Investigations

Question 1

What are the abnormal values for HbA1c?

Answer 1

Diagnosed DM = > 48mmol/mol

NDH = 42-47mmol/mol

Question 2

How do you measure abdominal circumference?

Answer 2

Placed directly on the skin, between the bottom of the ribs and top of the hip bone.
Reducing abdominal obesity improves insulin sensitivity.

Question 3

What type of obesity has the biggest effect?

Answer 3

Visceral

Question 4

Which ethnicity is most at risk of developing diabetes?

Answer 4

Black African and Caribbean backgrounds are 3x more likely to develop T2D.
South Asian heritage are 6x more likely.

Question 5

What are the typical presenting test results for DKA?

Answer 5

• Acidaemia - pH <7.3 or HCO3 <15mmol/l
• Hyperglycaemia- blood glu >11mmol/l or known DM
• Ketonaemia >3mmol/l or significant ketonuria (> 2+ on urine stick)

Question 6

What investigations would be done for DKA?

Answer 6

• Blood test - U+E, FBC, CRP, HbA1c (low Na, K)
• Urine dip/MSU - ketones, glucose
• ABG - metabolic acidosis