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Endocrine Diseases BDS2 > Diabetes Mellitus > Flashcards

Diabetes Mellitus Flashcards

1
Q

what does diabetes mellitus mean?

A

abnormality of glucose regulation

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2
Q

what does diabetes insipidus mean?

A

abnormality of renal function

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3
Q

what is the most common type of diabetes mellitus?

A

type 2

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4
Q

what does the exposure to chronic hyperglycaemia do?

A

increases the risk of microvascular complications and long-term macrovascular disease

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5
Q

what tests are used for diabates?

A

random sugar, fasting sugar, glucose tolerance test, HbA1C

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6
Q

what results come back from a random plasma glucose test indicating diabetes?

A

> 11.1mmol/L on 2 occasions

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7
Q

what does a glucose tolerance test indicate?

A

if fasting sample indicates impaired fasting glucose

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8
Q

what result from the HbA1C indicates that the patient is diabetic?

A

> 48mmol/mol (6.5%)

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9
Q

how do you do a glucose tolerance test?

A

measure the glucose level in blood before giving 75g of glucose and then measure afterwards

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10
Q

what are the ranges of values of normal to diabetic BEFORE giving glucose in the glucose tolerance test?

A 
<6.1 = normal 
6.1-7.0 = impaired fasting glucose 
>7 = diabetes
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11
Q

what are the ranges of values of normal to diabetic AFTER giving glucose in glucose tolerance test

A 
<7.8 = normal 
7.8-11.1 = impaired glucose tolerance 
>11.1 = diabetes
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12
Q

what is type 1 diabetes?

A

insulin deficiency, the autoimmune destruction of pancreatic B cells

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13
Q

what causes type 1 diabetes?

A

interplay between genetic and environmental factors

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14
Q

in type 1 diabetes what determines the clinical presentation?

A

rate of destruction

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15
Q

what is caused by the immune mediated pancreatic B cell destruction?

A

hyperglycaemia and ketoacidosis

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16
Q

what do low c-peptide levels indicate?

A

low insulin secretion

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17
Q

what circulating antibodies are present in type 1

A

GAD, ICA, IAA

18
Q

what is ketoacidosis?

A

body cells cannot access glucose for metabolism so they start to metabolise fat which results in ketones as end product

19
Q

what is the peak incidence of type 1

A

10-14yrs

20
Q

what antibodies do type 1 diabetic children have?

A

higher ICC and IAA

21
Q

what antibodies do type 1 diabetic adults have?

A

lower GAD

22
Q

what are the symptoms of diabetes?

A

polyuria, polydipsia and tiredness

23
Q

what is seen with acute presentation of diabetes?

A

hyperglycaemia with diabetic symptoms and ketoacidosis

24
Q

what is the stage between normoglycaemia and diabetes?

A

impaired glucose tolerance

25
Q

what age group does type 2 diabetes present in?

A

over 40s

26
Q

what is type 2 diabetes associated with?

A

obesity and inactivity, also strong family history

27
Q

what is type 2 diabetes characterised by?

A

defective and delayed insulin secretion and abnormal postprandial suppression of glucagon

28
Q

what is the pathogenesis of type 2 diabetes complicated with?

A

varying degrees of insulin deficiency, insulin action and genetic and environmental factors

29
Q

what is type 2 diabetes?

A

insulin resistance

30
Q

what factors add to insulin resistance?

A

defect in insulin synthesis, secretion and action
defect in pulsatile insulin secretion
visceral fat

31
Q

what are the contributing factors to the defects in insulin synthesis, secretion and action?

A

B cell response to hyperglycaemia is inadequate, elevated basal insulin levels, failure of gluconeogenesis suppression, insulin stimulated glucose uptake reduced

32
Q

what metabolic changes occur in type 2

A

inadequate release of incretins or response to incretins, increased absorption of glucose from GI tract due to increased transporter

33
Q

what are the multisystem effects of type 2

A

impaired glucose tolerance, hyperinsulinaemia, hypertension, obesity with abdominal distribution, dyslipidaemia, procoagulant epithelial markers, early and accelerated atherosclerosis

34
Q

what happens with insulin over time with type 2

A

the ability to secrete insulin falls

35
Q

what is the presentation of type 2 diabetes?

A

polyuria, polydipsia, tiredness, unusual infections, CVS complications (atherosclerosis)

36
Q

what is important in slowing the decline from IGT?

A

strict diet and exercise

37
Q

what medicines induce diabetes?

A

corticosteroids, immune suppressants, cancer medication, antipsychotics, antivirals

38
Q

what types of medication induces diabetes?

A

medicine that interferes with the secretion of insulin or glucagon, medicine which alters tissue uptake of glucose

39
Q

what other conditions is diabetes related to?

A 
endocrine disease (cushing's, phaeochromocytoma (adrenaline tumour), acromegaly)
pregnancy
40
Q

summarise type 1

A

younger, thinner, potential family history, diabetic symptoms, ketoacidosis common

41
Q

summarise type 2

A

older, obese, strong family history, multisystem complications, rarely get ketoacidosis

Endocrine Diseases BDS2 (5 decks)

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