Diabetes public health Flashcards
what does diabetes mellitus mean in greek
sweet urine due to sugar content in urine and frequent urination
what causes diabetes
insufficient insulin to maintain glucose homeostasis
absolute insulin deficiency - T1DM
relative insulin deficiency -T2DM (de-senstivity)
Failure of insulin synthesis, release or activity due to genetic mutations- MODY
what is normal fasting glucose
6.0 mol/L and below
what is normal random glucose
11.1 mol/L and below
what is normal 2-hr glucose in OGTT
11.1 mol/L
what are the 3 main types of diabetes
type 1 - (autoimmune B cell destruction leading to absolute insulin deficiency)
type 2- (progressive loss of B cell insulin secretion due to insulin resistance)
type 3- gestational (diagnoses in the second or third trimester or pregnancy which wasn’t clearly overt diabetes prior to gestation)
what happens to B cells in T1DM
they are destroyed by an autoimmune reaction
whats the clinical presentation of T1DM
pre-school and peri-puberty small peak in later 30s usually lean acute onset severe symptoms severe weight loss ketonuria +/- metabolic acidosis no evidence of microvascular disease at diagnosis immediate and permanent requirement for insulin
what are the 4 T sings of T1DM
toilet
thirsty
tired
thinner
T2DM clinical presentation
middle aged/elderly usually obese pre-diagnosis duration of 6-10 years insidious onset over weeks to years ketonuria minimal or absent evidence of microvascular disease in 20% manage initially with diet
when should people be tested for diabetes (in people who meet the criteria)
patients with prediabetes - tested yearly
women who had GDM - life ling testing every 3 years
all patients - testing should begin at age 45
if results normal testing should be at a minimum of 3 year intervals
risk factors for T2DM
obesity family history gestational diabetes age ethnicity (asian, African, afro-caribbean) PHx of MI/Stroke medications eg, antipsychotics IGT/IFG
what score on the diabetes risk test shows increased risk for having T2DM
5
symptoms of T2DM
thirst polyuria thrush weakness fatigue blurred Vision infections weight loss T2DM signs of complications - neuropathy, retinopathy
useful discriminatory tests
autoimmune markers
ketones -ketosis = type 1
c-peptides
type 1 had a strong HLA association
