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Endocrine > Diabetes-Basic Principles > Flashcards

Diabetes-Basic Principles Flashcards

1
Q

what is diabetes?

A

an elevation of blood glucose above a diagnostic threshold

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2
Q

what do young girls tend to have as a fasting plasma glucose?

A

4 mmol/l

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3
Q

what is the threshold for diagnosing diabetes?

A

based upon the risk of developing retinopathy

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4
Q

what is retinopathy?

A

a specific complication only seen in diabetes

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5
Q

what is the fasting plasma glucose threshold?

A

7 mmol/l

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6
Q

what is the 2 hour plasma glucose threshold?

A

11.1 mmol/l

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7
Q

what is the HbA1c threshold?

A

5.8% or 48 mmol/mol

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8
Q

what is particular about diagnosing diabetes if the patient is asymptomatic?

A

must have a repeat confirmatory test

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9
Q

what is normal fasting plasma glucose?

A

6.0 mmol/l and below

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10
Q

what is a normal 2 hour plasma glucose?

A

7.7 mmol/l and below

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11
Q

what is a normal HbA1c?

A

41 mmol/mol and below

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12
Q

what is different about gestational diabetes?

A

threshold is risk to the foetus/neonate and not the risk of retinopathy

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13
Q

what cells secrete insulin?

A

beta cells in pancreatic islets

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14
Q

what cells secrete glucagon?

A

alpha cells in pancreatic islet

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15
Q

what is C-peptide useful for?

A

a way to measure endogenous insulin secretion

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16
Q

why do we need to measure C-peptide?

A

to find out how much insulin the body is producing on its own. if insulin levels are measured it includes exogenous insulin too.

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17
Q

what is C-peptide?

A

co-secreted with insulin and is then cleaved from insulin and remains in the blood

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18
Q

what is involved the diabetes balance?

A

insulin secreted from beta cells, insulin resistance (impaired insulin action)

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19
Q

what is the most common disorder of insulin secretion?

A

type one diabetes

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20
Q

what are the other two types of insulin secretion disorders?

A

genetic and pancreatic

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21
Q

which disorder is a mix between insulin secretion disorder and insulin action disorder?

A

type 2 diabetes

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22
Q

what is a key feature of type 1 diabetes?

A

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

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23
Q

what age group does type 1 diabetes occur in?

A

all age groups of similar incidences

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24
Q

how many people have pancreatic autoantibodies in. their blood at diagnosis?

A

95%

25
Q

how is type 2 diabetes diagnosed?

A

diagnosis of exclusion

26
Q

what type of disorder is type 2 diabetes?

A

consists of insulin deficiency and insulin resistance

27
Q

which is the most common diabetes?

A

type 2 (90-95%)

28
Q

is there autoimmune destruction of the beta. cells in type 2 diabetes?

A

no

29
Q

what are common characteristics of type 1 diabetes?

A

onset in children and young adults, not associated with overweight, autoimmune, requires insulin treatment and can be fatal if left untreated

30
Q

what are common characteristics of type 2 diabetes?

A

onset in middle age and elderly, associated with obesity and sedentary lifestyle, not autoimmune, may require insulin but usually can be managed with lifestyle modifications and non-insulin treatment

31
Q

are diabetic patients commonly symptomatic or asymptomatic?

A

asymptomatic

32
Q

is type 1 or 2 diabetes more commonly asymptomatic?

A

type 2

33
Q

what are some common symptoms of diabetes

A

polyuria, thirst and polydipsia, blurred vision, genital thrush, fatigue, weight loss

34
Q

what are some signs and symptoms of complications (rare)?

A

loss of vision/retinal bleed, retinal changes found by an optician

35
Q

what are two diabetic emergencies?

A

diabetic ketoacidocis and hyperosmolar hyperglycaemic state

36
Q

what diabetic emergency is more common in type 1?

A

diabetic ketoacidosis

37
Q

what diabetic emergency is more common in type 2?

A

hyperosmolar hyperglycaemic state

38
Q

why treat diabetes?

A

to prevent acute symptoms and life-threatening illness

39
Q

what are some microvascular complications of diabetes?

A

retinopathy, neuropathy and nephropathy

40
Q

what are microvascular complications largely driven by?

A

chronic hyperglycaemia

41
Q

where does retinopathy affect?

A

back of the eye

42
Q

where does neuropathy affect?

A

numbness in feet and pain in legs

43
Q

where does nephropathy affect?

A

kidneys

44
Q

what are some macrovascular complications?

A

MI, ACS, stroke, PVD

45
Q

what are microvascular complications driven by?

A

hyperglycaemia, HBP and dyslipidaemia

46
Q

how is HbA1c measured?

A

blood test

47
Q

why is HbA1c measured?

A

to test how good someones blood sugar control is

48
Q

what is special about testing the HbA1c?

A

gives a measure of the blood sugar levels over the last few months

49
Q

what does the HbA1c test?

A

glycated haemoglobin in the blood

50
Q

what forms glycated haemoglobin?

A

glucose in blood binds to haemoglobin

51
Q

where should you be cautious measuring glycated haemoglobin?

A

conditions that cause increased red cell turnover e.g haemolytic anaemia and haemoglobinopathies

52
Q

what is HbA1c called now?

A

IFCC HbA1c

53
Q

what is HbA1c measured in?

A

mmol/mol not %age anymore

54
Q

what does 1% equal in mmol/mol?

A

11

55
Q

what is good control of blood sugar?

A

53-58mmol/mol or 7-7.5%

56
Q

what is the first step of treatment in type 2 diabetes?

A

therapeutic lifestyle changes

57
Q

what %age of weight loss can result in remission of type 2 diabetes?

A

10-15

58
Q

what weight loss can improve health outcomes in a year?

A

5-10kg

Endocrine (7 decks)

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