Diabetes

Question 1

Prevalence diabetes

Answer 1

1/10 or 463 million

Question 2

Proportion of diabetes patients that has type 2 diabetes

Answer 2

Around 90%

Question 3

Diabetes increases the risk of

Answer 3

Cardiovascular disease, kidney failure and blindness

Question 4

Effects of insulin

Answer 4

Stimulate uptake of glucose by skeletal muscle, liver and adipose tissue.
Inhibit synthesis (gluconeogenesis) and secretion of glucose by the liver.
-> Lower blood glucose levels.

Question 5

Types of diabetes

Answer 5

Type 1 diabetes, type 2 diabetes, gestational diabetes and rare types of diabetes.

Question 6

Common characteristic of all diabetes types

Answer 6

Hyperglycaemia (= high blood glucose levels)

Question 7

Characteristics pre-diabetes

Answer 7

1. Impaired fasting glucose (IFG)
   = Increased fasting blood glucose levels
2. Impaired glucose tolerance (IGT)
   = Increased glucose levels after a meal

Question 8

Characteristics type 2 diabetes

Answer 8

1. Insulin resistance
   = Cells respond less well to insulin
2. Beta-cell failure
   = Beta-cells do not produce enough insulin.

Question 9

Prevalence of diabetes will increase due to

Answer 9

Increase in population size, increase in life-expectancy and increase in obesity prevalence.

Question 10

‘Categories’ of diabetes complications

Answer 10

Acute metabolic disturbance, macrovascular complications, microvascular complications

Question 11

Microvascular complications

Answer 11

Affect capillaries and arterioles, particularly in the eye (retinopathy), kidneys (nephropathy) and nervous system (neuropathy)

Question 12

Structure insulin

Answer 12

51 amino acids, two peptide chains (A & B), contains disulphide bonds

Question 13

Insulin is produced by

Answer 13

Beta-cells of the Islets of Langerhans (pancreas)

Question 14

Normal blood glucose levels

Answer 14

3.5-8.0 mmol/L

Question 15

Counter-regulatory hormone of insulin

Answer 15

Glucagon (produced by pancreatic alpha-cells).

Question 16

Type 1 diabetes

Answer 16

Autoimmune disease (destruction of beta-cells leads to insulin deficiency), presents at younger age, genetic predisposition (specific HLA types).

Question 17

Type 2 diabetes

Answer 17

Often in people with poor nutrition and reduced physical activity (obesity), characterized by insulin resistance, presents at older age.

Question 18

Gestational diabetes

Answer 18

Diabetes appearing (for the first time) in pregnancy. Often dissapears after pregnancy but increases risk of developing diabetes again later in life.

Question 19

Pathophysiology type 2 diabetes

Answer 19

Nutrient excess > insulin resistance > insulin hypersecretion (compensation) > beta-cell loss > insulin hyposecretion.

Question 20

Acute presentation of diabetes

Answer 20

Polyuria (excessive urine), thirst, polydipsia (excessive fluid intake), weight loss

Question 21

Subacute presentation of diabetes

Answer 21

Lack of energy, visual blurring (retinopathy), skin infections, polyneuropathy (tingling/ numbness in feet), arterial disease.

Question 22

Diagnosis diabetes (+ cut off values)

Answer 22

Fasting plasma glucose (FPG) > 7.0 mmol/L
75-g oral glucose tolerance test (OGTT) > 11.1 mmol/L (after 2 hours)
Glycosylated haemoglobin (HbA1c) > 48 mmol/L

Question 23

Hypoglycaemia

Answer 23

Low blood glucose (< 3 mmol/L)

Common side-effect of insulin therapy; inject more insulin than needed.

Question 24

Diabetic ketoacidosis

Answer 24

Accumulation of ketones in the blood due to insulin deficiency.

Question 25

Why is diabetes a risk factor for cardiovascular disease?

Answer 25

Diabetes increases the risk of atherosclerosis.