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Endocrinology > diabetes - epidemiology and presentation > Flashcards

diabetes - epidemiology and presentation Flashcards

1
Q

define diabetes mellitus?

A

a group of metabolic diseases of multiple aetiologies characterised by hyperglycaemia together with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both

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2
Q

symptoms of hyperglycaemia?

A 
polydipsia
polyuria
blurred  vision
weight loss
infections
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3
Q

long term microvascular complications of hyperglycaemia?

A

retinopathy
neuropathy
nephropathy

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4
Q

long term macrovascular complications of hyperglycaemia?

A

stroke
MI
PVD

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5
Q 
describe the - 
1 - impaired fasting GLC 
2 - Impaired GLC tolerance
3 - HbA1c
for intermediate hyperglycaemia
A

1 - 6.1-7 mmol/l
2 - =/>7.8 and <11 mmol/l
3 - 42-47 mmol/mol

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6
Q

advantages of GLC testing as a diagnostic tool?

A

well established
smaller variations between labs
feasible in developing countries

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7
Q

disadvantages of GLC testing as a diagnostic tool?

A

requires fasting state
OGTT required
higher variability between individuals

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8
Q

advantages of HbA1c testing as a diagnostic tool?

A

no fasting
marker of glycemic control
lower variability between individuals

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9
Q

disadvantages of HbA1c testing as a diagnostic tool?

A

misleading results in cases of anaemia, renal failure
costly
may differ with age and ethnicity

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10
Q

% of Scottish population with diabetes?

A

5.5%

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11
Q

risk if father only has type 1?

A

6%

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12
Q

risk if mother only has type 1?

A

1%

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13
Q

risk if both parents have type 1?

A

30%

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14
Q

risk if sibling has type 1?

A

8%

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15
Q

risk if identical twin has type 1?

A

30-50%

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16
Q

risk if non-identical twin has type 1?

A

10%

17
Q

symptoms presented in type 1 diabetes?

A

SHORT duration of:

polydipsia/thirst
tiredness 
polyuria
weight loss
blurred vision 
abdo pain
18
Q

examination findings type 1 diabetes?

A 
ketones on breath 
dehydration 
increased resp. rate 
tachycardia
hypotension
low grade infections - e.g. thrush
19
Q

describe the structure insulin?

A

alpha (21) and beta (30) chains

linked together with disulphide bonds

20
Q

genetic risk of type 2 diabetes - identical twin?

A

90-100%

21
Q

genetic risk of type 2 diabetes - one parent?

A

15%

22
Q

genetic risk of type 2 diabetes - both parents?

A

75%

23
Q

genetic risk of type 2 diabetes - sibling?

A

10%

24
Q

genetic risk of type 2 diabetes - non-identical twin?

A

10%

25
Q

symptoms of type 2 diabetes?

A 
asymptomatic 
thirst 
tiredness
polyuria 
nocturia 
weight loss 
blurred vision 
symptoms of complications
26
Q

signs of type 2?

A

not ketotic
usually overweight
low grade infections
micro/macro-vascular complications

27
Q

which groups should have risk assessment for screening of diabetes?

A

eligible adults > 40yrs, EXCEPT pregnant women

those aged 25-39yrs of high-risk ethnic groups, South African, black African, Chinese

adults with conditions that have a high risk of diabetes

28
Q

particular conditions that increase risk of type 2?

A 
CVD
hypertension
obesity 
stroke 
polycystic ovary syndrome 
history of gestational diabetes 
mental health issues
29
Q

what is MODY?

A

Maturity Onset Diabetes in the Young

30
Q

cause of MODY?

A

single gene defect - impaired beta-cell function

31
Q

glucokinase mutations of MODY - onset, stage of hyperglycaemia, treatment and complications?

A

onset @ birth
stable hyperglycaemia
diet treatment
complications are rare

32
Q

transcription factor mutations of MODY - onset, stage of hyperglycaemia, treatment and complications?

A

onset @ adolescence/ young adult
progressive hyperglycaemia
1/3 diet, 1/3 OHA, 1/3 insulin
complications are frequent

33
Q

hyperglycaemia of pregnancy -cause?

A

increasing insulin resistance in pregnancy

34
Q

hyperglycaemia of pregnancy - associations?

A

associated with FH of type 2

35
Q

hyperglycaemia of pregnancy - when does it usually develop?

A

2nd/3rd trimester

36
Q

hyperglycaemia of pregnancy - when is it more common?

A

if overweight and inactive

37
Q

hyperglycaemia of pregnancy - resulting neonatal problems?

A

macrosomia, resp distress, hypoglycaemia

38
Q

examples of exocrine pancreas diseases and their effect on diabetes?

A

associated with they development of diabetes -

CF
haemochromatosis
chronic pancreatitis

39
Q

examples of endocrinopathies and their effect on diabetes?

A

associated with they development of diabetes -

acromegaly
Cushing’s syndrome
glucagonoma
Pheochromocytoma

Endocrinology (21 decks)

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