L1 diab

Question 1

LO1: what is DM.

Answer 1

• when blood gluc too high and over time leads to dam bv’s= prem death from cardiovasc dis. tox to endoth, incr dfatt deposits. can=block or haemorr.
• 10% nhs budget. 1 in 4 dev kidney dis. lead cause blind in working age. lower limb amputat. 15% life risk amputat. 70% feath due to cardiovasc dis eg cad/stroke. le reduc 5-10yr.

Question 2

LO2: why its imp chronic cond.

Answer 2

• lt conds eg obesity, diab, htn, cvd. poss prev or delayed lifest change eg diet and exercise. lifest rel dis incr, 2020 75% deaths from chronic dis.

Question 3

LO3: why diab devs.

Answer 3

• gluc in blodd from food. main energ source.
• bg incr= sig to panc, beta islet cells rel insulin.
• insulin binds cell R, allow gluc in, most used immed.
• bg rise due to beta cell fail T1 OR inadeq insulin/insulin resis linked to obesity us. cent obesity=abnorm fat metab=incr free fa interf with rel insulin and R. T2 us elem of both.

Question 4

LO4: why lifest imp.

Answer 4

• obesity 90% T2 overweight.
• exercise
• diet

Question 5

LO5: diff btw t1 and t2.

Answer 5

• T1 autoimm beta cell destruc. less comm, 10%. aB ag beta cells. us genet predisp- alleles of HLA-DQB1 an mhcii.
• T2 panc not prod enough insulin OR R resis due to block ag eg free fa.

Question 6

LO6: presentat of t1 and 2.

Answer 6

• T1 rap onset weight loss. polyuria. polydipsea. if late present may be vom due to ketoacidosis. pt us less than 30yo. v high bm.
• often asymp. most over 40yo. genet predisp. some ev inv imm sys. at diag 50% beta cells. cent obesity. var symp as slower incr bg. polyuria, dipsea, weight loss. decr energ. persis infec eg thrush/feet. slow heal. vis probs.

Question 7

LO7: princips of managem.

Answer 7

• T1. exog insulin. subcut injec sev times/day. now pumps with gluc sensors. amnt req varies.
• T2 often managed by diet and tabs stim beta rel or reduc resis. often insulin event as beta fail. pt educ and abil monit therapy results. look at other vasc riask facs eg bp, lips, smoking, exercise, diet. surv for chronic complics.

Question 8

LO8: complics.

Answer 8

• acute for hyperglycaemia- eg not take insulin. metab decomp. ketoacidosis in T1. hyperosmolar non ketotic synd in T2.
  acutee hypo- eg by hypo therapy. coma.
• chronic- macrovasc or large vess dis, narr. cerebrovasc, CV, periph vasc dis. stroke, MI, intermitt claudicat lack blood to leg musc, gangrene. microvasc or capill dis ie leak. retinopathy, neuropathy, nephropathy ie sclerosis. blind, need renl repl, erectile dysfunc, foot ulccer, diarr, constip, pain periph neuropathy.