diabetes Flashcards
what is diabetes melitus?
abnormality of glucose regulation
what is diabetes insipidus?
abnormality of renal function
what is diabetes?
a series of metabolic conditions sharing the major characteristic of hyperglycaemia
what does exposure to chronic hyperglycaemia risk?
microvascular complications and long term macrovascular disease
what tests can diagnose diabetes?
plasma glucose
glucose tolerance test
what is the intermediate zone between normal and diabetes termed?
pre-diabetic
strong indicators of future diabetes
what can be tested for diabetes?
random sugar
fasting sugar
GTT
HbA1c
when is GTT used?
if random plasma glucose >11.1mmol/L on 2 occasions
what test does not require a fasting sample?
HbA1c >48mmol/mol
what is type 1?
insulin deficiency
autoimmune destruction of pancreatic B cells
immune mediated pancreatic b cell destruction
what causes type 1?
interplay between genetic and environmental factors
-familial clustering
what determines clinical presentation?
rate of destruction
-spectrum of ages
how does diabetes usually present in young?
with ketoacidosis
-body cells cannot access glucose for metabolism so start to metabolise fate resulting in ketones
which antibodies are present in type 1?
GAD-glutamic acid decarboxylase
ICA- islet cell antibodies
IAA- insulin autoantibodies
what are the characteristics in adult onset (Type 1) ?
LADA- latent autoimmune diabetes in adults (>25y.o) GAD associates less weight loss less ketoacidosis variable period until insulin required
what are the symptoms of type 1?
polyuria
polydipsia
tiredness
what is the acute presentation of type 1?
hyperglycaemia with diabetic symptoms
ketoacidosis
describe the presentation of type 2
most common associated with obesity & inactivity usually >40 strong family history rarely ketoacidosis
what is type 2?
heterogeneous group of hyperglycaemic disorders with multiple dif mechanisms
what are the characteristics of type 2
defective & delayed insulin secretion and abnormal postprandial suppression of glucagon
what can cure type 2?
bariatric surgery
describe insulin resistance
B cell response to hyperglycaemia inadequate
elevated basal insulin levels
failure of gluconeogenesis suppression
insulin stimulated glucose uptake is reduced
inadequate release/response to incretins
increased absorption of glucose fron GIT due to increased transporter
what are the effects of type 2?
impaired glucose tolerance hyperinsulinaemia hypertension obesity w/ abdominal distribution dyslipidaemia procoagulant epithelial markers early & accelerated atherosclerosis
describe the onset of type 2
gradual over many years usually IGT for some time often retinal damage at diagnosis ability to secrete insulin falls with time
describe the presentation of type 2
polyuria polydipsia tiredness unusual infections diabetic complications
what slows decline from IGT?
strict diet and exercise
which medications can induce diabetes?
medicine which interferes with secretion of insulin/glucagon corticosteriods immune suppressants cancer medication antipsychotics antiviral- protease inhibitors
what conditions are related to diabetes?
endocrine -Cushing's -pheochromocytoma -acromegaly pregnancy- gestational risk factors -overweight -family hsitory -some ethnic groups -previous
