Diabetes

Question 1

How to diagnose diabetes?

Answer 1

Symptoms and random plasma glucose > 11.1mol
Fasting plasma > 7.7mol
HbA1c >48mmol/L

Question 2

Normal blood glucose?

Answer 2

4-7mmol/l

Question 3

Symptoms of diabetes (type I)

Answer 3

Increased thirst, polyuria, weight loss, fatigue, blurred vision, nausea

Question 4

Define type I and type II diabetes?

Answer 4

Type 1: autoimmune condition causing destruction of beta cells in islets of langerhans –> insulin dependent

Type 2: combination of insulin resistance and and insulin deficiency

Question 5

Difference between type I and type II?

Answer 5

Type I - sudden onset of symptoms

Type II - asymptomatic for long periods - can get long term complications presenting if undiagnosed

Question 6

What are micro and macrovascular symptoms of diabetes?

Answer 6

Macro: stroke, MI, peripheral vascular disease
Micro: retinopathy, nephropathy and neuropathy

Question 7

Tx of type I diabetes?

Answer 7

Insulin

Question 8

Symptoms of hypoglycaemia

Answer 8

Shaking, increase HR, sweating, dizzy, hunger, impaired vision, irritable

Question 9

Symptoms seen type II diabetes?

Answer 9

Increased weight - central obesity, hypertension

Question 10

Tx type II?

Answer 10

1. Weight loss and lifestyle

2. Medications

Question 11

Name medications that can be used in type II diabetes

Answer 11

Insulin
Metformin - doesn’t cause hypoglycaemia or weight gain
Sulphonylureas - stimulate insulin release e.g gliclazide

Others: insulin, ascarbose, pioglitazone

Question 12

Emergency management of hypoglycaemic pt?

Answer 12

Depend on level of consciousness

1. Oral glucose - 10-20mg - check blood sugar levels can be repeated
2. IM 1mg glucagon
3. IV glucose 75ml 20% glucose, 100ml 10% glucose

Question 13

How does diabetes affect dentistry?

Answer 13

Increase periodontal 
Increase caries
Dry mouth - type I autoimmune 
Increased risk of infection
Stress can raise blood glucose levels