diabetes principles Flashcards
what is diabetes?
An elevation of blood glucose above a diagnostic threshold
what are the thresholds for diabetes diagnosis?
fasting plasma glucose=7mmol/l
2hr plasma glucose=11.1mmol/l
HbA1c=48mmol/mol
what is a normal HbA1c?
41mmol/mol and below
what is the difference between gestational diabetes and diabetes?
in diabetes threshold levels are set by retinopathy risk and in gestational the threshold is set by the risk to foetus
how is the level of insulin that beta cells are secreting measured?
by measuring the C peptide level (C-peptide is co-secreted with insulin and is not part of injected insulin – so if c-peptide is present in the blood it must be coming from the person’s beta-cells)
can diabetes be caused by a pure disorder of the beta cells?
yes
is type 1 a disorder of insulin action?
no-its a disorder of insulin secretion
what are the disorders of insulin secretion?
diabetes T1
genetic disorders (MODY, neonatal diabetes)
pancreatic diseases (pancreatitis, cancer)
pure disorders of insulin action are rare-true or false?
true
what are some disorders of insulin action?
Donohue Syndrome
Rabson-Mendenhall Syndrome
Familial Partial Lipodystrophy
Congenital Lipoatrophy
Acquired Lipoatrophy
cushings syndrome
acromegaly
can be steroid induced
is type 2 diabetes an insulin secretion or insulin action disorder?
mixed-ranging from predominant beta cell deficiency to predominant insulin resistance
what is T1 diabetes?
autoimmune destruction of the pancreatic beta cells resulting in beta cell deficiency
what % of people with T1 have pancreatic autoantibodies in the blood at diagnosis?
95%
what are the features of T1 diabetes?
onset in children and young adults
not associated with overweight
autoimmune
requires insulin treatment
what are the features of type 2 diabetes?
onset in middle aged and elderly
associated with obesity and sedentary lifestyle
not autoimmune
may require insulin but can usually be managed with lifestyle changes
