FINAL CLINICAL- Diabetes Flashcards
Type 1 diabetes is the autoimmune destruction of pancreatic B cells. What are present in 85-90% of people that cause destruction of these cells?
Islet cell antibodies
Flag to the immune system to destroy these.
Diabetes is the fifth most common cause of death in the world!!
Around ______ people between 20 and 79 have their death attributed to diabetes
1 in 8 people
How long is life expectancy said to be decreased by for people with type 1 diabetes?
Reduced by 20 years
It’s becoming particularly common in children under 5 now
What happens in terms of insulin secretion in Type 2 diabetes?
Firstly HYPERINSULINAEMIA: body compensates for insulin resistance by increasing insulin secretion from Beta cells (lots of insulin)
Then HYPERGLYCAEMIA: resistance to insulin increases, beta cells can’t produce enough insulin to keep up, glucose levels rise
This all leads to beta cell failure. Glucose levels really badly controlled. Person has to go from oral treatment to insulin injections. Type 2 diabetes present
How long is life expectancy reduced by for people with Type 2 diabetes?
By approx 10 years
10-15% of people with diabetes have Type 2
List 5 of the less severe signs and symptoms of diabetes?
Thirst Polyuria (frequent weeing) Lethargy Visual disturbance (getting balance of fluid and glucose in eye: some patients say it's better some worse) Urinogenital infection
List 3 of the more severe symptoms/ complications with diabetes?
Diabetic Ketoacidosis with type 1 Hyperosmolar hyperglycemic state with type 2 Diabetic foot ulcer Diabetic retinopathy Myocardial infarction
To confirm a diagnosis of diabetes, what should blood glucose be when fasting?
7.0 or over
To confirm a diagnosis of diabetes, what should blood glucose be 2 hours after a glucose load?
11.1 or over
We can use HbA1c to diagnose diabetes. What value must this be?
48 mmol/mol or over
Remember these units!!
What percentage of people are currently undiagnosed with diabetes?
50% of people.
The need for regular screening is therefore very important
How often should someone with diabetes be reviewed?
ANNUALLY- once a year
They do retinal (eye) screening, nephropathy screening (kidneys)
Hypertension screening, vascular disease examination (fatty deposits in blood vessels)
Neuropathic foot problems are often ignored- not good!!
In a trial, intensive insulin therapy was seen to cause a 1-3 fold increase in what?
Severe hypoglycaemia
The more hypos you have, the more the body starts to think this is normal so doesn’t give out any signals before it- people can just fall unconscious unexpectedly
But this tighter control of blood glucose slowed the onset of retinopathy (eyes), nephropathy (kidneys), and neuropathy (feet)
What percentage of people with diabetes also have depression because of the effects it can have on emotions?
50%
5-10% on an antidepressant
