Diabetes Mellitus Flashcards
What is Type 1 Diabetes?
Disease where pancreas stops being able to produce insulin
Type 1 Diabetes is often associated with genetic factors and can be triggered by viral infections such as coxsackie B or enterovirus.
What are the classic triad symptoms of Type 1 Diabetes?
- Polyuria
- Polydipsia
- Weight loss
These symptoms are indicative of the body’s inability to use glucose effectively due to lack of insulin.
What is the normal blood glucose concentration range?
4.4-6.1 mmol/l
Blood glucose levels increase after eating carbohydrates and fall as the body uses glucose for energy.
What role does insulin play in the body?
Insulin reduces blood glucose levels by:
* Increasing absorption into cells for fuel
* Increasing absorption into muscle and liver cells for glycogen storage
Without insulin, cells cannot absorb or use glucose.
What is glucagon and when is it released?
Glucagon is released when blood glucose levels are low and causes:
* Breakdown of stored glycogen (glycogenolysis)
* Conversion of proteins and fats into glucose (gluconeogenesis)
This process helps to maintain blood glucose levels during fasting.
What occurs during ketogenesis?
Ketogenesis occurs when there is an insufficient supply of glucose and glycogen stores are exhausted, leading to:
* Conversion of fatty acids to ketones by the liver
* Ketones providing energy to the brain
This typically happens during prolonged fasting.
What are the short-term complications of diabetes?
- Hypoglycaemia
- Hyperglycaemia
These complications arise from imbalances in insulin and carbohydrate intake.
What are the symptoms of hypoglycaemia?
- Hunger
- Tremor
- Sweating
- Irritability
- Dizziness
- Pallor
- Reduced consciousness
- Coma
Treatment includes rapid-acting glucose and slower-acting carbohydrates.
What are the long-term complications of chronic hyperglycaemia?
- Macrovascular complications
- Microvascular complications
- Infection-related complications
Examples include coronary artery disease, peripheral neuropathy, and recurrent infections.
What is Type 2 Diabetes?
Common metabolic disease characterised by insulin resistance and hyperglycaemia
This condition develops over time due to repeated exposure to glucose and insulin.
What are the risk factors for Type 2 Diabetes?
- Non-modifiable:
- Older age (>40)
- Ethnicity (black African, Caribbean, south Asian)
- Family history
- Modifiable:
- Obesity
- Sedentary lifestyle
- High carb diet
- Alcohol excess
- Smoking
- Medical conditions:
- PCOS
- Gestational diabetes
These factors contribute to the development of insulin resistance.
What are the presenting features of Type 2 Diabetes?
- Tiredness
- Polyuria
- Polydipsia
- Weight loss
- Recurrent opportunistic infections
- Slow wound healing
- Blurred vision
- Acanthosis nigricans
Acanthosis nigricans is a skin condition associated with insulin resistance.
What is the diagnostic criteria for pre-diabetes?
HbA1c 42-47
Individuals in this range require lifestyle changes to prevent progression to Type 2 Diabetes.
What is the first-line treatment for Type 2 Diabetes?
Metformin
Metformin increases insulin sensitivity and decreases glucose production in the liver.
What is the mechanism of action for SGLT2 inhibitors?
SGLT2 inhibitors prevent reabsorption of glucose from urine into blood, increasing glucose excretion in urine
Examples include empagliflozin and dapagliflozin.
What are potential side effects of Pioglitazone?
- Weight gain
- Heart failure
- Increased fractures
- Bladder cancer
Pioglitazone is a thiazolidinedione that increases insulin sensitivity.
What is hyperosmolar hyperglycaemic state?
Condition characterized by hyperosmolality and hyperglycaemia without ketones
Symptoms include polyuria, polydipsia, weight loss, dehydration, tachycardia, and confusion.
Fill in the blank: Chronic hyperglycaemia leads to ________ complications similar to those of Type 1 Diabetes.
macrovascular, microvascular, and infectious
These complications arise from prolonged high blood sugar levels.
Sulfonylureas
Example, function, SE
- gliclazide
- insulin secretion from pancreas
- SE: weight gain, hypoglycaemia
DPP-4 inhibitors
Example, function, SE
- sitagliptin
- incretin mimetic
SE: headache, acute pancreatitis
GLP-1 mimetics
example, SE
- exenatide
- subcut injection
- SE: reduced appetite, weight loss, GI symptoms
