Diabetes Mellitus

Question 1

what does chronic hyperglycaemia cause?

Answer 1

microvascular (small capillary bed/nutrients)
microvascular (stroke/ischaemia) problems

Question 2

what does hyperglycaemia measure?

Answer 2

disease activity- it is a consequence not a cause of diabetes

Question 3

what is meant by impaired glucose zone?

Answer 3

indicator of pre-diabetes

Question 4

what are the four diagnostic tests for diabetes?

Answer 4

-random blood glucose test
-fasting blood glucose test
-glucose tolerance test
-HBA1C test

Question 5

what is a random blood glucose test- and what level would indicate diabetes?

Answer 5

> 11.1mmol/l on 2 occasions=diabetes

problem- blood glucose is not constant-varies throughout the day

Question 6

what is a fasting blood glucose test? and what are the normal, intermediate and diabetic levels?

Answer 6

taken after night of fasting
normal- <6.1mmol/l
intermediate 6.1-7 mol/l
diabetic >7mmol/l

Question 7

what is a glucose tolerance test and what are the normal, intermediate and diabetic levels?

Answer 7

taken after night of fasting and given 75g of glucose to check tolerance
normal- <7.8mmol/l
intermediate - 7.8-11.1mmol/l
diabetic- >11.1 mmol/l

Question 8

what is a HBA1C test? and what are the diabetic levels?

Answer 8

-used to monitor diabetes-monitors a longer period of time
- >48mmol/mol (>6.5%)= diabetic

Question 9

how does type 1 diabetes affect insulin ?

Answer 9

insulin deficiency- pancreas unable to make insulin

Question 10

what are the risk factors for type 1 diabetes?

Answer 10

-genetics
-environment

Question 11

is type 1 diabetics most common in children or adults?

Answer 11

children but can happen in lean young adults

Question 12

why is the pancreas not able to make insulin in type 1 diabetes?

Answer 12

because it is an autoimmune disease-and antibodies attack the pancreas causing destruction of pancreatic B cells

Question 13

at what percentage of destruction of B cells would diabetic symptoms show?

Answer 13

80-90% destruction

Question 14

how is the cells metabolism of glucose affected in type 1 diabetics?

Answer 14

cells metabolise fat-producing ketones-causes ketoacidosis (MED EMER- must get insulin injections to stay alive and stop acid production)

Question 15

what are 2 indicators of low insulin levels?

Answer 15

-low peptide C levels
-autoimmune antibodies

Question 16

what are the symptoms of type 1 diabetes ?

Answer 16

fast progression

-poluruia
-polydypsia
-fatigue/tiredness
-hyperglycaemia
-ketosis

Question 17

what are the risk factors of type 2 diabetes?

Answer 17

-obesity
-inactivity
-strong family history

Question 18

what is the rate of progress for type 2 diabetes and would ketoacidosis occur?

Answer 18

slow! and rarely as hyperglycaemia normally presents before insulin runs out
-normally present with complications before symptoms as gradual progression

Question 19

how does type 2 diabetes affect glucose metabolism?

Answer 19

cells become insulin resistant- and pancreas cannot produce adequate amounts of insulin to trigger resistant cells to take in glucose=high glucose levels in blood

Question 20

what medications increase the risk of type 2 diabetes?

Answer 20

-corticosteroids
-antivirals
-cancer med
-anti-psychotics

Question 21

where does insulin secretion occur?

Answer 21

portal vein—>liver

Question 22

what can long term hyperglycaemia cause?

Answer 22

damage to retina and cv system

Question 23

what are diseases/problems can lead to type two diabetes?

Answer 23

-cushings
-acromegaly