Diabetes Mellitus Flashcards

1
Q

What is the normal fasting blood glucose levels?

A

< 6.1 mmol/L

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2
Q

What is the fasting blood glucose level for prediabetes?

A

6.1 - 6.9 mmol/L

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3
Q

What is the fasting blood glucose level for diabetes?

A

7+ mmol/L

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4
Q

What is the normal 2h postprandial blood glucose level?

A

< 7.8 mmol/L

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5
Q

What is the 2h postprandial blood glucose level for prediabetes?

A

7.8 - 11 mmol/L

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6
Q

What is the 2h postprandial blood glucose level for diabetes?

A

11.1 mmol/L

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7
Q

What is a normal HbA1c?

A

< 43 mmol/mol

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8
Q

What is a prediabetic HbA1c?

A

43 - 47 mmol/mol

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9
Q

What is a diabetic HbA1c?

A

> 48mmol/mol

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10
Q

How would you treat prediabetes? (3)

A
  • NO MEDICATION
  • Lifestyle advice (diet, exercise, weight loss)
  • Annual review
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11
Q

What is type 2 diabetes mellitus (T2DM) (2)

A

Inappropriately low insulin + peripheral insulin resistance

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12
Q

What is T2DM caused by? (2)

A

Insulin resistance/ beta-cell dysfunction

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13
Q

What are the risk factors for T2DM? (7)

A
Male
Asians
Obesity
Genetics
Lack of exercise
Elderly
High-calorie intake
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14
Q

What are the symptoms of T2DM?

A
  • Asymptomatic!

- If very severe, develop signs of hyperglycaemia

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15
Q

How would you investigate T2DM? (4)

A
  • Random glucose
  • Fasting glucose
  • 2H Postprandial glucose
  • Finger-prick HbA1c test
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16
Q

How do you treat T2DM? (5)

A

Lifestyle changes: weight loss, exercise, healthy diet
If no change ie HbA1c rises to 58mmol/mol =
- Biguanide (metformin)
- Gliclazide (sulfonylurea)/ DPP4i (sitagliptin)
- + insulin

17
Q

What is type 1 diabetes mellitus (T1DM)?

A

Insulin deficiency from autoimmune beta-cell destruction

18
Q

When is the onset of T1DM?

A

Adolescent onset

19
Q

What are the clinical presentations of T1DM? (4)

A

Hyperglycaemia

  • Polydipsia (thirst)
  • Polyuria
  • Unexplained weight loss
  • Lethargy
20
Q

How do you investigate T1DM? (3)

A
  • Blood/ urine: low glucose, high ketones
  • Autoantibodies
  • C-peptide levels: low
21
Q

How do you treat T1DM?

A

Insulin!

22
Q

What causes diabetic ketoacidosis (DKA)?

A

Insufficient insulin (only in T1DM)

23
Q

What are the clinical presentations of DKA? (3)

A
  • Fruity breath
  • Kussmaul breathing (deep + rapid breathing)
  • Dehydration
24
Q

How would you diagnose DKA? (3)

A

Blood:

  • Acidotic
  • Hyperglycemic
  • Ketonemic
25
Q

How would you treat DKA? (3)

A
  • Fluids
  • Insulin
  • Electrolyte replacement (K+)
26
Q

What is hypoglycaemia?

A

Too much insulin/ oral hypoglycemic agents

27
Q

What are the clinical presentations of hypoglycaemia? (4)

A
  • Odd behaviour (aggression)
  • Sweating
  • Raised pulses
  • Seizures
28
Q

How would you treat hypoglycemia? (2)

A

Glucose (give food/ IV infusion)

Glucagon

29
Q

What is hyperglycaemic hyperosmolar state (HHS)?

A

Insufficient oral hypoglycemic agents (hyperglycemia causes high osmolarity w/out significant ketoacidosis)

30
Q

What are the clinical presentations of HHS? (2)

A

Signs of dehydration (dizzy, palpitations)

31
Q

How would diagnose HHS?

A

Blood glucose test

32
Q

How would you treat HHS? (3)

A
LMWH prophylaxis (anticoagulation)
Fluids

*insulin (only if severe)

33
Q

Which (T2DM) medications cause weight loss?

A

Biguanide (metformin)

34
Q

Which (T2DM) medications cause weight gain?

A

Gliclazide (sulfonylurea)

Glitazone (pioglitazone)

35
Q

Which (T2DM) medications don’t cause any weight change?

A

DPP4i (sitagliptin)