Diabetes

Question 1

How does glucose move through cell membranes

Answer 1

GLUT transporters, with Na as a co-transporter

Question 2

How do GLUT 1 and 3 differ from GLUT 4

Answer 2

GLUT-1 and GLUT-3 are insulin independent for the brain
GLUT-4 is dependent on insulin

Question 3

Define Diabetes Mellitus

Answer 3

A group of disorders with many causes, characterised by a persistently raised blood glucose level

Question 4

What is diabetes insipidus

Answer 4

Not true diabetes, but a lack of ADH causing excessive urination and thirst

Question 5

What is gestational diabetes

Answer 5

Diabetes that occurs during pregnancy that normally resolves after delivery
can progress to mother getting T2DM

Question 6

What are some dental complications of diabetes

Answer 6

• Periodontal - increased perio destruction
• Xerostomia
• Sialosis - asymptomatic enlargement of major salivary glands
• Fungal infections
• metformin has a very metallic taste

Question 7

What is type 1 diabetes mellitus

Answer 7

Auto-immune T-cell mediated destruction of the B-cell in islets of Langerhans in pancreas

Question 8

Diagnosis of type 1 diabetes mellitus happens in ______

Answer 8

early childhood/adolescence, presenting with diabetic ketoacidosis

Question 9

What is diabetic ketoacidosis

Answer 9

when the liver can’t store glucose, so breaks down fatty acids in gluconeogenesis
increased production of ketones, which are acidic and tank the pH

Question 10

Symptom of diabetic ketoacidosis

Answer 10

Fruity/acetone smell to their breath, loss of consciousness

Question 11

why is ketoacidosis a sign for type 1 and not type 2 diabetes?

Answer 11

it is triggered by a lack of insulin, in type 2 insulin in present but the pt has a resistance to it

Question 12

Define type 2 diabetes mellitus

Answer 12

failure of intracellular signalling pathway, reduced ability for muscle and fat cells to take up glucose (insulin resistance)

Question 13

Risk factors in T2DM

Answer 13

Obesity, family history, Asian/African ethnicity, Hx of gestational diabetes, low fibre diet

Question 14

Microvascular impact of chronic diabetes

Answer 14

capillary endothelial damage, retinopathy (damage to retina blood vessels), Neuropathy (numbness in fingers and toes)

Question 15

Macrovascular impact of chronic diabetes

Answer 15

Accelerated atherosclerosis, peripheral arterial disease, reduced wound healing

Question 16

how does diabetes impact wound healing

Answer 16

neutrophils are abnormal, can’t stick to endothelium to approach bacteria

Question 17

What is the name of the short acting insulin medication?

Answer 17

Humalog

Question 18

What is the name of the long acting insulin medication?

Answer 18

Lantus

Question 19

What is sitagliptin and how does it work?

Answer 19

DPP-4 inhibitor, inhibits the DPP-4 enzyme which is in glucose metabolism
indirectly stimulates more insulin production

Question 20

What is Gliclazide

Answer 20

Sulfonylurea, augments insulin secretion

Question 21

How is obesity defined

Answer 21

BMI over 30

Question 22

What are the factors of obesity

Answer 22

• lack of physical activity
• dietary habits
• genetics can contribute
• medications (antidepressants, corticosteroids)

Question 23

Impact of obesity in dentistry

Answer 23

Psychosocial, obstructive sleep apnoea, cancer, GORD, non-alcoholic fatty liver disease
access to building, chair weight limit, excess soft tissues around head and neck, riskier sedation, pressure sores