Diabetes Flashcards
What is secondary diabetes?
Caused by drugs, pancreatic pathology or endocrine cause
How is type 2 diabetes diagnosed?
Exclusion of all other types
What is MODY?
Monogenic diabetes
Wha t can cause type 2 diabetes?
Genetic susceptibility
Obesity
Western lifestyle
What occurs as a result of type 2 diabetes?
Insulin resistance
What occurs with insulin normally?
Insulin bind to receptor triggering glucose transport proteins which allow glucose to enter cells
What occur with insulin resistance?
Receptor not as responsive to insulin and less glucose enters cell.
Glucose then build up in the blood
What causes insulin resistance?
Ectopic fat accumulation and increase in free fatty acids in circulation
Increase inflammatory mediators
Inhibits insulin
Stimulates glycogen synthesis
What else can insulin resistance be associated with ?
Obesity Genetic Medication Smoking Fetal malnutrition Endothelial disease Age Hypertension
As beta cell function declines what happen to blood sugar levels?
Increase
What changes cam be made to lifestyle to treat type 2 diabetes?
Weight loss
Exercise
Smoking cessation
Improved diet
What is the reference range of blood glucose ?
4-6
What is the target range for diabetics?
6.5-7.5
What are the macro vascular complications associated with diabetes?
Ischaemic heart disease
Stroke
Micro vascular complications associated with diabetes?
Neuropathy Nepropathy Retinopathy Erectile dysfunction Psychiatric Loss of sensation in feet
What screening is available for micro vascular complications?
Urinary albumin creative ratio
Retinal photographs
Annual foot screening
Where are statins used in diabetic tx?
Diabetics who are over 40
What other drugs can be used in diabetic care?
Aspirin- secondary prevention of cardiovascular death
Beta blockers re. Bp
What is hypoglycaemia?
Low blood sugar
What happens if glucose falls?
Release of counter regulatory hormones:
Glucagon
Adrenaline
Cortisol
What is the aim of tx?
To stimulate glycogenesis
What are autonomic symptoms of hypoglycaemia?
Sweats, shakes, flushing, palpatation
What are neuroglycopenic symptoms of hypoglycaemia?
Confusion, collapse, seizures, coma
What are precipitating factors for hypoglycaemia?
Meds dosage Timing of insulin Delay in meals Alcohol Exercise Renal, adrenal, pituitary insufficiency
What is in hypo box?
Lucazade or alternative
Dexter tablets
Glucose gel
What type of diabetes does diabetic ketoacidosis occur in?
Type 1
What type of diabetes does hyperosmolar non ketotic coma occur in?
Type 2
What are the precipitating factors for DKA
Acute illnes
What is the presentation of type 1 diabetes?
Pancreatic beta cell destruction
Causing defect in insulin secretion
Presence of anti GAD / anti islet cell antibodies
