Diabetes

Question 1

What can cause diabetes insipidus?

Answer 1

ADH problems

Question 2

What is diabetes?

Answer 2

Inappropriate hyperglycaemia

Question 3

What is diabetes mellitus?

Answer 3

Metabolic disease characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action, or both

Question 4

What are the ranges for HbA1c?

Answer 4

Normal = 41 and below
Pre = 42-47
Diabetes = 48 and above (mmol/mol)

Question 5

What are the ranges for fasting glucose?

Answer 5

Normal = 6.0 and below
Pre = 6.1-6.9
Diabetes = 7 and above
(mmol/L)

Question 6

What are the ranges for 2-hour glucose in OGTT?

Answer 6

Normal = 7.7 and below
Pre = 7.8-11.0
Diabetes = 11.1 and above
(mmol/L)

Question 7

What are the ranges for random glucose?

Answer 7

Diabetes = 11.1mmol/L and above

Question 8

What are symptoms of Type 1 diabetes?

Answer 8

Frequent urination
Thirstiness
Tiredness
Lose of weight

Question 9

What are risk factors for Type 2 diabetes?

Answer 9

Obesity
Asian,African,Afro-Caribbean decent
PHx of MI/Stroke

Question 10

What are symptoms of Type 2 Diabetes?

Answer 10

Thirst
Polyuria
Thrush
Fatigue
Blurred vision
Infections
Weight loss
Complication indications such as neuropathy, retinopathy etc.

Question 11

What investigations are there for diabetes?

Answer 11

GAD/ Anti-Islet cell antibodies
Ketones
C-Peptides (Plasma)

Question 12

What pancreatic disorders can lead to Type 3 diabetes?

Answer 12

Chronic or recurrent pancreatitis
haemochromatosis
Cystic fibrosis

Question 13

What endocrine disorders can lead to type 3 diabetes?

Answer 13

Cushing’s syndrome
acromegaly
Phaechromocytoma
Glucagonoma

Question 14

What drugs can lead to type 3 diabetes?

Answer 14

Glucocorticoids
Diuretics
B-blockers

Question 15

What genetic disorders an lead to type 3 diabetes?

Answer 15

Cystic fibrosis
Myotonic dystrophy
Turner’s syndrome

Question 16

What should you look out for in monogenic diabetes?

Answer 16

Strong FHx
Assoc features e.g. renal cysts
Young onset
GAD-negative
C-peptide +ve

Question 17

What is type 4 diabetes?

Answer 17

gestational diabetes (pregnancy)

Question 18

What are macro-vascular complications?

Answer 18

Heart disease
Stroke
(cardio diseases)

Question 19

What are micro-vascular complications?

Answer 19

retinopathy
nephropathy
Neuropathy
Encepalopthy (brain, same as liver)

Question 20

What are the types of neuropathy?

Answer 20

peripheral
Autonomic
Proximal
Focal Neuropathy

Question 21

What is peripheral neuropathy?

Answer 21

pain/loss of feeling in feet and hands

Question 22

What is autonomic neuropathy?

Answer 22

Chanegs in bowel, bladder function. Sexual respone, sweating, heart rate, BP, Hypoglycaemic unawareness

Question 23

What is proximal neuropathy?

Answer 23

Pain in the thighs, hips or buttocks leading to weakness in the legs (Amyotrophy)

Question 24

What is focal neuropathy?

Answer 24

Sudden weakness in one nerve or a group of nerves causing muscle weakness or pain e.g. carpal tunnel, ulnar mono neuropathy, foot drop, bells palsy, cranial nerve palsy

Question 25

What are precipitating factors to neuropathy?

Answer 25

``` Increased length of diabetes Poor glycaemic control Type 1 > type 2 High cholesterol/lipids Smoking Alcohol Inherited traits mechanical injury ```

Question 26

What are symptoms of peripheral nerve damage?

Answer 26

``` Numbness/insensitivity Tingling/burning Sharp pains + cramps Sensitivity to touch Loss of balance + coordination ```

Question 27

What are complications of peripheral nerve damage

Answer 27

Infection/Ulcers Deformities Amputations

Question 28

What are the treatments for gastroparesis?

Answer 28

Metoclopramide Domperidone Erythromycin

Question 29

What are treatments for neuropathy pain?

Answer 29

SEE LECTURE

Question 30

What are GI associations with autonomic neuropathy?

Answer 30

Gastric slowing Gastroparesis Oesophagus nerve damage

Question 31

What happens with gastroparesis?

Answer 31

Slow stomach emptying, vomiting, bloating and appetite loss.