Diabetes mellitus

Question 1

What us diabetes mellitus?

Answer 1

Elevated blood concentration (hypeglycaemia) which over time leads to damage to small and large blood vessels causing premature death from cardiovascular diseases

Question 2

Why is diabetes a major concern?

Answer 2

Kidney disease
Blindness
Lower limb amputation
Cardiovascular disease

Question 3

Major risk factor diabetes type 2

Answer 3

Obesity

Question 4

2 principle mechanisms of diabetes

Answer 4

Inability to produce insulin
Insulin resistance (production is fine) - obesity

Question 5

Type 1 diabetes

Answer 5

Autoimmune destruction of B cells
Genetic predisposition - HLA, MHC class 2

Question 6

Presentation of diabetes mellitus

Answer 6

Polyuria
Polydipsia
Weight loss

(lethargy, weakness, blurring vison, thrush)

Question 7

Diagnosing diabetes

Answer 7

Fasting glucose
Oral glucose tolerance test
HbA1c - glucose coupled to proteins

Question 8

Diagnosis diabetes needs

Answer 8

Symptoms and 1 abnormal test result

2 abnormal results if no symptoms

Question 9

Presentation of type 1 diabetes

Answer 9

Rapid onset (weight loss, polyuria, polydipsia)
Late - vomitting from KETOACIDOSIS

Young patient, ketones

Question 10

Treatment type 1 diabetes

Answer 10

Subcutaneous insulin injections

Question 11

Ketone production why?

Answer 11

Insulin supresses ketone production (unless starvation mode)

Question 12

Ketoacidosis clinical triad

Answer 12

Hyperglycaemia
Ketonaemia (>3mmol/L)
Acidosis (ph <7.3)

Question 13

Type 2 diabetes reasons

Answer 13

Obesity - particularly central
Muscle and liver fat deposition
Physical inactivity
Genetics

Question 14

Treatment type 2 diabetes

Answer 14

Gastric bypass - low calorie diets
WEIGHT LOSS
Lifestyle changes

Question 15

Type 2 diabetes symptoms

Answer 15

Slower rise in blood glucose
Polyuria, polydipsia, weight loss
NO KETONES

Question 16

Medications type 2 diabetes

Answer 16

Biguanides

Sulphonylureas

Question 17

Monitoring diabetes

Answer 17

Capillary testing
Ketone testing
Continious glucose monitoring (free style libre)

Question 18

Acute complications diabetes

Answer 18

Ketoacidosis (type 1)

Hypo:
Coma- Brain needs glucose

Question 19

Chronic complications of diabetes

Answer 19

Macrovascular (stroke, heart attack, intermittent claudication, gangrene)

Microvascular (retinopathy, nephropathy, neuropathy)
- blindness, ulceration, renal replacement therapy

Question 20

What is metabolic syndrome?

Answer 20

Cluster of dangerous risk factors associated with cardiovascular disease

Question 21

Metabolic syndrome is

Answer 21

Diabetes
Raised fasting plasma glucose
Abdominal obesity 
High cholesterol
High BP