diabetes - everything else

Question 1

what is MODY

Answer 1

inherited genetic disorders –> reduced insulin production (mature onset diabetes of the young)

Question 2

inheritance MODY

Answer 2

autosomal dominant

Question 3

what type of diabetes do MODY patients get and when does it present

Answer 3

T2DM // <25

Question 4

what is MODY 3 a defect of

Answer 4

HNF-1 alpha gene

Question 5

what cancer does MODY 3 increase risk of

Answer 5

hepatocellular caricnoma

Question 6

MODY 2 gene defect

Answer 6

glucokinase

Question 7

MODY 5 defect

Answer 7

HNF1 beta –> liver and renal cysts

Question 8

most common MODY

Answer 8

3

Question 9

features MODY

Answer 9

<25 // FH // NO ketosis

Question 10

mx MODY

Answer 10

SURS eg Gliclazide, Tolbutamide

Question 11

what mutation causes neonatal diabetes

Answer 11

Kir6.2 or SUR1

Question 12

how long transient neonatal diabetes last + how is it treated

Answer 12

<3 months // insulin

Question 13

how is Permanent neonatal diabetes managed

Answer 13

lifelong insulin

Question 14

RF gestational diabetes

Answer 14

BMI > 30 // previous big baby // previous GDM // FH diabetes

Question 15

screening for GDM

Answer 15

oral glucose tolerance test

Question 16

glucose diagnosis GDM

Answer 16

fasting >5.6 // 2 hour >7.8

Question 17

in GDM if fasting <7 what mx should be trialed

Answer 17

diet + exercise

Question 18

pharmacological mx GDM

Answer 18

1 = metformin // 2 = short acting insulin

Question 19

if at time of diagnosis glucose >7 GDM what should be started

Answer 19

insulin

Question 20

alternative treatment to insulin GDM (or who do not tolerate metformin)

Answer 20

glibenclamide

Question 21

which drugs cause impaired glucose tolerance (6)

Answer 21

thiazides // steroids // tacolimus, ciclosporin // (interferon alpha // nicotinic acid // antipsychotics)

Question 22

what meds can reduce hypoglycaemic awareness

Answer 22

BB

Question 23

what should happen to metformin dose during ramadam

Answer 23

1/3 before sunrise // 2/3 after sunset

Question 24

diabetic sick day rules

Answer 24

check glucose 4 hour;y // 3L water // sugary drinks

Question 25

what should happen to medications if sick and diabetic

Answer 25

keep taking them (maybe stop metformin if dehydrates)

Question 26

DVLA criteria for diabetes (5)

Answer 26

no severe hypo 12 months // good monitoring // no significant complications // hypoglycaemic awareness

Question 27

symptoms insulinoma

Answer 27

hypoglucaemia just before meals // rapid weight gain // raised insulin // raised C peptide

Question 28

invx insulinoma

Answer 28

prolonged fasting // CT pancreas

Question 29

mx insulinoma

Answer 29

surgery // diazoxide +somatostatin if unsuitable

Question 30

condition assoc with insulinoma

Answer 30

50% have MEN1