Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrinology > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Define Type 1 diabetes

A

A metabolic disorder characterised by hyperglycaemia due to absolute insulin deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define Type 2 diabetes

A

a progressive disorder defined by deficits in insulin secretion and action that lead to abnormal glucose metabolism and related metabolic derangement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the physiology of insulin on blood glucose levels? (4)

A

Insulin is secreted by beta cells

  1. Binds unto insulin receptor
  2. Initiates protein activation cascade
  3. Translocation of Glut-4 to the plasma membrane
  4. Influx of glucose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the effects of insulin on target cells? (4)

A
  1. Influx of glucose
  2. Stimulates glycogen formation
  3. Stimulates amino acid absorption + protein synthesis
  4. Stimulates triglyceride formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is insulin secretion stimulated? (5)

A
  1. Glucose enters beta cells via Glut-2
  2. ATP generated from glucose closes K+ channels
  3. Cell depolarisation
  4. Influx of calcium
  5. Exocytosis of insulin rich granules.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 4 main glucose transporters in the body?

A
  1. GLUT-1: basal non-insulin- stimulated glucose uptake into many cells.
  2. GLUT-2: transports glucose into the Beta cell. Present in renal tubules and hepatocytes
  3. GLUT-3: non-insulin- mediated glucose uptake into brain neurons and placenta.
  4. GLUT-4: either insulin-dependent or exercise-dependent.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name the 4 endocrine cells in the pancreas

A
  1. Alpha cells (glucagon)
  2. Beta cells (insulin)
  3. Delta cells (Growth Hormone Inhibiting Hormone)
  4. F cells (Pancreatic Polypeptide)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does a diabetic patient present? (6)

A

Type 2 tends to be asymptomatic. If they have type 1 or severely uncontrolled type 2 they may present with:

  1. Fatigue
  2. Polydipsia
  3. Polyuria
  4. Blurred vision
  5. Nausea/Vomiting (more common type 1)
  6. Abdominal pain (more common type 1)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the risk factors for T2DM?

A
  1. Age
  2. BMI ( commonly 31 when diagnosed)
  3. Pregnancy (Gestational diabetes)
  4. FHx of T2DM
  5. Black/Hispanic/Native American
  6. Physical inactivity
  7. Polycystic ovary syndrome
  8. Hypertension
  9. CVD
  10. Pre-diabetic (HbA1c 42-47 mmol/mol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What investigation(s) would you do if you suspect T2DM? (3)

A 
HbA1c (>48 mmol/mol)
Fasting Glucose (>7 mmol/L)
Random Glucose (>11 mmol/L)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is your treatment for ongoing T2DM patient?

A
  1. BP control (ACEi/ARB/Thiazide/CCB (Afro-Caribbean)
  2. Lipid control (Statin)
  3. Lifestyle changes (smoking, diet, exercise, drinking)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the mode of action for metformin? (3)

A

Metformin activates AMP-activated protein kinase (AMPK), a liver enzyme that plays an important role in insulin signaling. Result is:

  1. Reduces gluconeogenesis
  2. Decreases intestinal absorption of glucose
  3. Increases peripheral glucose uptake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What investigation(s) would you do if you suspect T1DM?

A 
HbA1c (>48 mmol/mol)
Fasting Glucose (>7 mmol/L)
Random Glucose (>11 mmol/L)
Fasting C-peptide (low/undetectable)
Autoimmune markers (see BMJ)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the pathophysiology of T1DM?

A

autoimmune pancreatic beta-cell destruction in genetically susceptible individuals. When 80% to 90% of beta cells have been destroyed, hyperglycaemia develops.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name the different class of drugs for treatment of T2DM

A
  1. Thiozolidinedione (Pioglitazone)
  2. Sulfonylureas (Gliclazide)
  3. Meglitinides (Nateglinide)
  4. GLP1 agonist
  5. Dipeptidyl Peptidase-4 inhibitors (DPP-4i)
  6. Sodium-glucose cotransporter 2 inhibitors (SGLT-2)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the initial treatment if T2DM patient is hyperglycaemic? (HbA1c >58 mmol/mol) (4)

A

Dual Therapy

  1. Metformin + a DPP-4i
  2. Metformin + Pioglitazone
  3. Metformin and an SU
  4. Metformin and an SGLT-2i
17
Q

What is the initial treatment if T2DM patient is persistently hyperglycaemic? (HbA1c >58 mmol/mol) (2)

A

Triple Therapy

  1. Metformin, a DPP-4i and an SU
  2. Metformin, Pioglitazone and an SU
18
Q

What are the guideline target levels for glucose in a non diabetic vs a diabetic

A

Non-diabetic: (Pre meal) 4-5.9 mmol/L, (Post-meal <7.8 mmol/L)
Type 1: (Pre-meal) 4-7 mmol/L, (Post-meal 5-9 mmol/L)
Type 2: (Pre-meal) 4-7 mmol/L, (Post-meal <8.5 mmol/L)

HbA1c target for diabetics is <48 mmol/mol

Endocrinology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions