diabetes

Question 1

Types of Diabetes:

Answer 1

Types of Diabetes:
Type 1: Autoimmune, destruction/dysfunction of islets of Langerhans, insulin deficiency.
Type 2: Non-autoimmune, reduced insulin secretion, insulin resistance in liver, muscle, fat cells.

Question 2

Signs and Symptoms of Diabetes:
-poly

Answer 2

Signs and Symptoms of Diabetes:
Polyuria, polydipsia, polyphagia, tiredness, weight loss, thrush, acanthosis nigricans (type 2).

Question 3

Criteria for Diagnosis:
- stats

Answer 3

Criteria for Diagnosis:
HbA1c ≥ 48 mmol/mol (6.5%) or more.
Fasting plasma glucose ≥ 7.0 mmol/L.
Random plasma glucose ≥ 11.1 mmol/L with symptoms/signs of diabetes.

Question 4

Blood Glucose Control:

Answer 4

Blood Glucose Control:
Carbohydrates break down into glucose, requiring insulin for cell entry.
Liver regulates glucose release; insulin and glucagon are key hormones.

Question 5

Insulin and Glucagon:

Answer 5

Insulin and Glucagon:
Insulin removes glucose from blood, shifts metabolism to use glucose.
Glucagon switches to fatty acids for energy, increases glucose production.

Question 6

Pancreas and Islets of Langerhans:

Answer 6

Pancreas and Islets of Langerhans:
Pancreas has exocrine and endocrine functions.
Islets produce hormones: glucagon, insulin, somatostatin, ghrelin.

Question 7

Insulin Secretion and Blood Glucose Levels:

Answer 7

Insulin Secretion and Blood Glucose Levels:
Insulin secretion linked to glucose levels.
Released from pancreas beta cells via complex ATP, calcium, exocytosis process.

Question 8

Insulin Signal Transduction Pathways:

Answer 8

Insulin Signal Transduction Pathways:
Insulin binds to receptors, activates MAP kinase.
Leads to glucose transporter placement in cell membrane for transport.

Question 9

Insulin Resistance:

Answer 9

Insulin Resistance:
Occurs with prolonged high insulin levels.
Symptoms: Weight gain, lethargy, hunger, difficulty concentrating, high blood pressure.

Question 10

Acute and Chronic Complications of Diabetes:

Answer 10

Acute and Chronic Complications of Diabetes:
Acute: DKA, HHS, hypoglycemia.
Chronic: Retinopathy, foot problems, heart attack, stroke, nephropathy, neuropathy.

Question 11

Long-Term Complications: Retinopathy:

Answer 11

Long-Term Complications: Retinopathy:
Affects various eye parts.
Newly formed vessels, hemorrhages common.
Macula is vision center; microaneurysms can occur.

Question 12

Hyperglycaemia and its Effects:

Answer 12

Hyperglycaemia and its Effects:
High blood sugar levels lead to vessel damage, thickening.
Results in decreased oxygen supply, vessel permeability, and early abnormalities.

Question 13

Long-Term Complications: Nephropathy:

Answer 13

Long-Term Complications: Nephropathy:
Kidney complication.
Tests: Urinary protein, serum creatinine levels.
Microalbuminuria, treated with ACEIs, ARBs.

Question 14

Long-Term Complications: Neuropathy:

Answer 14

Long-Term Complications: Neuropathy:
Affects various body parts.
Effects: Numbness, tingling, muscle weakening, Charcot Foot, bladder issues, erectile dysfunction, gangrene.

Question 15

Diabetes Types and Characteristics:

Answer 15

Diabetes Types and Characteristics:
Type 1, Type 2, Monogenic in children.
Type 1 is polygenic, onset ≥6 months; Type 2 usually during puberty.
Autoimmunity in Type 1, ketosis common in Type 1, more obesity in Type 2.

Question 16

Aims of Treatment:

Answer 16

Aims of Treatment:
Targets for blood glucose levels:
Before meals: 3.5 - 5.5 mmol/l
2 hours post meals: < 9 mmol/l
HbA1c target: < 48 mmol/mol
Aims to prevent complications, encourage self-management.

Question 17

Monitoring Diabetes Treatment:

Answer 17

Monitoring Diabetes Treatment:
Self-testing 4 times/day using finger prick.
Continuous glucose monitoring for adults with type 1 diabetes.
HbA1c measured every 3-6 months.

Question 18

HbA1c and Its Use:

Answer 18

HbA1c and Its Use:
Combination of glucose and hemoglobin in the blood.
Reflects average blood glucose over 2-3 months.
High levels indicate poorly controlled diabetes.

Question 19

Targets for HbA1c and Blood Glucose:

Answer 19

Targets for HbA1c and Blood Glucose:
Target HbA1c: < 48 mmol/mol.
Individualized targets based on daily activities, complications, and hypoglycemia history.
Blood glucose targets for type 1 diabetes.

Question 20

Insulin Administration:

Answer 20

Insulin Administration:
Administered subcutaneously, not orally.
Common injection sites and devices.
New technology options.

Question 21

Potential Issues with Insulin Administration:

Answer 21

Potential Issues with Insulin Administration:
Lack of timely administration in hospitals.
Ignorance of diabetes by some hospital staff.
Lipohypertrophy issues.

Question 22

Islet/Pancreas Transplantation:

Answer 22

Islet/Pancreas Transplantation:
Used to restore normal β- and α-cell function in Type 1 Diabetes.
Can address complications and improve control.
Intrahepatic infusion or pancreas transplant.