diabetes basics Flashcards
what is diabetes ?
an elevation of blood glucose above a diagnostic threshold
what are thresholds for diagnosis of diabetes ?
fasting plasma glucose = 7mmol/L
2hr plasma glucose = 11.1mmol/L
risk of diabetes mellitus assessed on…
risk of retinal disease
risk of gestational diabetes assessed by…
risk to foetus / neonate
what is a useful way to measure “endogenous” insulin secretion and why is this useful ?
c-peptide (how muhc their pancreaas is doing)
what are disorders of insulin secretion ?
T1D
genetic disorders neonatal
pancreatic disease
what are disorders of insulin action ?
pure disorders rare mostly genetic
insulin resistance
endocrinopathies
steroid induced
T1D pathophysiology
autoimmune destruction
diabetes presentation
often asymptomatic (esp. T2D)
high blood glucose (polyuria, thirst and polydipsia, blurred vision, genital thrush, fatigue, weight kiss)
symptoms/signs of complications (rarely) - loss of visionm retinal bleed or retinal changes found by optician
presentation w/ diabetes emergencies
diabetic ketoacidosis (DKA)
hyperosmolar hyperglycaemic state
why treat diabetes ?
prevent acute symptoms, life threatening symptoms
what are microvascular complications ?
“diabetes specifc”, largely driven by chronic hyperglycaemia
what are macrovascular complcaitions ?
increased risk in all diabetes, due to hyperglycaemia, high blood pressure and dyslipidemia,
MI/ACS
stroke
PVD
HbA1c
measure of average glucose exposure 24hrs 7 days 90 days
why should you be careful w/ HbA1c in conditions such as haemolytic anaemia
HbA1c can be falsely lower in such conditions due to red cell turnover rate
