Diabetes Flashcards

1
Q

3 characteristics effects of diabetes mellitus

A

hyperglycaemia
deranged metabolism
Vascular sequelae

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2
Q

What are the main differences between type 1 and 2 diabetes?

A

Type 1 diabetes mellitus: results from the body’s failure to produce sufficient insulin.
Type 2 diabetes mellitus: results from resistance to the insulin, often initially with normal or increased levels of circulating insulin.

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3
Q

How does type 1 DM develop?

A

A combination of genetic predisposition and autoimmune factors result in the gradual destruction of the beta cells of the pancreas

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4
Q

Possible triggers for type 1 DM?

A

Viruses
dietary factors
environmental toxins
emotional/physical stress

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5
Q

What % of diabetics are type 1?

A

15%

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6
Q

Which population is most at risk of Type 1 DM?

A

Caucasian of northern European ancestry. Incidence is high in scandinavian people.

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7
Q

What % of diabetics are type 2?

A

85%

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8
Q

Which people have an increased prevalence of type 2 DM?

A
South Asian
African
African-Caribbean, Polynesian
Middle-Eastern
American-Indian
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9
Q

UK average prevalence of diabetes?

A

4.45%

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10
Q

Risk factors for type 2 DM

A
Obesity (particularly truncal)
Lack of exercise
History of gestational diabetes
Impaired glucose tolerance
Drug therapy
Low fibre, high glycaemic diet
Metabolic syndrome
Polycystic ovarian syndrome
Family history
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11
Q

How does diabetes present?

A

Patients with all types of diabetes may present with polyuria, polydipsia, lethargy, boils, pruritus vulvae or with frequent, recurrent or prolonged infections.

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12
Q

Define polyuria and polydipsia

A

Polyuria = passage of >3 litres of urine daily. (very subjective symptom)

Polydipsia = excessive thirst

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13
Q

How does type 1 DM presentation differ form type 2?

A

Patients with type 1 diabetes may also present with weight loss, dehydration, ketonuria and hyperventilation. Presentation of type 1 diabetes tends to be acute with a short duration of symptoms.

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14
Q

What abnormal plasma glucose reading can we base a diagnosis of DM on?

A

Random ≥11.1 mmol/L or fasting ≥7 mmol/L

in the presence of diabetic symptoms such as thirst, increased urination, recurrent infections, weight loss, drowsiness and coma.

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15
Q

What glycated haemoglobin (HbA1c) score can we base a DM diagnosis on?

A

An HbA1c of 48mmol/mol (6.5%)

NB. A value less than 48 mmol/mol does not exclude diabetes diagnosed using glucose tests

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16
Q

Risk factors for type 2 DM

A
Obesity (particularly truncal)
Lack of exercise
History of gestational diabetes
Impaired glucose tolerance
Drug therapy
Low fibre, high glycaemic diet
Metabolic syndrome
Polycystic ovarian syndrome
Family history
17
Q

How does diabetes present?

A

Patients with all types of diabetes may present with polyuria, polydipsia, lethargy, boils, pruritus vulvae or with frequent, recurrent or prolonged infections.

18
Q

Management for a person with diabetes includes..

A

Diabetes education
Diet and lifestyle monitoring
Maximising glucose control
Reduction of risk factors for diabetes
Monitoring and early intervention for complications of diabetes
A global assessment of an individuals cardiovascular risk is essential

19
Q

How often should type 1 diabetics be assessed?

A

At least annually and more frequently if there are any factors which may cause concern.

20
Q

What is the aim of diabetic assessment?

A

The aim of regular review should be to assess and decrease the risk of known complications of diabetes, such as peripheral arterial disease, nephropathy and retinopathy.

21
Q

Acute complications of diabetes

A

DKA

Hyperosmolar Hyperglycaemic state

22
Q

Chronic complications of diabetes

A

Cardiovascular disease
Diabetic nephropathy
Diabetic retinopathy and eye problems
Diabetic neuropathy
Diabetic foot, leg ulcers and painful foot
Frequent recurrent and persistent infections

23
Q

How much greater is the risk of cardiovascular disease in type 2 diabetes?

A

five times higher