Diagnosing diabetes

Question 1

Name 7 symptoms of diabetes.

Answer 1

1. polyuria
2. polydipsia
3. weight loss
4. recurrent infections
5. drowsiness
6. visual blurring
7. hypoglycaemic attacks

Question 2

Name 4 major risk factors for developing T2DM.

Answer 2

1. Obesity
2. Age
3. Family hx
4. Ethnicity

Question 3

What skin sign can be indicative of diabetes?

Answer 3

Acanthosis nigrans

Question 4

A random blood glucose of what level and above should lead to suspicion of diabetes?

Answer 4

11mmol/L

Question 5

Which two blood tests are considered better than a random glucose at diagnosing diabetes? What levels are indicative of diabetes?

Answer 5

HBa1C<48mmol/mol

Fasting glucose>7mmol/L

Question 6

What length of time should a person go without eating for a fasting glucose?

Answer 6

8 hours

Question 7

Name 4 conditions in which an HBa1C is an inappropriate measure of blood glucose levels.

Answer 7

1. Anaemia
2. Pregnancy
3. Recent blood transfusions
4. T1DM
5. Any form of haemoglobinopathy

Question 8

What is the diagnostic criteria for an asymptomatic patient?

Answer 8

In an asymptomatic person, the diagnosis of diabetes should never be based on a single abnormal HbA1c or fasting plasma glucose level; at least one additional abnormal HbA1c or plasma glucose level is essential. If the second test results are normal, it is prudent to arrange regular review of the person.

Question 9

What is the diagnostic criteria in a symptomatic patient?

Answer 9

In a symptomatic person, diabetes can be diagnosed with more confidence on the basis of a single abnormal HbA1c or fasting plasma glucose level (although a second test may be prudent). Be aware that severe hyperglycaemia in people with an acute infection, trauma, or circulatory (other stress) may be transitory and should not be regarded as diagnostic of diabetes.

Question 10

What immune marker is present in T1DM?

Answer 10

HLA D3/4

Question 11

Does type 1 or 2 DM typically present faster?

Question 12

What tests should be ordered in a suspected T1DM patient? (think primary care)

Question 13

What clinical features will be present on an hydration exam in a patient with undiagnosed T1DM?

Answer 13

1. Decreased skin turgor
2. Dry mucous membranes
3. Sunken eyes
4. Slow CRT
5. Tachycardia
6. Weak pulse
7. Hypotension

Question 14

What tests should be ordered in a suspected T2DM patient? (think primary care)