Diabetes in Clinical Practice Flashcards
What is high blood glucose a risk factor for?
Vascular complications
What 2 gross categories are the vascular complications of diabetes split into?
What conditions are in each category?
1) Microvascular = retinopathy, nephropathy, peripheral neuropathy (diabetic foot)
2) Macrovascular = cerebrovascular disease, ischaemic heart disease, peripheral vascular disease
What are the 2 subtypes of T1DM?
Type A = autoimmune
Type B = idiopathic = no markers of autoimmunity
What are the two components that need to happen for T2DM to occur?
A degree of insulin resistance
A degree of insulin deficiency
There MUST be a component of both
Which occurs first, micro or macrovascular complications of T2DM?
Which is DM specific?
Macro first which are non-specific
What does gestational diabetes increase the risk of?
It will resolve post-partly but gives mother increased risk of T2DM long term
How may a diabetic present?
Hyperglycaemic!
Normally, can be caught on screening = ideal!
With diabetic complications
With recurrent infections
With hyperglycaemic symptoms (e.g. osmotic symptoms)
Where are ketone synthesised?
In the mitochondria of liver cells
Why do diabetics urinate frequently?
Due to hyperglycaemia their urine contains glucose (glycosuria) which increases its osmolarity, which in turn results in osmotic diuresis
Why do diabetics drink lots?
Because they are urinating lots to remove glucose from blood in urine!
How may you diagnosis diabetes in someone who is symptomatic?
Why these levels?
X1 rest of either:
HbA1c >48mmol/mol or 6.5%
Venous plasma glucose (RANDOM or post 2hrs of 75g glucose load) >11.1mmol/L
These are the levels at which microvascular complications occur
How may you diagnosis diabetes in someone who is NON-symptomatic?
X2 abnormal HbA1c’s or venous plasma glucose (over the same values mentioned previously)
If FASTING venous plasma glucose, the value is >7mmol/L
What HbA1c is considered ‘pre-diabetic’?
43-47mmol/mol = 6.1-6.4%
What are the 2 types of pre-diabetes and what does each mean?
Can you have both?
IGT = blood glucose high but not enough to be diabetic, BOTH on fasting AND 2hrs post glucose load
IFG = blood glucose increased on fasting only
You can have both!
What does ketosis indicate the body is doing metabolically?
Using fat as its main fuel source
