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Endocrine- Diabetes > Diabetes Introduction > Flashcards

Diabetes Introduction Flashcards

1
Q

Why does diabetes develop?

A

Insufficient insulin to maintain glucose homeostasis

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2
Q

What type of insulin deficiency is type 1 diabetes?

A

Absolute

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3
Q

What type of insulin deficiency is type 2 diabetes?

A

Relative

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4
Q

What is MODY?

A

Failure of insulin synthesis, release or activity

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5
Q

What are 2 causes of type 2 diabetes?

A

Inadequate insulin production, or insulin resistance

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6
Q

Overall, DM is a group of disorders characterised by what?

A

Hyperglycaemia

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7
Q

What HbA1c is diagnostic of diabetes? What is normal?

A

48mmol/mol or more (normal 41 or less)

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8
Q

What fasting glucose is diagnostic of diabetes? What is normal?

A

7mmol/l or more (normal 6 or less)

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9
Q

What 2 hour glucose in OGTT is diagnostic of diabetes? What is normal?

A

11.1mmol/l or more (normal 7.7 or less)

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10
Q

What random glucose is diagnostic of diabetes?

A

11mmol/l or more

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11
Q

With regards to HbA1c, fasting glucose and 2 hour glucose in OGTT, if a patient does not have the score which is diagnostic of diabetes, but are not within normal limits, what are they said to have?

A

Pre-diabetes

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12
Q

Briefly describe pre-diabetes?

A

A stage which can last for 15-20 years, with increased CV risk

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13
Q

What can be the causes of type 1 diabetes?

A

Autoimmune or idiopathic

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14
Q

There is destruction of what in type 1 diabetes? What does this result in?

A

Destruction of pancreatic beta cells, resulting in loss of insulin production

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15
Q

Type 1 diabetes can be characterised by the presence of what antibodies?

A

Anti-GAD // Anti-islet cell

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16
Q

What must you rule out in order to diagnose type 2 diabetes?

A

Type 1, MODY, any condition or treatments which would cause secondary diabetes

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17
Q

What are some pancreatic diseases which can cause secondary diabetes?

A

Pancreatitis, haemochromatosis

18
Q

What are some endocrine diseases which can cause secondary diabetes?

A

Cushing’s, acromegaly, phaeochromocytoma, glucagonoma

19
Q

What are some drugs which can cause secondary diabetes?

A

Glucocorticoids, diuretics, beta blockers

20
Q

What are some genetic diseases which can cause secondary diabetes?

A

Turner’s, CF, myotonic dystrophy

21
Q

Who does MODY occur in?

A

Generally young people (neonate to adulthood) with a strong family history

22
Q

Will people with MODY have antibodies? Will they have C-peptide?

A

No antibodies, yes C-peptide

23
Q

Neonatal diabetes occurs before what age?

A

< 6 months

24
Q

What is gestational diabetes?

A

Any degree of glucose intolerance arising or diagnosed during pregnancy

25
Q

What are the 4 main clinical features of diabetes? (4 T’s)

A

Tired, thirsty, toilet, thinner

26
Q

As well as the 4 Ts, what are some other clinical features of diabetes?

A

Polyuria, weakness, blurred vision, infections

27
Q

What else may patients present with, specific to type 2 diabetes?

A

Signs of complications

28
Q

Weight loss is most likely a presentation of what type of diabetes?

29
Q

Ketonuria is seen in what types of diabetes?

A

Mainly type 1, sometimes secondary

30
Q

What are 3 useful tests for type 1 diabetes?

A

GAD/islet cell antibodies, ketones, C-peptide

31
Q

Is C-peptide always a sensitive test for type 1? Why/why not?

A

No- some people with type 1 will retain C-peptide for a few years after they stop producing insulin

32
Q

What are the diagnostic tests for diabetes?

A

Random lab BG, fasting BG, OGTT, HbA1c

33
Q

What does HbA1c provide?

A

A measure of glycemic control over the past 2-3 months

34
Q

An HbA1c score of what implies bad control?

A

> 75mmolmol

35
Q

Explain the oral glucose tolerance test?

A

Measure fasting BG. Take a very sweet tasting glucose drink. Take further BGs at 30 or 60 minute intervals for at least 2 hours.

36
Q

In individuals without diabetes, what should happen to BG levels after 2 hours in the OGTT?

A

BG should have lowered, similar to the fasting state again (action of insulin)

37
Q

In individuals with diabetes, what will happen to BG levels after 2 hours in the OGTT?

A

The BG will remain high, as there is no insulin allowing it to enter cells

38
Q

Give 2 examples of macroscopic complications?

A

Heart disease and stroke (atheroma)

39
Q

What are the 3 types of microvascular complications?

A

Retinopathy, nephropathy, neuropathy

40
Q

Retinopathy can ultimately cause what? Nephropathy can ultimately cause what?

A

Ret = blindness, neph = kidney failure (preventable with screening)

Endocrine- Diabetes (11 decks)

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