Diabetes Softchalk

Question 1

What is monogenic diabetes and what are two types?

Answer 1

are form of diabetes caused by a single gene mutation and often inherited. Maturity onset diabetes of the young (MODY) and neonatal diabetes are two forms of monogenic diabetes. Genetic testing can often identify monogenic diabetes, and treatment can vary based on the type of mutation.

Question 2

What is gestational diabetes?

Answer 2

any degree of glucose intolerance that occurs during pregnancy. Gestational diabetes occurs in the setting of an insulin resistant state caused by pregnancy, but the exact mechanism is largely unknown. Most women with gestational diabetes will return to a normo-glycemic state once the infant is born, though some women persist with type 2 diabetes following delivery.

Question 3

Normal process for homeostasis for low and high blood sugar

Answer 3

Question 4

____ cells of the pancreas release glucagon

______ cells release insulin

Answer 4

alpha

beta

Question 5

Symptoms of diabetes mellitus

Answer 5

The “polys” which are polydipsia, polyuria, and polyphagia are classic symptoms

Other symptoms of diabetes (all forms) include nocturia/nocturnal enuresis, weight loss, fatigue, headache and blurry vision.

Question 6

How is diabetes diagnosed?

Answer 6

Any one of the following:

–HbA1c ≥ 6.5%

–Fasting glucose ≥ 126 mg/dl

–Random glucose ≥ 200 mg/dl with symptoms

–2hr post-prandial glucose ≥ 200 mg/dl during Oral Glucose Tolerance Test (OGTT)

Question 7

Diagnosis of Type 1 vs Type 2 is based on

Answer 7

he presence or absence of autoantibodies specific to pancreatic beta cell destruction, low or elevated c-peptide, signs of insulin resistance, specifically acanthosis nigricans (rash), and obesity.

Question 8

Cause of Type 1

Answer 8

he autoimmune destruction of the pancreatic islet cells leads to complete failure of the pancreatic beta cell function.

Question 9

Mutations associated with Type 1

Answer 9

Type 1 diabetes is associated with an increased frequency of certain HLA’s (human leukocyte antigen), in particular DR3 and DR4, which is located on chromosome 6

chromosome 11 which is linked to HLA DQ B chain and the insulin gene itself.

Question 10

Best test to measure insulin

Answer 10

Insuline is metabolised in first pass and often exogenously picked up in testing, so C-peptide is measured. C-peptide and insulin are the products of proinsulin so 1:1

Question 11

What is Diabetic Ketoacidosis (DKA)

Answer 11

In states of severe insulin deficiency, diabetic ketoacidosis (DKA) can result as ketones are made as an alternative fuel source in the absence of insulin. Remember ketones are a form of acid. When ketones increase, side effects of ketoacidosis result including altered mental status, rapid breathing (called kussmaul breathing) in an effort to rid the body of the acid, fruity odor of the breath (ketones have a fruity odor) and severe dehydration due to the osmotic diuresis caused by the hyperglycemia.

Question 12

Causes of T2DM

Answer 12

Type 2 diabetes mellitus is characterized by insulin resistance and decreased insulin sensitivity, caused by genetic and lifestyle factors

Question 13

Main mechanism for T2DM

Answer 13

impaired insulin secretion and insulin resistance in peripheral tissues, such as adipose and muscle, and the liver. The development of chronic hyperglycemia further impairs beta-cell function and insulin secretion

Question 14

T1DM vs T2DM chart

Answer 14