Diabetes Flashcards
3 characteristics effects of diabetes mellitus
hyperglycaemia
deranged metabolism
Vascular sequelae
What are the main differences between type 1 and 2 diabetes?
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.
How does type 1 DM develop?
A combination of genetic predisposition and autoimmune factors result in the gradual destruction of the beta cells of the pancreas
Possible triggers for type 1 DM?
Viruses
dietary factors
environmental toxins
emotional/physical stress
What % of diabetics are type 1?
15%
Which population is most at risk of Type 1 DM?
Caucasian of northern European ancestry. Incidence is high in scandinavian people.
What % of diabetics are type 2?
85%
Which people have an increased prevalence of type 2 DM?
South Asian African African-Caribbean, Polynesian Middle-Eastern American-Indian
UK average prevalence of diabetes?
4.45%
Risk factors for type 2 DM
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
How does diabetes present?
Patients with all types of diabetes may present with polyuria, polydipsia, lethargy, boils, pruritus vulvae or with frequent, recurrent or prolonged infections.
Define polyuria and polydipsia
Polyuria = passage of >3 litres of urine daily. (very subjective symptom)
Polydipsia = excessive thirst
How does type 1 DM presentation differ form type 2?
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.
What abnormal plasma glucose reading can we base a diagnosis of DM on?
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.
What glycated haemoglobin (HbA1c) score can we base a DM diagnosis on?
An HbA1c of 48mmol/mol (6.5%)
NB. A value less than 48 mmol/mol does not exclude diabetes diagnosed using glucose tests
Risk factors for type 2 DM
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
How does diabetes present?
Patients with all types of diabetes may present with polyuria, polydipsia, lethargy, boils, pruritus vulvae or with frequent, recurrent or prolonged infections.
Management for a person with diabetes includes..
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
How often should type 1 diabetics be assessed?
At least annually and more frequently if there are any factors which may cause concern.
What is the aim of diabetic assessment?
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.
Acute complications of diabetes
DKA
Hyperosmolar Hyperglycaemic state
Chronic complications of diabetes
Cardiovascular disease
Diabetic nephropathy
Diabetic retinopathy and eye problems
Diabetic neuropathy
Diabetic foot, leg ulcers and painful foot
Frequent recurrent and persistent infections
How much greater is the risk of cardiovascular disease in type 2 diabetes?
five times higher
