Diabetes Mellitus

Question 1

Describe the condition of Diabetes Mellitus

Answer 1

• Chronic hyperglycaemia associated with elevated urine glucose
• Over the years leading to systemic damage

Question 2

Outline type 1 DM

Answer 2

• Rapid onset, usually but not always young
• Absolute insulin def = autoimmune destruction of beta-cells = no longer prod insulin
• Relative def = secretory response of beta-cells is abnormally slow/small

Question 3

Outline type 2 DM

Answer 3

• Typically but not always overweight/obese, older – can be asymptomatic
• Relative def in insulin = beta-cells unable to secrete adequate insulin levels
• Relative resistance = defective insulin receptor mechanism = change in receptor number/affinity
• Defect post-receptor events

Question 4

Describe and explain the typical pattern of presentation of Type 1 DM

Answer 4

• Typically younger, rapid onset, weight loss,
• polyuria/polydipsia
• presence of ketones

Question 5

What is the similar signs of both T1D and T2D?

Answer 5

Polyuria, polydipsia, burring of vision, thrush, tiredness, weakness, lethargy, weight loss

Question 6

Describe the typical presentation of Type 2 DM

Answer 6

• Typically older, most are overweight/obese
• Polyuria, polydipsia, weight loss
• No urinary ketones

Question 7

Explain the sequence of events leading to ketoacidosis in the uncontrolled diabetic

Answer 7

• Low glucose
• Breakdown of fats
• Forms acetyl-CoA
• Formation of ketone bodies = acidic = DKA

Question 8

Explain the causes and consequences of hypoglycaemia

Answer 8

High insulin

Malnutrition

Question 9

Explain the causes and consequences of hyperglycaemia

Answer 9

• Low insulin
• Neurovascular damage
• Blurring of vision
• Urogenital infection - thrush

Question 10

Describe, in broad outline, the principles of management of diabetes

Answer 10

• Diagnosis = fasting glucose, oral glucose, HbA1c
• T1D = insulin injections
• T2D = lifestyle, metformin

Question 11

Explain the principle and practice of measuring glycosylation of haemoglobin as an index of blood glucose control in the diabetic

Answer 11

• Hb1Ac
• Glycated Hb measured to identify 3 month average plasma glucose
• Test limited to 3 months

Question 12

What are the acute complications of DM?

Answer 12

Hyper = DKA
Hypo = coma

Question 13

List the common long term side effects of diabetes

Answer 13

• cardiovascular problems,
• diabetic eye disease,
• diabetic kidney disease,
• diabetic neuropathy
• diabetic foot

Question 14

What is metabolic syndrome?

Answer 14

cluster of the most dangerous risk factors associated with cardiovascular disease: diabetes and raised fasting plasma glucose, abdominal obesity, high cholesterol and BP