Diabetes

Question 1

What is Diabetes Mellitus?

Answer 1

Deficiency of insulin and resistance to effects of insulin

Question 2

What is Diabetes Insipidus?

Answer 2

Deficiency of anti-diuretic hormone

Question 3

What is insulin?

Answer 3

Peptide hormone, 51 amino acids, produced in ß-cells in pancreas

Question 4

What does insulin regulate?

Answer 4

Glucose uptake and metabolism

Question 5

What cells require insulin to absorb glucose?

Answer 5

Skeletal muscle cells and fat cells

Question 6

What does not require insulin to absorb glucose?

Answer 6

Neurons and a variety of other cells

Question 7

Why do skeletal and fat cells require glucose but neurons and others don’t?

Answer 7

Can accumulate large carbohydrate reserves

Question 8

What is the action of Insulin?

Answer 8

Uptake glucose and amino acids by cells, glycogen synthesis

Question 9

What is the control release of insulin?

Answer 9

Mainly direct feedback, ß-cells absorb glucose by GLUT2
Some autonomic control
Released from cholecystokinin

Question 10

What are the acute consequences of insulin deficiency?

Answer 10

Hyperglycaemia, ketosis, acidosis, hyperosmolar state

Question 11

What are the chronic consequences of insulin deficiency?

Answer 11

Cardiovascular disease, nephropathy, neuropathy, retinopathy

Question 12

What is Diabetes Mellitus Type 1?

Answer 12

Autoimmune destruction of ß-cells, trigged by infection, susceptible on HLA gene

Question 13

When does Diabetes Mellitus Type 1 typically start?

Answer 13

Childhood, though can start in adult

Question 14

What is Diabetes Mellitus type 2?

Answer 14

Insulin resistance, ß-cells response to glucose delayed/absent

Question 15

What is Diabetes Mellitus 2 associated with?

Answer 15

Lifestyle

Question 16

What is Gestational Diabetes?

Answer 16

Genetic, insulin resistance triggered by hormonal changed

Question 17

When is Gestational Diabetes resolved?

Answer 17

With delivery

Question 18

What are the risk factors of Gestational Diabetes?

Answer 18

Maternal age, family history of DM2, African/North American, previous gestational diabetes, previous baby over 4kg, smoking

Question 19

What are the dangers to the mother with Gestational Diabetes?

Answer 19

Risk of DM2, hypertension, pre-eclampsia, obstructed labour

Question 20

What are the dangers to the child with Gestational Diabetes?

Answer 20

Risk of DM2, risk of obesity, mactosomia, neonatal hypoglycaemia, neonatal jaundice, respiratory distress

Question 21

What conditions can lead to Secondary Diabetes Mellitus?

Answer 21

Chronic pancreatitis, cystic fibrosis, pancreatic surgery, haemachromatosis

Question 22

What drug related conditions can lead to Secondary Diabetes?

Answer 22

Endocrine - Cushings

Drug therapy - Corticosteriods

Question 23

What are the symptoms for Diabetes Mellitus Type 1?

Answer 23

Polyuria, polydipsia, hunger, weight loss

Question 24

What is Polyuria?

Answer 24

Increased urine output and polydipsia (increased thirst)

Question 25

What is the biochemical diagnosis of Diabetes Mellitus?

Answer 25

Fasting glucose - 7mmol Oral glucose - 11.1mmol Random glucose- 11.1mmol

Question 26

What happens in an acute presentation of Diabetes Mellitus? (K)

Answer 26

Ketoacidosis - Breakdown of fat and protein released ketones and acids in to blood

Question 27

What can Acute Ketoacidosis result in?

Answer 27

Come and death

Question 28

What is Acute Hyperosmolar Nonketotic state and what can it lead to?

Answer 28

Sever dehydration, DM2, coma and death

Question 29

What is Acute Hypoglycaemia and what can it lead to?

Answer 29

Insulin overdose, coma and death

Question 30

What is Acute Diabetic foot and what can it lead to?

Answer 30

Can lead to generalised sepsis and death

Question 31

What is Chronic Macrovascular Diabetes Mellitus?

Answer 31

Ischaemic heart disease, stroke, peripheral vascular disease

Question 32

What is Chronic Microvascular Diabetes Melitus?

Answer 32

Retinopathy, neuropathy, nephropathy

Question 33

What other chronic eye condition can happen to Diabetes Mellitus patients?

Answer 33

Cataract

Question 34

What is Diabetic Retinopathy?

Answer 34

Proliferation of blood vessels in retina, macular oedema

Question 35

What can happen with Hyperglycaemia to the eye?

Answer 35

Visual disturbance

Question 36

What is Diabetic Neuropathy?

Answer 36

Microangiopathy of vasa nervosum, numbness, pain, weakness

Question 37

What are the symptoms associated with Diabetic Neuropathy?

Answer 37

Vomiting, diarrhoea, constipation, impotence, incontinence, anorgasmia, hypotension