Diabetes - Epidemiology, aetiology and pathophysiology

Question 1

List the Primary diabetes

Answer 1

1. Type 1
2. Type 2

Question 2

What is secondary diabetes?

Answer 2

1. Liver disease
2. Pancreatic disease

Question 3

What is gestational diabetes ?

Answer 3

• Diabetes during pregnancy
• 3-4% of all pregnancies
• Caused by insulin resistance
• Usually return to normal following
  delivery

Question 4

Epidemiology

Describe the epidemiology of Type 1 diabetes

Answer 4

• 8% of diabetes patients
• Prominantly presented in childhood / adolescence
• Highest in caucasians

Question 5

Epidemiology

Describe the epidemiology of Type 2 diabetes

Answer 5

• 90% of diabetes patients
• risk increases with age and obesity
• risk factor includes: ppl of Afro-carribvean / S- asian descent / lifestyle

Question 6

Aetiology

Describe the aetiology of Type 1 diabetes

Answer 6

HLA-associated immune-mediated disease

Autoantibodies versus pancreatic cells - ( antibodies

Not genetically pre-determined but ↑
susceptibility to disease may be inherited

Question 7

Aetiology

Describe the aetiology of type 2 diabetes

Answer 7

• Stronger genetic relationship than Type 1
   Obesity
  ↑insulin resistance
  ↓number of beta- cells

Question 8

What is Metabolic Syndrome?

Answer 8

• Combination of comnditions which increase the risk of diabetes and CVD

e.g - increased bp , blood glucose

Question 9

Describe the pathiophysiology of diabetes

Answer 9

↓ number of beta- cells
Type 1 → <5-10% remaining
Type 2 →  50% remaining
 Down regulation of insulin receptors —> so used as a drugg target in Type 2

 Unregulated hepatic glycogenolysis &
gluconeogenesis

HYPERGLYCAEMIA

Question 10

Describe DKA

Answer 10

CAN OCCUR WHEN:

• Increased activity of antagonist regulatory hormaones e.g glucogon, cortisol, catecholamine & GH]

so

• Increased hepatic glucose production
  At same time:
  → ↑ lipolysis → ↑ free fatty acids released
  → metabolism exceeded
  → ketone bodies, acetoacetate & hydoxybutyrate
  released into circulation