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Year 2 Pathology > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What’s the basic definition of diabetes mellitus?

A
  • Deficiency of insulin

- Resistance to effects of insulin

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2
Q

True or false?

Insulin is an Amine hormone?

A

FALSE!

It’s a peptide hormone. Produced in the B-cells of the islet of the pancreas.

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3
Q

What is the role of insulin?

A
  • It regulates glucose uptake and metabolism
  • Has a role in uptake of amino acids
  • Causes increased glucogen synthesis
  • Increases synthesis and esterification of fatty acids
  • Causes decreased lipolysis, proteinolysis and gluconeogenesis.
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4
Q

Do neurons require insulin to absorb glucose?

A

No, they cannot accumulate significant carbohydrate reserves so do not require insulin.

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5
Q

Do skeletal muscle cells and fat cells require insulin to absorb glucose?

A

YES. Both can accumulate large carbohydrate reserves.

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6
Q

How is insulin release controlled?

A
  • Mainly by direct feedback (B-cells absorb glucose via glucose transporter GLUT2)
  • Some autonomic control
  • Also released by Cholecystokinin derived from entero-endocrine cells of intestinal mucosa.
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7
Q

What are some of the ACUTE consequences of insulin deficiency?

A
  • HYPERglycemia
  • Ketosis
  • Acidosis
  • Hyperosmolar state (dehidration)
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8
Q

What are some of the CHRONIC consequences of insulin deficiency?

A
  • Cardiovascular disease
  • Nephropathy
  • Neuropathy
  • Retinopathy
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9
Q

Name some types of diabetes?

A
  • Type1
  • Type2
  • Gestational
  • Secondary
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10
Q

Characteristics of Type 1 diabetes???

A
  • Autoimmune destruction of Bcells. probably triggered by viral infection (Coxsackie or rubella virus)
  • Susceptibility partly relies on HLA gene subtype (HLA-DR3/DR4)
  • Classically starts in childhood, though adult onset not rare.
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11
Q

Which type of diabetes typically starts in childhood?

A

Type 1. But adult onset is not rare.

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12
Q

What are some of the former names of Type 2 diabetes mellitus?

A
  • Non insulin dependant diabetes mellitus (NIDDM)
  • Obesity related diabetes mellitus
  • Adult-onset diabetes mellitus
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13
Q

Characteristics of Type 2 diabetes mellitus?

A
  • Pathophysiology complicated!
  • Peripheral insulin resistance
  • B-Cell response to glucose delayed or absent
  • Insulin concentrations norma;/high
  • STRONG association with lifestyle (obesity)
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14
Q

Characteristics of Gestational Diabetes?

A
  • Genetic Predisposition
  • Insulin resistance probably triggered by hormone changes of pregnancy
  • Resolves with delivery
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15
Q

What factors pose a risk with gestational diabetes?

A
  • Maternal age
  • Family history of T2DM
  • Africal/north american native
  • Previous gestational diabetes
  • Previous baby over 4kgs
  • Smoking
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16
Q

There are some risks to the mother in gestational diabetes. Name some:

A
  • Greater risk of T2DM later in life for the mother.
  • Hypertension in mother
  • Pre-eclampsia or eclampsia
  • obstructed labour
17
Q

There are some risks to the child in gestational diabetes. Name some:

A
  • Risk of T2DM in later life
  • Risk of obesity in later life
  • Macrosomnia (big baby)
  • Neonatal hypoglycaemia
  • Neonatal jaundice
  • Respiratory distress syndrome
18
Q

What can cause secondary Diabetes Mellitus?

A
  • Chronic pancreatitis
  • Cystic fibrosis
  • Pancreatic surgery
  • Haemachromatosis (high iron levels)
  • Endocrine disease (Cushing’s syndrome)
  • Drug therapy (corticosteroids)
19
Q

Hunger, Polyuria (large volume of urine), polydipsia (thirst), weight loss are all classic symptoms of what type of diabetes?

A

T1DM

Can be seen in T2DM but often camouflaged by other symptoms

20
Q

What is polyuria?

A

It’s when high levels of urine. Glucose can be found in urine also (glucosuia).
Polyuria leads to polydipsia (high thirst)

21
Q

What’s the biochemical diagnosis for diabetes mellitus?

Hint BM

A
  • Fasting plasma glucose level at or above7.0mm
  • 2 hours after 75g oral glucose load 11.1 or above
  • Random plasma glucose at or above 11.1mm
22
Q

What’s ketoacidosis?

A

It’s causes by the rapid breakdown of fats and proteins which releases Ketones (including acetone) and acid in bloodstream.

Usually type one, rarely T2DM. Can lead to coma and death.

23
Q

What’s hyperosmolar nonketotic state?

A

It is sever dehydration and can lead to come and death. Usually T2DM

24
Q

What’s hypoglycaemia?

A

It’s insulin overdose, generally accidental and can lead to come and death.

25
Q

What are some of the risks of diabetic foot?

A

It can lead to sepsis, amputation, and death.

26
Q

What’s macrovascular disease?

A

It’s a disease of any of the large blood vessles and can be a presentation of chronic diabetes. Can cause ischemic heart disease, stroke, and peripheral vascular disease.

27
Q

What’s microvascular disease?

A

It’s disease of any small vessles of the body and can be a presentation of chronic diabetes. Can cause retinopathy, neuropathy and nephropathy.

28
Q

What is diabetic Retinopathy?

A

It’s proliferation (increase in number) of vessels in the retina causing retinal haemorrhages. Can cause macular oedema (fluid exudate into retina) and blindness.

29
Q

What is the name given to the diabetic condition that causes proliferation of blood vessles in the retina and can cause blindness?

A

Diabetic Retinopathy

30
Q

What’s diabetic neuropathy?

A

It’s disease of the small blood vessels (microangiopathy) in the vasa nervosum. Causes: -peripheral numbness/tingling

  • occasional neuropathic pain,
  • muscle weakness
  • autonomic neuropathy (vomiting, diarrhoea, constipation, impotence, incontinence, anorgasm, postural hypotension)
31
Q

What’s diabetic nephropathy?

A 
It's disease of the small blood vessles (microangiopathy) in the glomerular capillaries. 
Causes:
-Chronic renal failure
-Nephrotic syndrome
-Hypertension
32
Q

True or false:

Diabetic are at no higher risk of infections compared to non-diabetics?

A

FALSE

They are at increased risk of many infections such as- post op, spticaemia, rectal abscess, pyelonephritis, osteomylitis

Year 2 Pathology (19 decks)

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