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The Endocrine System > Diabetes Overview > Flashcards

Diabetes Overview Flashcards

1
Q

What are the two broad categories of diabetes?

A
  1. Diabetes mellitus
  2. Diabetes insipidus
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2
Q

In which way are insulin molecules stored?

A

Hexamers

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3
Q

Why does type 1 DM develop?

A

Complete destruction of pancreatic B cells

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4
Q

Why does type 2 DM develop?

A

Relative insulin deficiency

Inadequate insulin production/secretion/insulin resistance

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5
Q

MODY is usually due to what?

A

Failure of insulin synthesis, release or activity

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6
Q

Diabetes mellitus is an umbrella term encompassing conditions which are characterised in which ways?

A

Metabolic diseases characterised by hyperglycaemia resulting from defects in insulin secretion, insulin action or both

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7
Q

What is HbA1c?

A

Haemoglobin A1c

This is a glycated version of haemoglobin (Hb that joins with glucose)

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8
Q

Why is measuring HbA1c levels useful?

A

It gives a measure of blood glucose levels

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9
Q

Diabetes can be diagnosed at which levels of HbA1c?

A

48mmol/mol

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10
Q

What are the normal levels of HbA1c?

A

< 41mmol/mol

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11
Q

Diabetes can be diagnosed with a fasting glucose level of what?

A

7mmol/l

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12
Q

What are normal fasting blood glucose levels according to the WHO?

A

< 6.1mmol/l

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13
Q

What are truly normal fasting blood glucose levels?

A

< 5.6 mmol/l

(diabetes is not diagnosed above this level)

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14
Q

What is an OGTT?

A

Oral glucose tolerance test

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15
Q

Diabetes can be diagnosed at what glucose level after a 2hr OGTT?

A

11.1mmol/l

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16
Q

A normal 2hr OGTT would be below which level of glucose in the blood?

17
Q

A random glucose level may be able to diagnose diabetes at what level?

A

11.1mmol/l

18
Q

In any test for diabetes diagnosis what is required for confirmation?

A

A repeat test

19
Q

Type 1 diabetes is characterised by the presence of which antibodies?

A
  1. Anti-GAD
  2. Anti-islet cell
20
Q

Why is type 1 diabetes not diagnosed before the age of 1?

A
  1. They may have MODY
  2. It may be transient
  3. Unlikely to be type 1
21
Q

How does type 1 diabetes manifest clinically?

A
  1. In pre-school and peri-puberty (small peak in late 30s)
  2. Usually lean individuals
  3. Acute
  4. Severe
  5. Weight loss
  6. Ketonuria +/- metabolic acidosis
  7. Immediate and permanent insulin requirement
22
Q

How does type 2 diabetes manifest clinically?

A
  1. Middle aged/elderly
  2. Obese
  3. Pre-diagnosis stage for around 10 years
  4. Insidious onset over weeks to years
  5. Evidence of microvascular disease at diagnosis in around 20%
  6. Managed with diet, exercise and tablets
23
Q

What are the risk factors for type 2 diabetes?

A
  1. Obesity
  2. FH
  3. Gestational diabetes
  4. Age
  5. Ethnicity (asian, african, afro-carribean)
  6. PHx of MI/stroke
24
Q

What are the symptoms of DM?

A
  1. Thirst
  2. Polyuria (excessive drinking)
  3. Thrush
  4. Weakness and fatigue
  5. Blurred vision
  6. Infections
  7. Weight loss
  8. Neuropathy, retinopathy (T2DM)
25
Q

Name 3 useful discriminatory tests for DM

A
  1. GAD/anti-islet cell antibodies
  2. Ketones
  3. C-peptide in the plasma
26
Q

Ketosis is most associated with which type of diabetes?

27
Q

Type 4 DM may be due to which 4 main things?

A
  1. Pancreatic disease
  2. Endocrine disease
  3. Drug induced
  4. Genetic causes (abnormalities of insulin and its receptor)
28
Q

Which type of pancreatic disease may lead to type 4 diabetes?

A
  1. Chronic or recurrent pancreatitis
  2. Haemochromatosis
  3. Cystic fibrosis
29
Q

Which types of endocrine disease can cause type 4 diabetes?

A
  1. Cushing’s syndrome
  2. Acromegaly
  3. Phaechromocytoma
  4. Glucagonoma
30
Q

Which types of drugs can induce type 4 diabetes?

A
  1. Glucocorticids
  2. Diuretics
  3. B-blockers
31
Q

Which genetic disease may lead to the development of type 4 diabetes?

A
  1. Cystic fibrosis
  2. Myotonic dystrophy
  3. Turner’s syndrome
32
Q

Monogenic diabetes usually has which tell-tale features?

A
  1. Strong FH
  2. Associated features e.g. renal cysts
  3. Young onset
  4. GAD negative
  5. C-peptide positive
33
Q

Type 3 diabetes is also know by which other name?

A

Gestational diabetes

(diabetes during pregnancy)

34
Q

What are some macro-vascular complications of diabetes?

A
  1. Heart disease
  2. Stroke
  3. Hypertension
  4. PVD

(these are the main causes of death)

35
Q

What are the microvascular complications of diabetes?

A
  1. Retinopathy
  2. Nephropathy
  3. Neuropathy
36
Q

What does DAFNE stand for and what is it?

A

Dose Adjustment For Normal Eating

An educational programme allowing those with type 1 diabetes to understand their condition better including how much carbohydrate is in each meal and when/how much insulin to inject

The Endocrine System (35 decks)

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