Glucose and diabetes mellitus

Question 1

hypoglycemia

Answer 1

too little available glucose

Question 2

hyperglycemia

Answer 2

too much glucose in the bloodstream

Question 3

insulin

Answer 3

lowers blood glucose by promoting its storage and conversion to glycogen

Question 4

stress hormones

Answer 4

increase the blood glucose level

in conjunction with growth hormone

Question 5

Type 1 Diabetes

Answer 5

result of pancreatic beta cell distruction and is prone to ketoacidosis
includes Latent Autoimmune Diabetes in Adults (LADA)

Question 6

Type II diabetes

Answer 6

insulin resistance w/ relative insulin deficiency or predominant secretory defect w/ insulin resistance
can be ar esult of metabolic syndrome

Question 7

metabolic syndrome

Answer 7

abdominal obesity, hypertension, dyslipidemia, insulin resistance, dysglycemia

Question 8

treatment for metabolic syndrome

Answer 8

treat hyperglycemia and underlying cardiovascular risk factors

Question 9

Symptoms of diabetes

Answer 9

Polyuria
Polydipsia
Unexplained weight loss

Question 10

Normal fasting blood glucose level

Answer 10

4.5-6.1 mmol/L

Question 11

Hexokinase

Answer 11

involved in converting glucose to glucose-6phosphate

measured photometrically

Question 12

Glucose oxidase

Answer 12

involved in measuring glucose
hydrogen peroxide released can be broken down to O2 and measured by an oxygen sensitive electrode
reduced by peroxidase and measured spectrophotometrically

Question 13

Glucose dehydrogenase

Answer 13

involved in measuring glucose

measure reduction of NAD+ to NADH spectrophotometrically

Question 14

Oral glucose tolerance test (OGTT)

Answer 14

Fast overnight
drink 75g glucose
blood glucose is measured before, 1 hour after and 2 hours after
an exaggerated rise in blood glucose occurs in patients with insulin-dependent diabetes mellitus (IDDM)

Question 15

Diagnosis of diabetes

Answer 15

fasting plasma glucose > 7.0 mmol/L
random plasma glucose > 11.1 mmol/L
plasma glucose >11.1 mmol/L at 2 hours after OGTT
hemoglobin A l c >6.5% in adults

Question 16

HbA1c test

Answer 16

gives insihgt into the average blood glucose leve over approximately the past 2-3 months as they have a lifespan of 120 days
exempt: hemoglobinopathies
blood glucose undergoes a non enzymatic glycation reaction with hemoglobin A –> hbA1c

Question 17

Fructosamine test

Answer 17

albumin turnover is much faster than hemoglobin turnover
gives an estimate of avg. blood glucose over 4 wks
albumin is also glycated by glucose to become fructosamine

Question 18

Point of care (POC ) glucose test

Answer 18

finger prick

Question 19

Urine screening

Answer 19

glucose is filtered through the glomerulus and passes into the ultrafiltrate where it is reabsorbed
the reabsorptino capacity of the kidney is 8-9 mmol/L
if glucose is at a level greater than 9 mmol/L it spills into urine

Question 20

Long term compications

Answer 20

result of glycation
Microvascular complications: nephropathy, retinopathy, peripheral neuropathy, erectile dysfunction
Macrovascular: cardiovascular disease

Question 21

Urinary Microalbumin and Estimated Glomerular Filtration Rate (eGFR) tests

Answer 21

renal damage allows small trace amounts of albumin “microalbumin” to leak into the urine –> proteinuria

Question 22

Type 2 DM treatment

Answer 22

diet, exercise, oral hypoglycemic agents, insulin, symptomatic treatment of complications

Question 23

Type 1 DM treatment

Answer 23

insulin, artificial pancreas, symptomatic treatment of complications