diabetes Flashcards
diabetes mellitus
abnormality of GLUCOSE regulation
- metabolic disease
- can die
blood sugar is high, glucose in urine is high
diabetes insipidus
abnormality of RENAL FUNCTION (WATER)
lost ability to concentrate urine
- volume of urine secretion increase
ADH decreases – pulls water
Ok if fluid input matches fluid output
what does sugar level vary with
food intake, energy usage and fat storage
Need to define what diabetes is
- Know circumstance in which you take test to establish if normal or not
- Need to test in standardised way
fasting sugar test description
fasting sugar sample from overnight before eating
glucose tolerance test description
Give a fixed amount of sugar after doing a fasting test (75g after fasting)
Take again after 2 hours - should be in a certain level as decrease again
random plasma glucose (RPG)
> 11.1mmol/L on 2 occasions is diagnostic of DIABETES
glucose tolerance test normal values
FPG <6.1
Making enough insulin to move blood sugar into cells
glucose tolerance test impaired fasting glucose values
FPG 6.1-7.0
System not coping well – under stress can be ineffective, take longer to return to normal
- Deals less well with glucose load
- More chance of complications
glucose tolerance test diabetes values
FPG >7.0
Damage from diabetes occurs due to time spent over 7
- Below 7 risk of standard diabetic complication less
FPG <6.1
normal reaction after glucose tolerance test
FPG 6.1-7.0
impaired fasting glucose after glucose tolerance test
FPG >7.00
diabetes result after glucose tolerance test
what does a score <7.8 after 2 hour plasma glucose level indicate
normal reaction
what does a score 7.8-11.1 after 2 hour plasma glucose level indicate
impaired glucose tolerance
Pre diabetes in impaired group - potential to become fully diabetic
what does a score >11.1 after 2 hour plasma glucose level indicate
diabetes
type 1 diabetes mellitus
insuline deificient
type 2 diabetes mellitus
insuline resistance
what occurs in type 1 diabetes
Immune mediated pancreatic B cell destruction
Need to have insulin to stay alive
- Glucose in blood and insulin moves blood sugar into cells
3 circulating antibodies present in Type 1 diabetes
GAD glutamic acid decarboxylase
ICA Islet cell antibodies
IAA insulin autoantibodies
what are 2 consequences of type 1 diabetes
hyperglycaemia
Ketoacidosis
Blood sugar down
- Cells need glucose to metabolise - if not ketones
- Not efficient and by waste products are acidic
- Ketoacidosis can be lethal
how are pancreatic B cells destroyed in type 1 diabetes
Antibodies attacks pancreatic B cells
- Autoimmune disease
- Cannot make insulin
- Normal to diabetic in few months
- Rapid change
pattern of inheritance for type 1 diabetes
Family autoimmune disease
- Genetic predisposition - environmental trigger causes antibody response
factors that contribute to type 1 diabetes
genetic and environmental
genetic influences of type 1 diabetes
Familial Clustering
- type 1 diabetes risk in sibling 6% - 0.4% in population
Monozygotic twins concordance ~40%
- 10% in dizygotic twins
HLA associated
- DR 3 & 4, DQ 2 & 8