Diabetes

Question 1

what is diabetes?

Answer 1

an elevation of blood glucose above a diagnostic threshold

Question 2

what happens to average fasting plasma glucose as the age of patients increases?

Answer 2

it increases

Question 3

what are the thresholds for diagnosis of diabetes based on?

Answer 3

the risk of developing diabetic retinopathy

Question 4

what fasting glucose suggests normal glucose tolerance?

Answer 4

6.0mmol/L and below

Question 5

what 2 hour glucose suggests normal glucose tolerance?

Answer 5

7.7mmol/L and below

Question 6

what HbA1c suggests normal glucose tolerance?

Answer 6

41 mmol/mol and below

Question 7

what fasting glucose indicates impaired glucose tolerance?

Answer 7

6.1 - 6.9 mmol/L

Question 8

what 2 hour glucose indicates impaired glucose tolerance?

Answer 8

7.8 - 11.0 mmol/L

Question 9

what HbA1c indicates impaired glucose tolerance?

Answer 9

42-47 mmol/L

Question 10

what is another name for impaired glucose tolerance?

Answer 10

pre diabetes

Question 11

what fasting glucose is diagnostic of diabetes?

Answer 11

7.0mmol/L and above

Question 12

what 2 hour glucose is diagnostic of diabetes?

Answer 12

11.1mmol/L and above

Question 13

what random glucose is diagnostic of diabetes?

Answer 13

11.1mmol/L and above

Question 14

what HbA1c is diagnostic of glucose?

Answer 14

48 mmol/mol and above

aka 5.8% and above

Question 15

what determines the thresholds for diagnosing gestational diabetes?

Answer 15

not based on the risk of retinopathy

determined by the risk to the foetus

Question 16

what is gestational diabetes?

Answer 16

diabetes that comes on during pregnancy

Question 17

which has higher thresholds - regular diabetes or gestational diabetes?

Answer 17

normal diabetes

values for diagnosis of gestational diabetes are much lower

Question 18

what happens when plasma glucose is low?

Answer 18

alpha cells release glucagon to raise it again

Question 19

what happens when plasma glucose is high?

Answer 19

beta cells release insulin to lower it

Question 20

what can be measured to measure endogenous insulin secretion?

Answer 20

C-peptide

Question 21

what does an insulin assay in a person receiving exogenous insulin show?

Answer 21

the injected insulin

Question 22

how can C-peptide be used to measure endogenous insulin secretion?

Answer 22

C peptide is co-secreted with insulin, so if present in the blood it shows that a person’s beta cells are producing insulin

C-peptide not found with injected (exogenous) insulin

Question 23

what determines blood glucose?

Answer 23

the balance between how much insulin is produced and how effective this insulin is

Question 24

what are the two ways diabetes can occur?

Answer 24

beta cells not secreting enough/any insulin

insulin resistance

Question 25

what is the main disease caused by deficiency of beta cell secretion?

Answer 25

type 1 diabetes

Question 26

name two genetic disorders that involve deficiency of beta cell secretion

Answer 26

MODY | neonatal diabetes

Question 27

how can pancreatic disease cause type 1 diabetes?

Answer 27

damage to the pancreas can impact insulin secretion

Question 28

name some pancreatic diseases that can cause diabetes

Answer 28

pancreatitis pancreatic cancer cystic fibrosis

Question 29

what is type 1 diabetes?

Answer 29

autoimmune destruction of the pancreatic beta cells resulting in beta cell deficiency

Question 30

when does type 1 diabetes come on?

Answer 30

any age classically thought of as a disease in children/young adults, but this is not the case

Question 31

what is found in the blood of most type 1 diabetics at diagnosis?

Answer 31

pancreatic autoantibodies

Question 32

how is type 1 diabetes treated?

Answer 32

life long insulin therapy

Question 33

what type of diabetes is most common?

Answer 33

type 2

Question 34

do people with type 2 diabetes require insulin therapy?

Answer 34

the majority do not, but some people benefit from it

Question 35

how is type 2 diabetes usually managed?

Answer 35

lifestyle modification and non-insulin treatments

Question 36

what type of diabetes can often be asymptomatic?

Answer 36

type 2

Question 37

how can asymptomatic diabetes be picked up?

Answer 37

as part of a routine blood test

Question 38

name some symptoms of high blood glucose

Answer 38

``` polyuria thirst blurred vision genital thrush fatigue weight loss ```

Question 39

what are two possible diabetic emergencies?

Answer 39

diabetic ketoacidosis | hyperosmolar hyperglycaemic state

Question 40

which type of diabetes is more commonly associated with DKA?

Answer 40

type 1

Question 41

what type of diabetes is more commonly associated with HHS?

Answer 41

type 2

Question 42

what are the two classes of diabetes complications?

Answer 42

micro vascular | macro vascular

Question 43

What is the main driver for micro vascular complications?

Answer 43

Chronic hyperglycaemia

Question 44

Name some micro vascular complications of diabetes

Answer 44

Neuropathy Retinopathy Nephropathy

Question 45

What causes macro vascular complications in diabetes?

Answer 45

Hyperglycaemia High blood pressure Dyslipidemia

Question 46

Name some macrovascular complications of diabetes

Answer 46

MI Stroke Peripheral vascular disease

Question 47

What are two ways to monitor blood glucose over a long period of time?

Answer 47

Continuous blood glucose monitoring | HbA1c

Question 48

What is HbA1c?

Answer 48

Glycated haemoglobin

Question 49

How does haemoglobin become glycated?

Answer 49

When it becomes exposed to glucose

Question 50

What does HbA1c provide a measurement of?

Answer 50

Glucose exposure over the last 90 ish days (as a red blood cell survives around 90 days)