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Endocrinology > Diabetes mellitus > Flashcards

Diabetes mellitus Flashcards

1
Q

What is diabetes?

A

Hyperglycaemia

over years

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2
Q

What are the groups of symptoms of diabetes mellitus?

A

Symptoms due to hyperglycaemia

Symptoms due to inadequate utilisation of glucose

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3
Q

What are the symptoms due to hyperglycaemia?

A

Polyuria

Polydipsia

Blurring of vision

Urogenital infections - thrush

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4
Q

What are the symptoms of inadequate utilisation of glucose?

A

Lethargy

Weight loss

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5
Q

What is polyuria?

A

Increased urine

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6
Q

How does diabetes cause polyuria?

A

Blood glucose rises above renal threshold 10mM
glucose in urine
draws water out of cells
gives increased volume of urine

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7
Q

What is polydipsia?

A

Increased thirst

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8
Q

How does diabetes cause polydipsia?

A

Increased urine production leads to dehydration

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9
Q

How does diabetes cause urogenital infections?

A

Increased glucose in urine

predisposes to infection

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10
Q

How does diabetes cause lethargy, weight loss?

A

Not able to use glucose from diet

Have to mobilise energy stores

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11
Q

What do the severity of the symptoms of diabetes depend on?

A

Rate of rise of blood glucose

Absolute levels of blood glucose achieved

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12
Q

How is diabetes diagnosed?

A

Fasting glucose - raised (above 7mM)

Oral glucose tolerance test

HbA1c - raised (above 6.5%)

Symptoms + 1 abnormal test
Asymptomatic + 2 abnormal tests

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13
Q

What is HbA1c a measure of?

A

How much glucose is attached to red blood cells

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14
Q

How can diabetes be prevented?

A

Lifestyle changes

  • eating healthier
  • increased exercise
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15
Q

Which type of diabetes is seen in younger people?

A

Type 1

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16
Q

What causes type 1 diabetes?

A

Autoantibodies against pancreatic beta cells

destruction of beta cells

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17
Q

What are insulin levels in type 1 diabetes?

A

Absolute lack of insulin

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18
Q

How does type 1 diabetes present?

A

Onset of polyuria, polydipsia, weight loss over a few weeks

Elevated ketone bodies in blood

Vomiting due to ketoacidosis

19
Q

How is the presence of ketones confirmed?

A

Presence of ketones in urine

measured by ketostik

20
Q

How is type 1 diabetes treated?

A

Exogenous insulin
given via subcutaneous injection
dose and type depends on many factors

21
Q

What type of diabetes has increased over the past few years?

A

Type 2

22
Q

What is the age range for type 2 diabetes?

A

Most patients are older than 40

23
Q

What group of people is type 2 diabetes increasing in?

A

Younger people

children

24
Q

Most patients with type 2 diabetes are..?

A

Overweight or obese

25
Q

What causes type 2 diabetes?

A

Cells are resistant to insulin

26
Q

What causes insulin resistance in type 2 diabetes?

A

Abdominal obesity in

Fat deposition in muscle and liver

Elevated circulating free fatty acids

Physical inactivity

Genetic influences

27
Q

What are the symptoms of type 2 diabetes?

A

May be asymptomatic

May have weight loss, polyuria, polydipsia

28
Q

Are ketone bodies synthesised in type 2 diabetes? Why?

A

No

because have high enough levels of insulin to inhibit ketone body synthesis

29
Q

How is type 2 diabetes treated?

A

Changes in lifestyle

Non-insulin therapies

Insulin

Lower other risk factors e.g. hypertension, hyperlipidaemia, smoking

Surveillance for chronic complications

30
Q

What are some examples of non-insulin therapies?

A

Biguanides e.g. metformin

GLP1 analogues

SGLT2s

31
Q

Why is insulin given in later stages of type 2 diabetes?

A

Beta cells in pancreas die eventually

32
Q

How is type 2 diabetes prevented?

A

Maintain healthy body weight
BMI = 18.5 - 24.9kg/m2

Exercise

33
Q

What happens if type 2 diabetes is untreated?

A

Worsening of symptoms

Develop complications of diabetes

34
Q

What are the acute complications of hyperglycaemia?

A

Type 1 - ketoacidosis

35
Q

What are the acute complications of hypoglycaemia?

A

Coma

36
Q

How does diabetes affect blood vessels?

A

Damages endothelial lining of blood vessels

37
Q

What are the complications of damage to the endothelium?

A

Atherosclerosis

Thrombosis

38
Q

What are the chronic complications of diabetes?

A

Vessel disease

Capillary disease

39
Q

What are the different types of vessel disease? What do they each lead to?

A

Cerebrovascular disease - stroke

Cardiovascular disease - angina, MI

Peripheral vascular disease - gangrene

40
Q

What are the different types of capillary disease? What do they each lead to?

A

Retinopathy - blindness

Nephropathy

Neuropathy - foot ulceration because can’t feel pain in it

41
Q

What is metabolic syndrome?

A

Group of risk factors

associated with cardiovascular disease

42
Q

What are some of the risk factors that lead to cardiovascular disease in metabolic syndrome?

A

Diabetes

High fasting plasma glucose

Hypertension

High cholesterol

Abdominal obesity

43
Q

What is measured to confirm metabolic syndrome? How many does a person need to have to be diagnosed with metabolic syndrome?

A

Waist measurement - large

Triglyceride - raised

HDL - raised

Blood pressure - raised

Blood glucose - raised

Three

44
Q

What factors can lead to metabolic syndrome?

A

Physical inactivity

Abdominal obesity

Genetics - runs in families

Insulin resistance

Endocrinology (14 decks)

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