Diabetes Flashcards

1
Q

how is glucose stored in the body

A

liver as glycogen
adipose tissue as fat
stored in muscles as glycogen

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2
Q

what by definition is diabetes

A

high levels of blood glucose ie hyperglycaemia

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3
Q

what is the normal range for blood glucose, high and low

A

around 5 mmol/L

low is less than 4 and high is more than 11

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4
Q

what is the role of alpha and beta cells, delta and gamma cells in the pancreas

A

alpha - produce glucagon

beta cells produce insulin (75% of cells)

delta - produce somatostatin

gamma - pancreatic polypeptide

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5
Q

what is also released when insulin is made

A

c peptide

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6
Q

what type of disease is diabetes, what are the signs and symptoms

A

syndorme
symptoms - thirst, polyuria, weightless and tiredness
signs - dry mouth, weight loss, hyperglycaemia

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7
Q

what is the diagnosis of diabetes

A

fasting glucose higher than 7 mmol/L
75g oral glucose tolerence test
HbA1c criteria - more than 48mmol/L

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8
Q

what is the difference between type 1 and type 2 diabetes

A

type 1 - autoimmune destruction of islet beta cells usually young people

type 2 - insulin resistance due to genetics or obesity - mainly older people

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9
Q

what is the pathophysiology of type 1 diabetes

A

HLA2 and environmental trigger
T1DM autoantibodies, rapid onset, weight loss, diabetic ketoacidosis
insulinitis - inflammation of islets of langerhams due to infiltrating macrophages and T/b cells

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10
Q

what are the symptoms and management of type 2 diabetes

A

minimal weight loss, vision or foot ulcers, fungal infection

exercise and diet
oral metformin

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11
Q

what is gestational diabetes, risk factors, consequences and management

A

during pregnancy
high OGTT after fasting
high BMI, can cause pre-eclampsia, still birth develop T2DM in mother
manage wit diet and metformin but also insulin

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12
Q

when would you not use HbA1c for diabetes testing

A

for pregnant women

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13
Q

what are three types of genetically inherited diabetes

A

MODY - maturity onset diabetes in young - autosomal dominant inheritance

maternal inherited diabetes and deafness

Wolfram syndrome (DI, DM, optic atrophy and deafness)

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14
Q

what type of disease of the pancreas lead to secondary diabetes

A

chronic / calcific pancreatitis
cystic fibrosis fuses pancreatic duct
haemochromatosis - iron overload

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15
Q

what types of drugs can induce diabetes

A

diuretics
steroids
antipsychotics / psychiatric
retroviral in HIV

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16
Q

how does acromegaly cause diabetes

A

high growth hormone levels can increase in blood glucose and cause diabetes

17
Q

how can cushings cause diabetes

A

excess cortisol independent of ACTH secretion - causes high glucose

18
Q

how does a pheochromocytoma cause diabetes

A

tumour of chromatin cells that secrets high amounts of catecholamines - increases blood glucose

19
Q

what hormones oppose the action of insulin and increases blood sugar

A

glucagon, adrenaline/ NA, glucocorticoids such as cortisol

20
Q

what are stimulants of insulin release

A

glucose, fattt acids and ketones, vagal nerve stimulation, drugs prostaglandins

21
Q

what causes the inhibition of insulin release

A

sympathetic stimulation, alpha adrenergic agents (dopamine, serotonin etc)

22
Q

what is the role of glucagon, what stimulates and inhibits it

A

increase secretion of insulin and growth hormone by negative feedback
increase glucose levels
induce - glycogenolysis, glujconeogeneis and lipolysis

simuli - amino acids, beta aderergic stim, exercise
inhibition - glucose, free fatty acids, ketones

23
Q

what organ aids monitoring of blood glucose

A

hypothalamus

24
Q

what happens during hyperglycaemia via hypoglycaemia

A

hyper - insulin - lower levels

hypoglycaemia - glucagon, pituitary - ACTH to adrenal cortex - cortisol
pituitary - GH - increase levels
Pituitary - adrenal medulla - adrenaline and catecholamines increase blood glucose