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Endocrinology > Diabetes- Epidemiology, aetiology & Pathophysiology > Flashcards

Diabetes- Epidemiology, aetiology & Pathophysiology Flashcards

1
Q

What are the two types of Diabetes Mellitus?

A

Primary and secondary diabetes

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2
Q

What are the two types of primary diabetes?

A
  • Type 1 (Formerly insulin-dependent diabetes mellitus - IDDM)
  • Type 2 (Formerly non-insulin-dependent diabetes mellitus- NIDDM)
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3
Q

What percentage of new diabetes cases are secondary diabetes?

A

1-2%

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4
Q

Name 4 examples of secondary diabetes.

A
  • Liver disease (e.g. cirrhosis)
  • Pancreatic disease (e.g. cystic fibrosis)
  • Endocrine disease (e.g. Cushing’s syndrome, Thryotoxicosis)
  • Drug induced (e.g. thiazide diuretics, corticosteroids)
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5
Q

What is Gestational Diabetes?

A
  • Diabetes during pregnancy (usually in 2nd or 3rd trimester)
  • Occurs in 3-4% of all pregnancies
  • Risk of large birth weight baby
  • Usually return to normal following delivery
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6
Q

What causes Gestational diabetes and how is it managed?

A
  • It is caused by insulin resistance
  • It is usually managed by diet but may need insulin
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7
Q

Overall worldwide (2017), how many people had diabetes?

A

425 million

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8
Q

Overall, in the UK (2005), how many people had diabetes?

A

2.1 million

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9
Q

Overall, in the UK (2015), how many people had diabetes?

A

3.3 million

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10
Q

Overall, in the UK (2019), how many people had diabetes?

A

4.7 million

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11
Q

Overall, in the UK, how many people have undiagnosed diabetes?

A

Up to 1 million

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12
Q

What percentage of people with diabetes have Type 1 diabetes?

A

8%

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13
Q

In which ethnic group is Type 1 diabetes the highest?

A

Highest in Caucasians (especially Finland & other North European countries)

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14
Q

In which country is Type 1 diabetes the lowest?

A

Lowest in Japan & Pacific area

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15
Q

At what age would Type 1 diabetes present?

A
  • May present at any age, but prominent disease of childhood, peaking at puberty.
  • 50-60% present < 20yrs
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16
Q

Which type of diabetes is most common, Type 1 or Type 2?

A

Type 2

17
Q

What percentage of patients with diabetes have Type 2 diabetes?

A

90%

18
Q

Type 2 diabetes is higher risk with ______ and __________.

A

Age and Obesity

19
Q

Type 2 diabetes is high risk within which ethnicities?

A
  • 3-4 x higher : African/Caribbean
  • 4-7 x higher : Hispanic American + S.Asia/Arabian with Western lifestyles
20
Q

What does aetiology mean?

A

The cause or origin of disease

21
Q

What percentage of people with type 1 diabetes carry HLA-DR3 &/or DR4

A

> 90%

22
Q

What is HLA-associated immune-mediated disease?

A

People with certain HLA antigens are more likely to develop certain autoimmune diseases, such as type I diabetes

23
Q

Which type of diabetes is likely to be caused if HLA antigens are present?

A

Type 1

24
Q

What are the 4 causes/aetiology for Type 1 diabetes?

A
  • HLA-associated immune-mediated disease
  • Autoantibodies versus pancreatic cells
  • Not genetically pre-determined but high susceptibility to disease may be inherited
  • Environmental
25
Q

What are the 3 causes/aetiology for Type 2 diabetes?

A
  • Stronger genetic relationship than Type 1
  • Obesity (occurs in ~80%)
  • Low birth weight & weight at 12 months
26
Q

Why is obesity a cause of type 2 diabetes?

A
  • Increased insulin resistance
  • Low number of beta-cells
27
Q

Why is low birth weight & weight at 12 months a cause of type 2 diabetes?

A
  • Poor nutrition in early life -> impaired beta-cell development and function
28
Q

What is metabolic syndrome?

A

Combination of medical disorders when occurring together increases the risk of cardiovascular disease and Type 2 diabetes mellitus.

  • High Blood pressure
  • High Blood glucose
  • Central abdominal obesity (men > 102cm , women >88cm)
  • High cholesterol
29
Q

What does pathophysiology mean?

A

Pathophysiology describes the changes that occur during a disease process

30
Q

What 4 changes/pathophysiology occurs for diabetes?

A
  • Lower mass of beta-cells
    • Type 1 : 5-10% remaining
    • Type 2 : ~50% remaining
  • Down regulation of insulin receptors
    • Especially Type 2 due to “insulin resistance”
  • Unregulated hepatic glycogenolysis & gluconeogenesis
  • All mainly leading to HYPERGLYCAEMIA
31
Q

What is Glycogenolysis?

A

Glycogen breaks down into glucose-1-phosphate and glucose

32
Q

What is Gluconeogenesis?

A

The process of making glucose from its own breakdown products or from the breakdown products of lipids (fats) or proteins

33
Q

What is Hyperglycaemia?

A

High blood glucose. Hyperglycemia is blood glucose greater than 125 mg/dL while fasting and greater than 180 mg/dL 2 hours postprandial.

Endocrinology (14 decks)

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