Diabetes

Question 1

What is secondary diabetes?

Answer 1

Caused by drugs, pancreatic pathology or endocrine cause

Question 2

How is type 2 diabetes diagnosed?

Answer 2

Exclusion of all other types

Question 3

What is MODY?

Answer 3

Monogenic diabetes

Question 4

Wha t can cause type 2 diabetes?

Answer 4

Genetic susceptibility
Obesity
Western lifestyle

Question 5

What occurs as a result of type 2 diabetes?

Answer 5

Insulin resistance

Question 6

What occurs with insulin normally?

Answer 6

Insulin bind to receptor triggering glucose transport proteins which allow glucose to enter cells

Question 7

What occur with insulin resistance?

Answer 7

Receptor not as responsive to insulin and less glucose enters cell.
Glucose then build up in the blood

Question 8

What causes insulin resistance?

Answer 8

Ectopic fat accumulation and increase in free fatty acids in circulation
Increase inflammatory mediators
Inhibits insulin
Stimulates glycogen synthesis

Question 9

What else can insulin resistance be associated with ?

Answer 9

Obesity 
Genetic
Medication
Smoking
Fetal malnutrition
Endothelial disease
Age
Hypertension

Question 10

As beta cell function declines what happen to blood sugar levels?

Answer 10

Increase

Question 11

What changes cam be made to lifestyle to treat type 2 diabetes?

Answer 11

Weight loss
Exercise
Smoking cessation
Improved diet

Question 12

What is the reference range of blood glucose ?

Answer 12

4-6

Question 13

What is the target range for diabetics?

Answer 13

6.5-7.5

Question 14

What are the macro vascular complications associated with diabetes?

Answer 14

Ischaemic heart disease

Stroke

Question 15

Micro vascular complications associated with diabetes?

Answer 15

Neuropathy
Nepropathy
Retinopathy
Erectile dysfunction
Psychiatric 
Loss of sensation in feet

Question 16

What screening is available for micro vascular complications?

Answer 16

Urinary albumin creative ratio
Retinal photographs
Annual foot screening

Question 17

Where are statins used in diabetic tx?

Answer 17

Diabetics who are over 40

Question 18

What other drugs can be used in diabetic care?

Answer 18

Aspirin- secondary prevention of cardiovascular death

Beta blockers re. Bp

Question 19

What is hypoglycaemia?

Answer 19

Low blood sugar

Question 20

What happens if glucose falls?

Answer 20

Release of counter regulatory hormones:
Glucagon
Adrenaline
Cortisol

Question 21

What is the aim of tx?

Answer 21

To stimulate glycogenesis

Question 22

What are autonomic symptoms of hypoglycaemia?

Answer 22

Sweats, shakes, flushing, palpatation

Question 23

What are neuroglycopenic symptoms of hypoglycaemia?

Answer 23

Confusion, collapse, seizures, coma

Question 24

What are precipitating factors for hypoglycaemia?

Answer 24

Meds dosage
Timing of insulin
Delay in meals
Alcohol
Exercise
Renal, adrenal, pituitary insufficiency

Question 25

What is in hypo box?

Answer 25

Lucazade or alternative
Dexter tablets
Glucose gel

Question 26

What type of diabetes does diabetic ketoacidosis occur in?

Answer 26

Type 1

Question 27

What type of diabetes does hyperosmolar non ketotic coma occur in?

Answer 27

Type 2

Question 28

What are the precipitating factors for DKA

Answer 28

Acute illnes

Question 29

What is the presentation of type 1 diabetes?

Answer 29

Pancreatic beta cell destruction
Causing defect in insulin secretion
Presence of anti GAD / anti islet cell antibodies