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Endocrine > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What does mellitus mean

A

sweet- high sugar content (hyperglycaemia)

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2
Q

what is insipidus

A

excessive thirst and urination - rare

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3
Q

what is diabetes?

A

inappropriate glucose homeostasis, hyperglycaemia, insulin insufficiency to meet regulation.

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4
Q

what type of diabetes is absolute insulin deficiency?

A

type 1

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5
Q

Type 2 is what type of insulin deficinecy

A

relative

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6
Q

what is the failure of insulin synthesis, release or activity known as?

A

MODY

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7
Q

HbA1c would score what if diabetic

A

> 48m/m

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8
Q

fasting glucose score would be what if diabetic

A

> 7m/mol

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9
Q

what would the random glucose score be in someone with diabetes

A

> 11.1m/mol

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10
Q

what is the score for 2hr glucose OGTT

A

> 11.1

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11
Q

what antibodies are usually present in type 1 diabetes

A

Anti GAD and anti- islet cell antibodies

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12
Q

what is insulinitis

A

lymphocyte infiltration

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13
Q

When does type 1 usually present

A

childhood/ peri puberty

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14
Q

what onset is type 1

A

acute +severe WEIGHT LOSS

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15
Q

does type 1 require insulin?

A

HELL YEAH

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16
Q

when does type 2 present

A

middle aged/ obese

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17
Q

how do you manage type 2 diabetes?

A

diet and tablets

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18
Q

what are complications of type 2 diabtes

A

neuropathy, retinopathy

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19
Q

whom does monogenic diabetes most commonly affect?

A

children

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20
Q

what would the antibodies be in monogenic diabetes

A

negative- GAD and C peptide positive

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21
Q

what does HbA1c show?

A

glucose control measure over 2-3 months

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22
Q

what microvascular complications can occur?

A

retinopathy, neuropathy, nephropathy

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23
Q

What macrovascular complications

A

heart disease and stroke

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24
Q

risk factors for type 2

A

previous MI and stroke, pregnancy, obesity, age, medications- antipsychotics

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25
Q

what is the classic presentation of type 1 diabetes?

A

polyuria, WL, polydipsia

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26
Q

Are cystic fibrosis patients likely to develop diabetes?

A

yes- >25%

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27
Q

What is prominent in bardet beadle syndrome

A

polydactyly, hypogonadal, visual/hearing impairment, DIABETES

28
Q

In LADA are antibodies positive or negative?

A

positive (where MODY is negative)

29
Q

What autoimmune conditions are associated with diabetes

A

coeliac, thyroid, anemia, IgA deficiency, Addisons

30
Q

what are key elements of type 2 diabetes

A

insulin resistance and b cell dysfunction

31
Q

describe the concept of insulin resistance

A

the receptor is not as responsive to insulin molecule and therefore less glucose enters cell, resulting in a build up of glucose in the blood

32
Q

what factors cause insulin resistance

A

BUILD UP OF FAT, INFLAMMATORY, reduction In glycogen synthesis due to reduced glucose transport

33
Q

truew or flase, at time of diabetes presentation, b cell function is already approx. half depleted

A

truuueee

34
Q

which body shape is worse for diabetes, apple or pear

A

apple

35
Q

what factors make up the metabolic syndrome

A

high BP, high triglycerides, low HDL, insulin resistance

36
Q

what kind of lifestlyr advice can you give

A

WL, exercise, smoking cessation and improve diet

37
Q

name a biguanide

A

metformin

38
Q

what type of anti hyperglycaemic agents is glicazide/ glipizide

A

sulphylureas

39
Q

What is pioglitazone

A

a thiazolidiones

40
Q

what is the usual starting dose of metformin

A

500mg OD

41
Q

What do the class biguanides do?

A

insulin sensitizers

42
Q

does metformin cause hypos?

A

nooo

43
Q

true or false, metformin can cause micro and macrovascular problems

A

FlALSE FALSE FALSE

44
Q

IS METFORMIN SAFE IN PREGNANCY?

A

yes

45
Q

are GI side effects common in metformin?

A

Yes-25%

46
Q

Should you be weary with MI/strokes in patients taking metformin?

A

yeah

47
Q

what should you do if eGFR is less than 30ml/min?

A

stop metformin

48
Q

what do sulphonylureas do?

A

secrete insulin by acting of potassium channel

49
Q

does sulphonylureas prevent micro and macrovascualar problems?

A

No- prevents microvascualr complications but NOT macrovascular

50
Q

what is one of the biggest risks of sulphonylureas?

A

hypo attacks in older people

51
Q

when should you totally avoid sulphonylureas?

A

in severe renal or hep[atic disease

52
Q

thiazolinedione does ewhat?

A

transcripts genes that are insulin sensitive

53
Q

What happens to your weight in TZDs?

A

you put weight on!

54
Q

Patients with heart failure should not get TZDs

A

true- risk of fluid retention

55
Q

does TZDs prevent against macrovascular complications?

A

Yes

56
Q

True or flase- there si not a risk of hip fracture when taking plioglitazone

A

false!- 20% risk

57
Q

what is the incretin pathway?

A

where glucose is absorbed better orally than iv

58
Q

what are 2 incretins?

A

GIP form K cells and GLP-1 from L cells

59
Q

what do GLP1 receptor agonists do?

A

suppress glucagon, promote insulin secretion, decrease gastric emptying, reduce apetite WL

60
Q

why are DPP4 good?

A

becase they keep weight newutral and supress glucagon

61
Q

what normally happens to sugar oin the body

A

sugar is completely reabsorbed

62
Q

what doo SGLT2 inhibitors do?

A

decrease uptake of sugar

63
Q

what are downsides to SGLT2 inhibitors

A

increase thrush, increase UTI?

64
Q

when is insulin used?

A

basically as a last resort

65
Q

How should you treat hypertension in patients that have diabetes?

A

NO ASPIRIN, statins, fibrates,

Endocrine (23 decks)

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