Diabetes type 2

Question 1

Diabetes type 2 pathophys

Answer 1

1. Body makes insulin but there is insulin resistance
2. Positive feedbacks so more insulin in released via beta cell hyperplasia and hypertrophy
3. Normoglycaemia - higher than normal insulin levels so glucose levels can be normal
4. Beta cells are also releasing Amylin protein which is forming amayloid plaques within the pancreas
5. Eventual hypotrophy and death of beta cells
6. hyperglycaemia

Question 2

Hyperosmolar hyperglycemic state (HHS)

Answer 2

• Diabetic ketacidosis does not usually develop
• Occurs in type 2 when insulin high enough to supress breakdown of fat -> no ketonurua/ketoanaemia

1. Increased plasma osmolarity from dehydration and increased blood glucose conc
2. Water leaves body cells and enters the blood
3. Total body dehydration - mental status changes

Question 3

Gestational diabetes

Answer 3

• Pregnant women have increased blood glucose

* Usually third trimester

Question 4

Diagnosis of Type 1 or Type 2

Answer 4

1. Fasting glucose test - no food or drink for 8 hours
   ( 110-125= prediabetes)(>126 - diabetes)
2. Non fasting random glucose test - > 200mg
3. Oral glucose tolerance test - given glucose and measured at intervals to see how well it is being cleared from the blood\
4. HbA1C - the level of haemoglobin with glucose stuck to it (6.5% > = diabetes)

Question 5

Hypoglycaemia

Answer 5

• Caused by excessive insulin
• Too much injected or too much carb consumed
• Sweating, tremor, palp
• V severe - neuroglycopenia ( shortage of glucose in the brain) causing confusion, coma and long term brain damage