Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

RW Endocrinology > General Diabetes > Flashcards

General Diabetes Flashcards

1
Q

What is the definition of diabetes mellitus?

A

A group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the main classification of types of diabetes?

A
  • Type 1
  • Type 2
  • Type 3 (other including MODY)
  • Type 4: Gestational
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What rough percentage of the population has diabetes, and what Type does the majority (88%) have?

A

~5%, Type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the time course/presentation ages of different types of diabetes?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the classification of different types of diabetes based on clinical features?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which is more genetic, Type 1 or Type 2 diabetes?

A

Type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What tests can help distinguish Type 1 and Type 2 diabetes?

A

GAD/IA2 antibodies, C-peptide and ketosis (as well as symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do various factors differentiate Type 1 and Type 2 Diabetes?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the main tests for diagnosing diabetes and the cut-offs?

A
  • Random lab blood glucose (11.1)
  • Fasting glucose (7mmol/L)
  • OGTT (11.1)
  • HbA1C (6.5%/48mmol/mol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is HbA1c?

A

Glycated hemoglobin - a form of hemoglobin that shows the three-month average plasma glucose concentration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the criteria of diabetes, pre diabetes and normal using HbA1c?

A

Normal: below 42 mmol/mol (<6%) Pre diabetes: 42-47 mol/mol (6-6.4%) Diabetes: 48 mol/mol (>6.5%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the diagnostic criteria for diabetes for HbA1c?

A

HbA1c - 48mmol/m and above (6.5%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the diagnostic criteria of diabetes using Oral Glucose Tolerance Test?

A

> 11.1 mmol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the diagnostic criteria of diabetes using random glucose ?

A

>11.1 mmol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the diagnostic criteria of diabetes using fasting glucose ?

A

> 7mmol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the main measure of glycemic control?

A

HbA1c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the HbA1c goal for controlling diabetes?

A

<7% (53 mmol/m)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the BG targets for before and after meals, for T1, T2, children and pregnant women?

A

4-7 mmol/l before meal, and 5-9mmol/l after meal in T1DM and children, and <8.5 mmol/l later meal in T2DM (NICE 2015) (pregnant women is same but more specific, children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What screening tests are there for diabetics?

A

Eye clinics, foot clinics, BMI, blood pressure and bloods: HbA1c, renal function and lipids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When is hospitalisation required in diabetes?

A

DKA, significant ketonaemia and/or vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the main complications of diabetes?

A

Macrovascular: heart disease and stroke Microvascular: Retinopathy, nephropathy and neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Generally, how does diabetes cause micro/macrovascular complications?

A

Multiple contributing factors that occur with hyperglycaemia (i.e. direct damage of glucose, inflammation, oxidative stress, mitochondrial dysfunction, AGE_RAGE) contribute to hypoxia and accelerate vascular disease, resulting in reduced blood flow and damaged nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Autonomic neuropathy

A

Alterations in functioning of organs e.g. changes in bowel, bladder function, sexual response, sweating, heart rate, blood pressure, hypoglycaemic unawareness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Proximal neuropathy

A

Affects the lumbosacral plexus e.g.pain in the thighs, hips or buttocks leading to weakness in the legs (Amyotrophy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Focal Neuropathy
Sudden weakness in one nerve or a group of nerves causing muscle weakness or pain e.g. carpal tunnel
26
Peripheral Neuropathy
Distal symmetric or sensorimotor neuropathy - Pain/ loss of feeling in feet and hands (commonest)
27
What is Charcot foot?
Destruction of metatarsal bones
28
What are the treatment options for painful neuropathy?
Amitriptyline, duloxetine, gabapentin, or pregabalin. Alternatively as a topical treatment: Capsaicin Cream
29
What are the digestive complications of autonomic neuropathy?
- Gastroparesis (slow emptying) and oesophagus nerve damage (difficulty swallowing)
30
What are the treatment options of gastroparesis?
- Dietary - smaller, more frequent food portions. Low fat. Low in fiber (Bezoars). If severe may need liquid meals - Promotility drugs eg. metoclopramide, domperidone, and erythromycin - Anti-nausea medications eg. prochlorperazine and serotonin antagonists - Abdominal pain - NSAIDs, low dose tricyclic antidepressants, gabapentin, tramadol and fentanyl. - Botulinum Toxin - Gastric Pacemaker
31
True/False: Gustatory sweating (sweating at night or when eating) is a complication of diabetes
True, due to autonomic neuropathy of sweat glands. Treated with topical glycopyrrolate, clonidine, botulinum toxin
32
What diagnostic tools are there for neuropathy?
Nerve conduction studies or EMG, HR studies, US and gastric emptying studies
33
What is nephropathy?
A progressive kidney disease caused by damage to the capillaries in the kidneys' glomeruli. It is characterized by nephrotic syndrome and diffuse scarring of the glomeruli
34
What test is used to screen for nephropathy and what levels are diagnostic?
Urinary albumin creatinine ratio (ACR) - Microalbuminuria is a bad sign, indicated by 30-300mg/ml or ACR ≥3.5 mg/mmol (female) or ≥2.5 mg/mmol (male) with ACR
35
What treatment should be given to patients with microalbuminuria?
ACE inhibitor or ARB
36
What are the different structures of the back of the eye?
37
What eye pathologies do people with diabetes get?
- Diabetic Retinopathy - microvascular disease - Cataract- clouding of the lens (develops earlier in people with diabetes) - Glaucoma- increase in fluid pressure in the eye leading to optic nerve damage (2 x more common in diabetes) - Acute hyperglycaemia- visual blurring (reversible)
38
What are the stages of retinopathy?
- Mild non-proliferative (Background) - Moderate non-proliferative - Severe non-proliferative - Proliferative
39
What is the biochemical triad that characterises diabetic ketoacidosis?
Hyperglycaemia, ketosis and acidosis
40
Ketosis
Occurs when the body can't use glucose for energy (due to not enough insulin for example) so breaks down fat instead, producing ketones
41
Acidosis
When ketones build up in the body, it becomes acidic
42
Diabetic Ketoacidosis (DKA)
Acute metabolic complication of diabetes that is potentially fatal, resulting from a severe lack of insulin means the body cannot use glucose for energy so ketosis occurs, then causing acidosis
43
What are the biochemical criteria for ketosis, hyperglycaemia and acidosis for DKA?
Ketosis: Ketonaemia \> 3mmol/L Hyperglycaemia: Blood glucose \>11.0 mmol/l Acidosis: Bicarbonate \< 15 mol/L or venous pH \< 7.3
44
What are the signs and symptoms of DKA?
Osmotic related: Thirst, polyuria and dehydration Ketone body related: Flushed, vomiting, abdominal pain and tenderness, Breathless – Kussmaul’s respiration (may smell ketones on breath)
45
What is the management of DKA?
IV fluids, insulin and potassium therapy
46
Hyperglycaemic Hyperosmolar Syndrome (HHS)
Serious complication of diabetes, characterised by profound hyperglycaemia (\>33mmol/l), hyperosmolality (\>320), and volume depletion in the absence of significant ketoacidosis
47
What are the main differences between DKA and HHS?
48
Lactic acidosis
A form of metabolic acidosis due to the inadequate clearance of lactic acid from the blood, as a byproduct of anaerobic respiration
49
What are the 2 types of lactic acidosis?
Type A (Associated with tissue hypoxia - either from lack of perfusion or hyperaemia) and Type B (no tissue hypoxia, - associated with underlying conditions eg. Diabetes and drugs)
50
What are the clinical signs of lactic acidosis?
Hyperventilation, mental confusion or stupor/coma if severe
51
What are the lab findings of lactic acidosis?
Reduced bicarb, raised anion gap, possibly raised glucose, no ketonaemia
52
What are the main nutritional considerations for Type 1 Diabetes?
Consistency and timing of meals and CHO, timing on insulin and regular monitoring of blood glucose
53
What is the general rule on when to increase insulin to carb ration?
If BG level more than 2 mmol/l above pre meal level on 3 consecutive days
54
What 2 components are involved in Advanced Carb Counting?
Insulin to carbohydrate ratio (ICR) - how many insulin units to give per grams of carbohydrate and Insulin sensitivity factor (ISF)/Correction factor (CF) - number of units of insulin to give to correct a certain amount of blood glucose (eg. 1 unit to reduce by 3 mmol)
55
What are the main nutritional considerations for Type 2 Diabetes?
Weight loss, smaller meals and snacks, physical activity and monitoring blood glucose and medication
56
What is DAFNE and in which insulin regimes is it suitable?
Dose Adjustment for Normal Eating (advanced carb counting) - used with basal bolus insulin
57
Glycaemic index
Rank of rate at which food makes BG rise
58
What are the 2 main options for blood glucose monitoring?
Urine or blood testing for ketone (Self monitoring blood glucose - SMBG e.g. fingersticking) or Continuous glucose monitoring system (CGMS)
59
How does hypoglycaemia present?
Hunger, autonomic activation (pale, anxious, sweating, palpitations), tired/weak, nauseous and dizzy
60
What is the treatment for hypoglycaemia?
- 15-20 grams of glucose or simple carbohydrates (or 1mg Glucagon) - Recheck your blood glucose after 15 minutes, repeat if still hypo - small complex carb snack afterwards
61
What is Impaired Hypoglycaemia Awareness, and in who does it often occur?
When hypoglycaemia occurs (\<4.0 mmol/l) and individuals feel no or a change symptoms. Often occurs in those who: frequently have low blood glucose episodes, Long duration type 1 or 2 diabetes or Intensively-treated type 1 diabetes (low HbA1c
62
What is the UK criterion of hypoglycaemia?
4mmol/l (4 is the floor)
63
What are 2 conditions can be main contributors to hypoglycaemia risk? (basically for exams-box-ticking, rare in actual life)
Addison's (pigment in mouth) and Cushing's
64
Why is it retinal, nerve and vascular tissue that are primarily affected by hyperglycaemia?
Insulin normally regualtes the movement of glucose into cells, however these tissues are insulin-independent meaning they cant regulate the movement of glucose into them. Leading to retinopathy, neuropathy and nephropathy
65
What is the Poyol pathway and how does it cause damage in hyoerglycaemia?
* It is a pathway which is normally inactive and the glycolysis pathway is carried out instead, however it activates when there is excess glucose * Its enzyme aldose reductase converts glucose into sorbital (its alcohol sugar) * Sorbital exerts osmotic pressure on the cells as it is so large and this causes the cells to die
66
What tests are done at a diabetic review and what are they checking?
* HbA1c - *glucose control* * Blood pressure - *hypertension and vascular problems* * BMI * Creatinine in bloods - *check for renal failure* * Proteinuria - *check for nephropathy or hypertension* * Foot examination * Retinal screening
67
Why are diabetics more likely to have a higher blood pressure?
* Vasodilator effects of insulin are limited * Increased reabsorption at the kidneys caused by insulin may occur of there's is hyperinsulinaemia
68
What is the fundamental vascular complication that causes nephropathy, neuropathy and retinopathy?
Capillary microangiography - results in thickened, permeable and dilated blood vessels. Leads to microaneurysms and protein leakage
69
What tool is used for recording results of a diabetic foot examination?
SCI- DC
70

RW Endocrinology (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions