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Endocrine > Diabetes Mellitus > Flashcards

Diabetes Mellitus Flashcards

1
Q

define diabetes mellitus

A

a group of metabolic disease of multiple aetiologies characterised by hyperglycaemia together with the disturbance of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion and/or action.

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2
Q

what are the symptoms of hyperglycaemia?

A 
> polydipsia
> polyuria
> blurred vision
> weight loss
> infections
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3
Q

what fasting venous plasma glucose level would suggest diabetes?

A

7mmol/l or more

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4
Q

what random venous plasma glucose level would suggest diabetes?

A

11.1mmol/l or more

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5
Q

what oral glucose tolerance test result would be seen in a diabetic?

A

11.1mmol/l

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6
Q

what is the diagnostic HbA1c for diabetes?

A

48mmol/mol or more

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7
Q

what is normoglycaemia used for?

A

describing glucose levels associated with low risk of developing diabetes/cardiovascular disease

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8
Q

how is diabetes diagnosed?

A

ONE: diagnostic lab glucose plus symptoms

TWO: diagnostic lab glucose or HbA1c levels without symptoms

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9
Q

what is HbA1c?

A

glycated haemoglobin.

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10
Q

what does HbA1c indicate?

A

blood glucose levels over last 8-12 weeks

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11
Q

when can HbA1c no be used for diagnosis?

A 
> children
> pregnancy
> short duration of symptoms
> patients who are high risk and ill
> patients on medication that may cause rapid glucose rise (corticosteroids)
> pancreatic damage
> renal failure
> HIV infection
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12
Q

what risk is there of developing type 1 diabetes if your monozygotic twin has it?

A

30-50%

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13
Q

what is the risk of developing diabetes type 1 if your father has it?

A

6%

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14
Q

your mum has type 1 diabetes, what is your risk of developing it?

A

1%

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15
Q

if your sibling has type 1 diabetes what is your risk of developing it?

A

8%

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16
Q

what is your risk of developing type one diabetes if your non-identical twin has it?

A

10%

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17
Q

what is your risk of developing type 1 diabetes if both your parent have it?

A

30%

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18
Q

what is the effect of insulin of adipose tissue?

A

reduced lipolysis

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19
Q

what is the effect of insulin on the liver?

A

reduced glucose production

20
Q

what is the effect of insulin on muscle?

A

increased glucose uptake

21
Q

what symptoms could be seen in type 1 diabetes?

A 
> thirst
> tiredness
> polyuria/nocturia
> weight loss
> blurred vision
> abdominal pain
22
Q

what could be seen on examination in type 1 diabetes?

A 
> ketones on breath
> dehydration
> increased respiratory rate
> tachycardia
> hypotension
> low grade infections (thrush)
23
Q

what is the risk of type 2 diabetes if your identical twin has it?

A

90-100%

24
Q

what is the risk of developing type 2 diabetes if one parent has it?

A

15%

25
Q

what is the risk of developing type 2 diabetes if your sibling has it?

A

75%

26
Q

what is the risk of developing type 2 diabetes if your sibling or non-identical twin has it?

A

10%

27
Q

what is the effect of increased cellular insulin resistance in type 2 diabetes?

A

> altered lipolysis
increased glucose production
reduced glucose uptake

28
Q

what are the symptoms of hyperglycaemia?

A 
> thirst
> tiredness
> polyuria/nocturia
> weight loss (sometimes)
> blurred vision
29
Q

what signs might be seen in type 2 diabetes?

A

> not ketotic
usually overweight but not always
low grade infection (thrush)
could see microvascular or macrovascular complications

30
Q

what are the risk factors for type 2 diabetes?

A 
> overweight
> family history
> over 30 (Asian/maori)
> over 40 (if European)
> previous history of diabetes in pregnancy
> had a big baby (>4kg)
> inactive lifestyle
> previous impaired glucose intolerance
31
Q

what is MODY?

A

maturity onset diabetes in the young

32
Q

true or false:

MODY is autosomal recessive

A

false it is autosomal dominant

33
Q

how are beta cells affected in MODY?

A

it is impaired due to a single gene defect

34
Q

what is the onset of glucokinase mutation MODY?

A

at birth

35
Q

what is seen in glucokinase mutation MODY?

A

stable hyperglycaemia

36
Q

what treatment is there in glucokinase mutation MODY?

A

diet treatment

37
Q

what is the onset of transcription factor mutations MODY?

A

adolescence/ young adult

38
Q

what is seen in transcription factor mutation MODY?

A

progressive hyperglycaemia with frequent compllications

39
Q

how is transcription factor mutation MODY managed?

A

> diet
oral hypoglycaemic agents
insulin

40
Q

what can cause secondary diabetes mellitus?

A

> drug therapy (corticosteroids)
pancreatic destruction
genetic syndromes (DIDMOAD)
endocrine disorders

41
Q

what can cause pancreatic destruction leading to secondary diabetes mellitus?

A

> haemochromatosis
cystic fibrosis
chronic pancreatitis
pancreatectomy

42
Q

what endocrine disorders can cause secondary diabetes mellitus?

A

> cushings syndrome
acromegaly
pheochromocytoma

43
Q

what is gestational diabetes?

A

increasing insulin resistance in pregnancy

44
Q

when does gestational diabetes develop?

A

2nd or 3rd trimester

45
Q

what at the risk factors for gestational diabetes?

A

> overweight

> inactive

46
Q

what neonatal problems is gestational diabetes associated with?

A

> macrosomia
respiratory distress
neonatal hypoglycaemia

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