Diabetes Mellitus Type 1 + 2

Question 1

what is type 1 and 2 diabetes?

Answer 1

Type 1 DM = Chronic hyperglycaemia due to insulin deficieny, caused by autoimmune destruction of the pancreatic beta cells.

Type 2 DM = Chronic hyperglycaemia due insulin resistance. (Insulin is produced by beta cells, but has reduced effect on cells)

Question 2

Who does type 1 diabetes affect?

Answer 2

Usually juvenile onset. (genetic influence)

Question 3

who does type 2 DM affect?

Answer 3

Adults (obese, lack exercise)

Increased prevalence in asians,

Question 4

What are the symptoms of diabetes>

Answer 4

• Polyphagia (increased appetite)
• Polyuria (increased frequency)
• Polydypsia (increased thirst)

Question 5

What fasting plasma glucose is fitting with diabetes>

Answer 5

Fasting plasma glucose >7.0mmol/L

Question 6

what tests are done to confirm diabetes?

Answer 6

1) Fasting blood glucose (>7mmol/l)
2) Random plasma glucose (>11mmol/L)
3) Glucose tolerance test
4) HbA1c

Question 7

What is the classic 2-6 week history that young people present with indicating type 1 diabetes?

Answer 7

1) Weightloss
2) Polyuria
3) Thirst

Question 8

What are the exam/clinical findings typical of DM?

Answer 8

-weight loss
-dehydration
-sweet breath (ketones)
-diabetic retinopathy
(cotton wool spots)
-glucosuria
-other autoimmune conditions (type 1 DM)

Question 9

What are the complications of DM?

Answer 9

1) MI
2) stroke
3) Ulcers
4) Diabetic retinopathy
5) macular oedema
6) cataract (earlier development)
7) Nephrotic syndrome
8) UTIs
9) neuropathy (glove+stocking)
10) Diabetic ketoacidosis

Question 10

What are the risk factors for T2DM?

Answer 10

• obesity
• lack of exercise
• calorie excess

Question 11

How is metabolic control of DM measured?

Answer 11

1) Urine dipstick (look for glucose and protein)
2) Home blood glucose testing
3) HbA1c (should be less tha 7.5%)

Question 12

what is the management / treatment of diabetes mellitus?

Answer 12

1) LIFESTYLE:
- weightloss
- exercise
- controlled diet

Medication:

• control CV risk with ACEi, statin, aspirin.
• Type 1 DM => insulin

TYPE 2:

1) Biguanide (metformin)
2) Sulfonylureas (gliclazide)
3) Thiazolidinediones
4) insulin

Question 13

Differental diagnosis: what are some endocrine causes of secondary diabetes?

Answer 13

1) Cushing’s disease
2) Acromegaly
3) Thyrotoxicosis
4) Phaemochromocytoma
5) glucagonoma

Question 14

Differential diagnosis: what are some pancreatic causes of secondary diabtes?

Answer 14

1) chronic pancreatitis
2) pancreatic destruction in haemochromatosis, cystic fibrosis.
3) Pancreatic cancer