Diabetes Mellitus Flashcards
Pathophysiology of T1DM
- Autoimmune disorder
- insulin-producing beta cells destroyed by the immune system
=> absolute deficiency of insulin
=> raised glucose levels
What age do patient’s tend to present with T1DM?
- childhood/early adult life
Pathophysiology of T2DM
- relative deficiency of insulin
- due to an excess of adipose tissue
What is Maturity Onset Diabetes of the Young (MODY)?
- group of inherited genetic disorders affecting insulin production
=> younger patients develop symptoms similar to T2DM
e.g. asymptomatic hyperglycaemia but can also get DKA
What is Latent Autoimmune Diabetes of Adults (LADA)?
- autoimmune (T1DM) presenting for the first time later in life
- these patients are often misdiagnosed with T2DM
What conditions may damage the beta cells and cause diabetes to develop?
- chronic pancreatitis
- haemochromatosis
What drugs can cause raised blood sugar levels?
Steroids
Common presentation of T2DM
Often picked up incidentally on routine blood tests
Polydipsia
Polyuria
Typical Presentation of T1DM
Weight loss
Polydipsia
Polyuria
DKA:
abdominal pain
vomiting
reduced consciousness level
Why do patients with diabetes experience polydipsia?
Osmotic effect of glycosuria
How is diabetes diagnosed?
Symptomatic:
- Fasting BM >7.0 mmol/l
- Random BM >11.1 mmol/l
Asymptomatic:
the above demonstrated on 2 separate occasions
An HbA1c of >6.5% (48 mmol/mol) is diagnostic of diabetes mellitus. TRUE/FALSE?
TRUE
Insulin mechanism of action and its main side effects.
MOA = Direct replacement for endogenous insulin
S/E = Hypoglycaemia
Weight gain
Lipodystrophy
What conditions may mean that HbA1c cannot be used for diagnosis?
- haemoglobinopathies
- haemolytic anaemia
- untreated iron deficiency anaemia
- suspected gestational diabetes
- HIV
- CKD
- patients on steroids
What values on a fasting glucose and post OGTT would indicate impaired glucose tolerance?
Fasting >6.1 but <7.0
OGTT 2-hour value >7.8 mmol/l but <11.1 mmol/l
