Diabetes Mellitus

Question 1

Processes which affect glucose

Answer 1

o Decrease:
* Glycolysis
* Glycogenesis  glucagon
* Lipogenesis  fat formation
insulin

o Increase:
* Gluconeogenesis
* Glycogenolysisv
cortisol, glucagon, catecholamines, growth hormone (stress response)

Question 2

Diagnosis:

Answer 2

• History
• Examination
• Urine dipstix
•  glucose  cortisol, glucagon, catecholamines, growth hormone (stress response)
•  glucose  insulin
• HGT
• HbA1C
• ABG  if DKA or very ill
  **- Fasting glucose > 7.0mmol/L
  **- 2-hr PG > 11.1mmol/L during OGTT
  ** - HbA1C > 6.5%
• Symptoms / signs of increased glucose with random PG > 11.1mmol

Question 3

Autonomic neuropathy:

Answer 3

• Silent ischaemia  won’t complain of chest pain
• GERD  at risk of aspiration
• BP lability  baroreceptors do not respond well
• Sudden death risk

Question 4

Signs & symptoms DKA

Answer 4

• Altered sensorium
• Kussmaul breathing
• Fruity breath
• Nausea & vomiting
• Abdominal pain
• Severe dehydration
• Fatigue & malaise
• Excessive thirst
• Loss of appetite
• Blurred vision
• Confusion
•  urination

Question 5

Dx DKA

Answer 5

• Ketonuria /  serum ketones
• Acidosis
• Hyperglycaemia

Question 6

BMI formula