diabetes

Question 1

endocrine functions of the pancreas arise from the hormones produced in the islets of langerhands. what are the 4 cell types and what do they produce?

Answer 1

Alpha cells - glucagon
Beta cells - insulin
delta - somatostatin
PP: pancreatic polypeptide

Question 2

Stimulated by growth hormone and serves to increase growth but also to regulate the secretion of insulin and glucagon?

Answer 2

somatostatin

Question 3

♣ Functions as the regulator of both the endocrine and exocrine functions of the pancreas.

Answer 3

pancreatic polypeptide

Question 4

what is cleaved from insulin on release ?

Answer 4

c peptide

Question 5

does the c peptide serve a function ?

Answer 5

no

Question 6

the antagonist of insulin and acts to increase blood sugar in response to a decrease in levels

Answer 6

glucagon

Question 7

in response to a low blood sugar, what cells release glucagon in the pancreas?

Answer 7

alpha cells

Question 8

what effect does glucagon have on the liver?

Answer 8

it causes the liver to break down glycogen to glucose

Question 9

normal range of blood sugar from fasting?

Answer 9

4.4-6.1

Question 10

what are the tests used to diagnose diabetes?

Answer 10

fasting glucose
2 hour glucose tolerance test
Hba1c

Question 11

3 antibodies identified in type 1 diabetes?

Answer 11

anti GAD
anti IA2
anti znT8

Question 12

pathophysiology of T1DM?

Answer 12

autoimmune destruction of beta cells in the islets of langerhans

Question 13

when does type 1 usually present?

Answer 13

in children or teenagers

Question 14

presentation of type 1?

Answer 14

fatigue 
weight loss
polydypsia and polyuria 
DKA
abdominal pain 
vomiting 
signs of systemic shock

Question 15

what does LADA stand for?

Answer 15

late onset of diabetes of adulthood

Question 16

when does LADA usually present ?

Answer 16

25-40

Question 17

sole treatment of T1DM?

Answer 17

insulin therapy

Question 18

what should target HbA1c be in type 1?

Answer 18

48-59

Question 19

sick day advice for type 1?

Answer 19

even if sick, don’t stop taking insulin
try to eat and drink as much as possible
increase blood glucose monitoring to a minimum of 4 times per day
seek medical advice if ketones found on dip

Question 20

what is basal bolus regimen?

Answer 20

take long acting insulin before bed and short acting insulin before each meal

Question 21

what insulin regimen is best for patients with regular diet and lifestyle?

Answer 21

biphasic injections (x2 injections of mixed insulin)

Question 22

short acting?

Answer 22

Humulin, Humalog, novorapid

Question 23

Long acting insulins?

Answer 23

Lantus and Lenevenir

Question 24

mixed solution ?

Answer 24

novomix

Question 25

what is lypohypertrophy?

Answer 25

fatty lumps from continually using same injection sites

Question 26

what is thought to contribute to the insulin resistance in T2DM?

Answer 26

obesity and high sugar intake

Question 27

pathophysiology of T2DM?

Answer 27

a static level of insulin resistance but a progressive failure of insulin secretion. Eventually production becomes non existent

Question 28

what is the diagnostic criteria for T2DM?

Answer 28

if symptomatic - one raised fasting or OGTT result

asymptomatic - two raised fasting or OGTT results

Question 29

first line management of type 2?

Answer 29

diet

Question 30

2nd line tx of type 2

Answer 30

metformin (insulin sensitizer)

Question 31

when is insulin therapy commenced in type 2?

Answer 31

when all other drug therapy has been exhauseted

Question 32

all type 2 diabetic patients above 40 should be commenced on?

Answer 32

statin - no matter what the lipid profile

Question 33

monogenic autosomal dominant form of diabetes which can present in neonates, teenagers or young adults?

Answer 33

MODY (maturity onset diabetes of the young)

Question 34

which drugs are good at treating MODY

Answer 34

sulfonylureas

Question 35

management of MODY?

Answer 35

addressing cardiovascular risk factors in order to lower overall risk