Endocrinology Flashcards
What does anterior and posterior pituitary gland release?
What is diabetes mellitus?
What is type 1 ?
What is type 2 diabetes mellitus?
Type 1 DM: Usually adolescent onset but may occur at any age. Cause: insulin deficiency from autoimmune destruction of insulin-secreting pancreatic Beta cells. Patients must have insulin, and are prone to ketoacidosis and weight loss. Associated with other autoimmune diseases (>90% HLA DR3 ± DR4). Concordance is only ~30% in identical twins, indic ating environmental infl uence. Four genes are important: one (6q) determines islet sensitivity to damage (eg from viruses or cross-reactivity from cows’ milk-induced antibodies). Latent autoimmune diabetes of adults (LADA) is a form of type 1 DM, with slower progression to insulin dependence in later life.
Type 2 DM: (Formerly non-insulin-dependent DM, NIDDM) is at ‘epidemic’ levels in many places, mainly due to changes in lifestyle, but also because of better diagnosis and improved long evity.4 Higher prevalence in Asians, men, and the elderly (up to 18%). Most are over 40yrs, but teenagers are now getting type 2 DM (OHCS p156). Cause: decreased insulin secretion ± increased insulin resistance. It is associated with obesity, lack of exercise,
calorie and alcohol excess. >80% concordance in identical twins, indicating stronger genetic infl uence than in type 1 DM. Typically progresses from a preliminary phase of impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). (This is a unique window for lifestyle intervention.) Maturity onset diabetes of the young (MODY) is a rare autosomal dominant form of type 2 DM affecting young people.
What are the microvascular and macrovascular complications of hyperglycaemia:
microvascular (retinopathy, nephropathy, neuropathy)
macrovascular problems:
stroke, MI, renovascular disease, limb ischaemia.
