Diabetes Mellitus Flashcards
What is diabetes?
A disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood
What is the pathophysiology of diabetes?
Type 1
- pancreas does not produce sufficient insulin
- autoimmune beta cell destruction
Type 2
- insulin resistance
- insulin receptors do not respond to insulin
Symptoms of diabetes?
Polyuria
Polydipsia
Tiredness
Weight loss
Later
- visual changes
How do you diagnose diabetes?
Symptoms and 1 abnormal test OR 2 abnormal tests if asymptomatic
Fasting glucose
Oral glucose tolerance test
HbA1c
Presentation of type 1 diabetes
Rapid onset
- weight loss
- polyuria
- polydipsia
Younger patient
Presence of ketones
Management of type 1 diabetes
Exogenous insulin
What causes insulin resistance to develop?
Obesity
- muscle and liver fat deposition
- elevated circulating free fatty acids
Physical inactivity
Genetic influences
Presentation of type 2 diabetes
Older patient
Slower rise in blood glucose
- often asymptomatic
Management of type 2 diabetes
Weight loss
Medication
- metformin
- sulphonylureas
- DPP4 inhibitors
- SGLT2s
Insulin
What are acute complications of diabetes?
Diabetic ketoacidosis - type 1
Hyperosmolar non-ketotic syndrome - type 2
Hypoglycaemia
What are chronic complications of diabetes?
Macrovascular disease
- PVD
- stroke
- gangrene
- MI
Microvascular disease
- retinopathy
- neuropathy
- ulceration
What is metabolic syndrome?
Cluster of most dangerous risk factors associated with cardiovascular disease
What are the factors of metabolic syndrome?
Diabetes Raised fasting plasma glucose Abdominal obesity High cholesterol Hypertension
How do you diagnose metabolic syndrome?
Waist measurement
- > 94cm men
- > 80cm women
+ 2 of
- triglyceride >1.7mmol/L
- HDL cholesterol <1 men and <1.2 women
- BP >135/85
- fasting glucose >5.6
What causes metabolic syndrome?
Insulin resistance
Central obesity
Physical inactivity
Genetics
