
symptoms and signs of diabetes?
Type 1 = will usually present with KETOACIDOSIS in the young. Body cells cannot access glucose for metabolism so the start to metabolise fat which results in Ketones as end product.
- Type 1 can’t make insulin, sugar is up, build acidic biproducts that make you sick
Type 2 = Fat storage, suppression of glucogenesis, more glycogen storage, abdominal obesity = hyper insulin anaemia
Treatment of diabetes mellitus including social, behavioural and medical aspects
Type 1 = Insulin pump and islet cell transplant
Type 2 = metformin and gliptins; diet and exercise, weight loss surgery
Acute and chronic complications of Diabetes Mellitus (hypoglycaemia)?
- Increased risk of microvascular diseases – damage to vessels – heart attack or stroke – atherosclerosis in vessels due to high cholesterol
- Nerve damage – microvascular – small blood vessel supply and blockage – no nutrients
- Nerves affected = any nerve = autonomic, sensory or motor
- Chronic burning pain = diabetic neuropathy; when autonomic = pain and no response = bladder and bowel control is a problem, heart rate and etc
- Neuropathy increases during diabetes
- Possibility of cataracts, maculopathy = loss of detailed vision, proliferative retinopathy = bv grow on the back of retina
- Renal disease = macrovascular = high BP = atherosclerosis of renal artery; microvascular = glomerulus failure
- Neuropathy = “tight shoes” = poor wound healing and higher infection risk = both types
dental complications in diabetes?
- Type 1 = dental treatment interferes with routine = could cause an emergency
- Type 2 will be an issue, increased risk of perio and loss of periodontal attachement
- Oral candidiasis if poorly controlled, HbA1C test can be used to test if it controlled
- High sugar blood contents means high in saliva too = more chances of tooth decay
- Hypoglycaemia after more severe treatment
What two drug types might the patient may be prescribed with type 2 diabetes?
metformin and gliptins (DD4 inhibitor)
Two pieces of advice you would give to a diabetic patient prior to treatment
monitor blood glucose and do not fast before appointment
3 typical diabetes symptoms
increased thirst, urination, feeling tired and losing weight
symptoms of type 1 diabetes
thirst, frequent urination, feeling tired, weight loss, often yeast infections
Mr C, a 65-year-old gentleman attends his general medical practitioner (GMP) complaining of a dry mouth and the need to pass a good volume of urine frequently during the day and at least three times at night. He feels generally tired and has done for some weeks. His optician had advised he see his GP having noticed changes on his retinal examination.
On examination, the GMP finds him to have a BMI of 36. His pulse is 70/minute, regular and his blood pressure is 160/95 mmHg. He is suspected of having Diabetes Mellitus.
1. What is the most likely type of Diabetes Mellitus responsible for Mr C’s trouble?
Type 2
Give TWO blood glucose tests that could confirm this diagnosis. For each give the value at which the test becomes diagnostic for diabetes mellitus.
a random venous plasma glucose concentration ≥ 11.1 mmol/l or.
a fasting plasma glucose concentration ≥ 7.0 mmol/l (whole blood ≥ 6.1 mmol/l) or.
two hour plasma glucose concentration ≥ 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT).
What TWO pieces of lifestyle advice would be best to help this man manage his condition?
exercise, meditterian diet, less carbs
Mr C finds this very hard to do and asks if there is alternative treatment
4. Name only TWO drug types that should be considered.
biguanides, glipins
