Diabetes mellitus Flashcards
What is the cause of Type 1 Diabetes Mellitus (T1DM)?
Autoimmune destruction of pancreatic β-cells, leading to insulin deficiency. Commonly diagnosed in childhood or adolescence.
What is the primary cause of Type 2 Diabetes Mellitus (T2DM)?
Insulin resistance and/or reduced insulin secretion. Often related to lifestyle factors like obesity, sedentary habits, and genetic predisposition.
What is gestational diabetes mellitus (GDM)?
Glucose intolerance first recognized during pregnancy; involves insulin resistance and/or insufficiency and carries a high risk for later T2DM.
List key risk factors for Type 2 Diabetes.
Obesity, older age, sedentary lifestyle, family history, gestational diabetes, glucose intolerance, certain infections.
What are the risk factors specific to gestational diabetes?
PCOS, previous large birth weight baby (>4500g), history of GDM or stillbirth, infertility issues.
What is the pathophysiology of diabetes mellitus?
Chronic hyperglycemia due to insufficient insulin action, resulting in excess blood glucose and intracellular glucose starvation.
What are the classic signs and symptoms of diabetes?
Polyuria, polydipsia, polyphagia, weight loss, fatigue, glucosuria, recurrent infections, delayed wound healing.
What causes polyuria and dehydration in diabetes?
Glucosuria causes osmotic diuresis, pulling water into urine and leading to dehydration and increased plasma osmolarity.
How does hyperglycemia cause cellular dysfunction?
Excess glucose causes glycosylation of proteins in blood vessels and neurons, impairing nutrient exchange and action potential conduction.
What complications are associated with diabetes mellitus?
Microvascular: Retinopathies, nephropathies, neuropathies
Macrovascular: Atherosclerosis, CAD, PAD, stroke
Metabolic: Diabetic ketoacidosis (DKA), hyperlipidemia
What is diabetic ketoacidosis (DKA)?
A life-threatening complication mainly in T1DM caused by insulin deficiency, leading to lipolysis, ketone production, and metabolic acidosis.
What are the main diagnostic tests for diabetes mellitus?
Fasting blood glucose
Oral glucose tolerance test (especially for GDM)
HbA1c (most commonly used)
What does the HbA1c test measure?
The average blood glucose levels over the past 2–3 months by measuring glycosylated hemoglobin levels.
What is the general HbA1c target for individuals with diabetes?
Below 55 mmol/mol (7.0%), though targets may be individualized.
How is Type 1 Diabetes managed?
Insulin therapy (subcutaneous)
Blood glucose monitoring
Dietary & activity adjustments
Hypoglycemia & DKA education
How is Type 2 Diabetes managed?
Lifestyle changes (diet, exercise)
Oral hypoglycemics (e.g., metformin, sulfonylureas)
Insulin if needed
Regular glucose monitoring
What are the management strategies for gestational diabetes?
Diet & exercise
Blood glucose monitoring
Insulin if needed (especially during labor)
Birth planning depending on glycemic control
What is the mechanism of action of Metformin (a biguanide)?
Increases insulin sensitivity and decreases hepatic glucose production.
What are potential adverse effects of metformin?
Lactic acidosis (especially with kidney dysfunction); lower risk of hypoglycemia compared to other meds.
What is the mechanism of action of Sulfonylureas (e.g., Glipizide)?
Stimulate insulin release from the pancreas and inhibit gluconeogenesis.
What is the mechanism of action of SGLT-2 inhibitors (e.g., Empagliflozin)?
Inhibit glucose reabsorption in the kidney, increasing urinary glucose excretion.
What is the action of GLP-1 agonists (e.g., Dulaglutide)?
Mimic incretin to enhance insulin secretion and delay gastric emptying.
