Diabetes Flashcards
Define the bascis of diabetes.
A group of metabolic diseases characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action or both
What are the 4 criteria of which any can be used to diagnose diabetes?
HbA1c 48mmol/mol +
Fasting glucose - 7mmol/L+ 2hr glucose in OGTT 11.1mmol/L+
Random glucose 11.1mmol/L+
What are the 4 main types of Diabetes?
Type 1
Type 2
Other specific types
Gestational Diabetes
What are the 2 cardinal symptoms of diabetes?
Polydipsia (excessive thirst)
Polyuria
Give a list of other syptoms that can occur with any diabetes in general?
Thrush (candidal or other infection)
Blurred vision
Weakness fatigue
What are the 3 main microvascular complications in diabetes?
Nephropathy
Retinopathy
Neuropathy
Define gestational diabetes.
any degree of glucose intolerance arising or diagnosed during pregnancy
Which autoantibodies are normally present in T1DM?
anti-GAD and /or anti-islet cell antibodies
What is type 2 DM?
A diagnosis of exclusion - not type 1 and not some other specific type
Does autoimmune destruction to the beta-cells occur in type 2 DM?
No
It is not an AI disease
Give 5 specific types of diabetes? Not incding T1, T2 or gestational diabetes
LADA MODY Drug induced NND Endocrine disease Wolfram syndrome
How does type 1 DM usually present?
Pre-school or peri-puberty Usually lean Acute onset of severe symptoms Often severe weight loss ketonuria with/wo metabolic acidosis No evidence of complications
What is the basis pathogenesis of T1DM?
Interaction between genes imparting susceptibility and resistance –> Variable insulinitis and beta-cell sensitivity to injury –>
Pre-diabetes –> Overt diabetes
What is your risk of havin T1DM if both of your parents have it?
~30%
Briefly describe the management of type 1 DM.
BG and ketone monitoring Insulin CHO estimation Dieticia and DSN contact Annual review assessment Record severe hypoglycaemia episodes and DKA
What is the typical presentation of T2DM?
Middle aged/ elderly Usually obese Pre-diagnosis duration of ~6-10 years Insidious onset Ketonuria – minimal or absent Evidence of microvascular disease/complications at diagnosis in 20-50 %
Give the risk factors for the development of T2DM.
Obesity FH Age Ethnicity (Asian, African, Afro-Carribean) PMH - MI or CVA Antipsychotics IGT/IFG
What is a diagnosis of the “metabolic syndrome” made on?
Need insulin resistance and T2DM plus 2 of the following to have the metabolic syndrome:
Micralbuminuria
Obesity (BMI >30 or WHR 1.7, HD <1.0
What are the basic steps of treatment for T2DM?
Therapeutic lifestyle change Monotherapy Combination therapy (w/o insulin) Combination therapy (with insulin)
What does LADA stand for?
Latent autoimmune diabetes of adults
When should you suspect LADA?
AGe 25-40 Usually non-bese Associated AI conditions Male preponderance Auto-antibody positive
What does MODY stand for?
Maturity onset diabetes of the young
What kind of inheritance does MODY express?
Autosomal dominant inheritance - rare
What are the 2 main types of MODY?
Glucokinase and transcripton factors
