Diabetes

Question 1

Describe the pathophysiology for diabetes (6)

Answer 1

Type 1 is a pre existing autoimmune disorder having quick onset and is characterised by Beta cells in islets of Langerham in pancreas being damaged so no insulin is produced therefore they have to take insulin from lymphocytes attacking antigens on Beta cells destroying them. Has a genetic link

Type 2 slower onset relative to lifestyle obesity can be a risk factor for it as fat stored block insulin from having an effect on the cell (lock and key) therefore insulin can’t be absorbed by cells so it doesn’t work properly

Question 2

Signs and symptoms of diabetes (7)

Answer 2

Thirst
Blurred vision
Lethargic
Frequent urination
Slow wound healing
Weight loss
Thrush/genital itching

Question 3

Complications from diabetes (14)

Answer 3

Miscarriage
Stillbirth
Congenital malformation
Neonatal hypoglycaemia
Fetal macrosomia
Birth trauma
Pre eclampsia
Hypertension
IOL or LSCS
obesity/diabetes in baby
Rental impairment
Increased infection risk
Pre term birth
Psychological impact

Question 4

Risk factors for diabetes (5)

Answer 4

BMI over 30
Previous macrosomic baby weighing over 4.5kg
Previous GDM
First degree relative with diabetes
Family origin south Asian black carribean and middle eastern

Question 5

Blood glucose investigations (4)

Answer 5

For GDM;
Fasting-5.6 or more =GDM
Random- 2hr plasma glucose of 7.8or more =GDM
HBa1C
At home monitoring;
Waking- 5-7
Pre meal- 4-7
90min post- 5-9

Question 6

You see Carla at her booking appointment she discloses she has type 1 diabetes what’s your management plan for her care?

Answer 6

☺️

Question 7

Anne is at her 16/40 appointment with you. You see she has a hx of GFM in her previous pregnancies and there’s a family HX of diabetes what’s your management plan?

Answer 7

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