Diabetes

Question 1

What is the definition of Diabetes

Answer 1

a complete lack of or a decreased sensitivity to insulin

Question 2

What is the definition of Diabetes with regards to Fasting blood glucose, random blood glucose, and HBA1C?

Answer 2

FBG = >7

RBG = 11.1

HBA1C = >48mmol (7.5%)

Question 3

What is the numerical definition of impaired glucose tolerence?

Answer 3

FBG = 6-7

HBA1C = 42-48

Question 4

What tests can you do to investigate a patient with diabetes

Answer 4

1. Finger prick test
2. Urine glucose
3. HBA1C
4. Oral glucose tolerence test

Question 5

What is the definitionof Type 1 diabetes

Answer 5

This is the complete lack of insulin due to autoimmune destruction of beta cells in the islets of langerhan

Question 6

What is the presentation of Type 1 diabetes?

Answer 6

1. Polyurea
2. Polydipsea
3. Weight loss
4. Urinary or serum ketones

Question 7

what is the definition of type 2 diabetes?

Answer 7

decreased sensitivity and decreased production of insulin

Question 8

What is the presentation of type 2 diabetes

Answer 8

1. Polyurea
2. Polydipsia
3. Tired
4. Increase in weight

Question 9

What is the test to differentiate between a diagnosis of T1DM and T2DM ?

What is the result?

Answer 9

C - Peptide - its also created in the pancreas

Low levels = T1 DM

High levels = T2 DM

Question 10

What are the secondary causes of diabetes

Answer 10

1. Drugs - Anti HIV, Steroids, Thiazides, Atypical Antipsychotics
2. Pancreatic damage - Destruction e.g. surgery / AI, Removal, infection / trauma, cancer
3. Endocrine - Acromegaly, Cushings, Pregnancy, PCC, Hyperthyroidism

Question 11

What is the management of Type 1 DM

Answer 11

1. Insulin
   - Fast Acting (Nova rapid)
   - Intermediate acting (Glargine)
   - Mixed (both long and short acting)

Question 12

What is the management of type 2 DM?

Answer 12

1. Metormin
2. • Gliptin, Suplphonylurea, Thiazid
3. insulin

Question 13

What regimen could be used for insulin?

Answer 13

1. BD - two inermediate acting insulins
2. QDS - 1 x Long acting and 3 x Short acting
3. OD - 1 x long acting given at night

Question 14

What is the function of metformin

Answer 14

Increase insulin sensitivity

Question 15

What is the function of sulphonamides

Answer 15

Increase insulin secretion

Question 16

What is the function of thaizolidinediones (Pioglitazone)

Answer 16

Increase insulin sensitivity

Question 17

What is the function of glistens

Answer 17

inhibit glucagon secretion

Question 18

What is the function of SGLT2

Answer 18

Inhibit renal glucose reabsorption

Question 19

What is the management of Type 1 DM

Answer 19

1. Insulin
   - Fast Acting (Nova rapid)
   - Intermediate acting (Glargine)
   - Mixed (both long and short acting)

Question 20

What is the management of type 2 DM?

Answer 20

1. Metormin
2. • Gliptin, Suplphonylurea, Thiazid
3. insulin

Question 21

What regimen could be used for insulin?

Answer 21

1. BD - two inermediate acting insulins
2. QDS - 1 x Long acting and 3 x Short acting
3. OD - 1 x long acting given at night

Question 22

What is the function of metformin

Answer 22

Increase insulin sensitivity

Question 23

What is the function of sulphonamides

Answer 23

Increase insulin secretion

Question 24

What is the function of thaizolidinediones (Pioglitazone)

Answer 24

Increase insulin sensitivity

Question 25

What is the function of glistens

Answer 25

inhibit glucagon secretion

Question 26

What is the function of SGLT2

Answer 26

Inhibit renal glucose reabsorption

Question 27

What are the complications of diabetes (Split in to 3 sections)

Answer 27

Eyes - Diabetic retinopathy - Diabetic Maculopathy - Glaucoma - Cataracts Renal - Diabetic nephropathy Neuropathy - Acute painful - Sensory motor - Amtrophy - Autonomic

Question 28

What are the side effects of Metformin?

Answer 28

GI Upset | Lactic acidosis

Question 29

What are the side effects of sulphonamides

Answer 29

Hypoglycaemia Weight gain Hyponatremia

Question 30

What are the side effects of thaizolidinediones

Answer 30

``` Weight gain fluid retention (contraindicated in HF or HTN) ```

Question 31

What are the side effects of gliptins

Answer 31

Pacreatitis

Question 32

What is the risks of SGLT2

Answer 32

increased risk of DKA

Question 33

What is the treatment of gastroparesis

Answer 33

Meterclopermide | erythromycin

Question 34

Treatment of postural hypotension

Answer 34

Fludrocortisone

Question 35

What are the features of autonomic neuropathy

Answer 35

1. Gastroparesis 2. Nausea and vomiting 3. postural hypotension 4. sweating 5. erectile dysfunction 6. urinary retention

Question 36

What are the main components of a diabetic review

Answer 36

1. Check for microvascular complications (Eyes, renal function, neuropathy) 2. Check for microvascular complications (BP, Lipids, BMI, Diet) 3. Check patients control 4. Check for side effects