Diabetes

Question 1

What is Diabetes INSIPIDUS?

Answer 1

deficiency of antidiuretic hormone

Question 2

What is DIABETES MELLITUS?

Answer 2

• deficiency of insulin

- resistance to effects of insulin

Question 3

What are the actions of INSULIN?

Answer 3

• uptake of glucose
• uptake of aminoacid
• increased synthesis
• increased synthesis & esterification of fatty acids
• decreases lipolysis, protienolysis & gluconegenesis

Question 4

What cells absorb glucose?

Answer 4

B- cells

Question 5

What are ACUTE consequences of Insulin deficiency?

Answer 5

hyperglycamia
ketosis
acidosis
hyperosmolar state

Question 6

What are the CHRONIC consequence of Insulin deficiency?

Answer 6

cardiovascular disease
nephropathy (kidney disease)
neuropathy (numbness)
retinopathy (vision imparement)

Question 7

What are the types of diabetes mellitus?

Answer 7

Type 1
Type 2
Gestational

Question 8

What is TYPE 1 diabetes?

Answer 8

autoimmune destruction on B-cells
triggered by a viral infection such as coxsackie or rubella
dependant on HLA gene subtypes
normally appears in childhood but can be adult (rare)

Question 9

What is TYPE 2 diabetes?

Answer 9

insulin resistant
B-cell response delayed or absent
strong association with lifestyle

Question 10

What is GESTATIONAL diabetes?

Answer 10

insulin resistant

probably triggered by hormonal changes of pregancy

Question 11

What are the RISK factors of GESTATIONAL diabetes?

Answer 11

maternal age
family history of type 2 diabetes
African or native American
previous gestational diabetes
smoking

Question 12

What are the dangers of GESTATIONAL diabetes?

Answer 12

MUM - risk of type 2 diabetes
- hypertension
-pre-eclampsia
-obstructed labour
CHILD - risk of type 2 
-risk of obesity
-macrosomia
-jaundice
-respitory distress

Question 13

What are the classic symptoms of type 1 diabetes?

Answer 13

polyuria
polydipsia
hunger
weight loss

Question 14

What is POLYURIA in type 1 diabetes?

Answer 14

normal for glucose to be secreted into the urine.
normal-resorbed in the proximal renal tube.
threshold for resorption is 10mmol/l increase lead to glycosuria

Question 15

What does glycosuria lead to?

Answer 15

osmotic polyuria

Question 16

What does POLYURIA lead to?

Answer 16

POLYDIPSIA

Question 17

What is the BIOCHEMICAL diagnosis of type 1 diabetes?

Answer 17

• fasting glucose @ 7mmol or above
• plasma glucose @ 11.1 mmol or above 2 hours after a 75g oral glucose load.
• random glucose level @ 11.1mmol.

Question 18

What is KETOACIDOSIS?

Answer 18

-rapid breakdown of fat & protein releases KETONES & acid into blood stream
DM type 1 rarely 2
can lead to coma & death

Question 19

What is HYPERSMOLAR NONKETOTIC STATE?

Answer 19

severe dehydration
DM type 2
can lead to coma & death

Question 20

What is hypoglycaemia?

Answer 20

insulin overdose
normally accidental
can lead to coma & death

Question 21

What can diabetic foot lead to?

Answer 21

Sepsis & Death

Question 22

What are the chronic presentations of Diabetes Mellitus?

Answer 22

MACROVASCULAR (ihd/stroke/pvd)
MICROVASCULAR (retinopathy/neuropathy/nephopathy)
CARTARACT

Question 23

What is Diabetic Retinopathy?

Answer 23

proliferation of blood vessels in retina
mascular odeama (fluid)

Question 24

What is Diabetic Neuropathy?

Answer 24

microangiopathy of vasa nervosum

• numbness
• tingling
• neuropathic
• weakness
• Auntomatic neurop (vomiting,diarrhoa,constipation)

Question 25

What is Diabetic Nephropathy?

Answer 25

microangiopathy of glomerular capil
PATH = nodular & diffuse
CLINICAL = chronic/renal failure/nephrotic syn/hypertension

Question 26

What are the infection risk levels for diabetes?

Answer 26

risk ratio - 1.21
oseteomyelitis - 4.39
septicaemia - 2.45
Post Op - 2.02
Rectal Abcess - 1.97
pyelone phritis - 1.95