endocrine system

Question 1

what causes type 1 diabetes

Answer 1

lack of insulin production due beta cell defect

• caused by autoimmune destruction of pancreatic beta cells.

Question 2

how doe glucagon cause increase in blood glucose

Answer 2

pancreatic alpha cells of the islets of langerhans produce glucagon

glucagon increases blood glucose levels by inhibiting synthesis of glycogen

causing an increase in the formation of glucose from proteins and fats (gluconeogenesis)

Question 3

Glucagon treatment in insulin induced hypoglycaemia

Answer 3

1mg every 20 minutes once/twice is there is still no response.

along with carb supplements to replenish glycogen stores when patient regains consciousness.

Question 4

what is OGTT

Answer 4

oral glucose tolerance test

fast for 8 hours
then given 75 mg of anhydrous glucose/polycal/Rapilose

2 hours after a venuous blood sample is taken

Question 5

what are the main drug classes to treat type 2 diabetes

Answer 5

1) sulphonylureas (SU)
2) sodium glucose co-transporter 2 inhibitors (SGLT-2i)
3) Biguanides (metformin
4) Thiazolidinediones (glitazones)
5) Dipeptidyl peptidase 4 inhibitors (DPP4i)
6) Glucagon like peptide 1 (GLP-1): incretin mimetics.

Question 6

Things to monitor for diabetes

Answer 6

Blood Glucose Monitoring: For both Type 1 and Type 2 diabetes to ensure glucose control. Pre-meal levels should generally be between 4-7 mmol/L, and post-meal levels should be around 5-9 mmol/L.

HbA1c: For both types, the general target is <48 mmol/mol (6.5%), though individualized targets may be appropriate based on factors like age, comorbidities, and hypoglycemia risk.

Blood Pressure: Target for both types is <140/80 mmHg, with more stringent goals (e.g., <130/80 mmHg) for those with kidney damage or cardiovascular risk factors.

Cardiovascular Risk: Annual reviews to assess cardiovascular health (lipids, smoking, etc.) and consider medications like statins are part of routine management. Statin therapy may be more aggressively considered in individuals aged 40-75 with Type 2 diabetes.

Kidney Care: Monitoring for kidney damage with regular albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) testing is key for both conditions, with a focus on early detection of kidney disease.

Eye and Foot Care: Regular eye exams and foot assessments are critical for detecting diabetic retinopathy and peripheral neuropathy, respectively. More frequent check-ups may be necessary for individuals with existing complications.

(condense this card down)

Question 7

what is HHS

Answer 7

Hyperosmolar hyperglycaemic state

type 2 diabetes complication

higher than 30mmol for several days

Question 8

is DKA more common in type 1 or type 2

Answer 8

type 1

Question 9

DKA signs

Answer 9

type 1
blood glucose higher than 11mmol
polydypsia/poluria/weight loss/abdominal pain/ fruity breath

urinary ketones: higher than 2+
or capilarry blood ketones higher than 3mmol/L

Question 10

page 15

Question 11

what is DKA

Answer 11

page 14