Endo II - Diabetes Mellitus

Question 1

classic features of hyperglycaemia (high blood sugar)

Answer 1

polyuria
polydipsia
polyphagia

Question 2

non-specific features of hyperglycaemia

Answer 2

fatigue
pruritis
unexplained weight loss
susceptible to infections
poor wound healing
visual disturbances

Question 3

function of α cells - glucagon

Answer 3

increases blood glucose through glucogenolysis in liver

Question 4

function of β cells - Insulin

Answer 4

reduces blood glucose and regulates glucose utilisation in tissues

Question 5

longterm marker for insulin secretion

Answer 5

C peptide
islet cells synthesise: prepreoinsulin –> proinsulin –> insulin + c peptide

Question 6

function of δ cells - somatostatin

Answer 6

suppress insulin & glucagon release

Question 7

function of F cells (PP cells)
(pancreatic polypeptide)

Answer 7

secreted by F cells from islets of Langerhans -
gastric & intestinal enzyme secretion
inhibition of intestinal motility
(no effect on insulin / glucagon)

Question 8

Pre-diabetes diagnostic criteria:
1) fasting plasma glucose ______
2) 2-hr plasma glucose ______
3) glycated haemoglobin (HbA1c) ______

Answer 8

1) fasting plasma glucose = 100-125mg/dL
2) 2-hr plasma glucose = 140-199mm/dL
3) glycated haemoglobin (HbA1c) = 5.7-6.4%

Question 9

Diabetic diagnostic criteria:
A1C _____
FPG (fasting) _____
2-hr plasma glucose _____
random plasma glucose _____

Answer 9

Diabetic diagnostic criteria:
A1C = >6.5%
FPG (fasting) = 126mg/dL (7mmol/L)
2-hr plasma glucose = >200mg/dL (11.1mmol/L)
random plasma glucose = >200mg/dL (11.1mmol/L)

Question 10

features of diabetes

Answer 10

glucosuria (glucose in urine)
polyuria
polydipsia
polyphagia
dehydration
blurred vison
fatigue, weakness
irritability, mood changes, headache
tingling, numbness
delayed would healing
muscle cramps
susceptible infections

Question 11

what processes are defective in diabetes

Answer 11

neutrophil chemotaxis
phagocytosis
cell-mediated immunity

Question 12

what infections/diseases are commonly associated with diabetes

Answer 12

candida
peridontal disease
necrotising papillitis
murcormycosis - nasal sinuses
malignant otitis externa -* p. aeruginosa*

Question 13

what are the main classifications of diabetes

Answer 13

type 1 DM
type 1.5 autoimmune (1A) - LADA
type 2 DM
Gestational diabetes
MODY - maturity onset … young

Question 14

<20yo
weight normal / loss
progressive decrease in insulin
autoantibodies present (anti-GAD)
ketoacidosis present

Answer 14

type 1 DM

Question 15

positive for HLA genes:
DR3, DR4, DQ8
non-HLA genes:
CTLA4, PTPN22

Answer 15

type 1 DM

Question 16

main defect of type 1 DM

Answer 16

autoimmune T cell mediated destruction of β cells

Question 17

main defect of type 2 DM

Answer 17

increased resistance to insulin
progressive pancreatic β cell failure

Question 18

other causes of type 1 DM

Answer 18

destruction of islet tissue - β cells:
- immune effector cells reacting against self antigens
- environmental factors
- viral infections - molecular mimicry

Question 19

what is APS-2

Answer 19

autoimune polyendocrine syndrome - 2
combo: adrenal insufficiency + autoimmune thyroiditis + type 1 DM