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Y3R5: Medicine I 🩺 > L1: Diabetes Mellitus > Flashcards

L1: Diabetes Mellitus Flashcards

1
Q

Tips in DM

A
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2
Q

Pathway of CHO in the body & its relation to insulin

A
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3
Q

Effects of Insulin (In Brief)

A
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4
Q

Effect of DM (In Brief)

A
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5
Q

Insulin & Anti-Insulin Hormones

A
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6
Q

Role of Incretins

A
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7
Q

HLA in DM

A
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8
Q

Def of DM

A
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9
Q

Classification of DM

A
  • Type 1 diabetes
  • Type 2 diabetes
  • Gestational DM
  • Other Specific Types of DM
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10
Q

Types of Type I DM

A

A : Immune mediated.
B : Idiopathic.

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11
Q

what are other types of DM?

A
  • Genetic defects of B-cell function.
  • Genetic defects in insulin action.
  • Exocrine pancreatic causes
  • Endocrinal causes
  • Infections
  • Drugs
  • Other genetic syndromes
  • Uncommon forms of immune mediated diabetes
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12
Q

what are secondary causes of DM?

A
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13
Q

Exocrine pancreatic causes of DM

A
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14
Q

Endocrinal causes of secondary DM

A
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15
Q

Infections causing DM

A
  • Congenital rubella.
  • Cytomegalovirus.
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16
Q

Drugs Causing DM

A

Interferon, Corticosteroids, CCP, Diuretics

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17
Q

what are Genetic Syndromes that may Cause DM?

A
  • Down’s syndrome.
  • Klinefelter syndrome.
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18
Q

Uncommon forms of immune mediated diabetes

A

Anti-insulin receptor Ab.

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19
Q

Characters of MODY type of DM

A

Mature Onset Diabetes in the Young:

  • Represent 15 % of cases.
  • Autosomal dominant.
  • In young obese people.
  • Treated by oral antidiabetics.
  • less liable for microangiopathy
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20
Q

what is LADA short for?

A

Late onset Autoimmune Diabetes of Adult

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21
Q

Pathaphysiology of DM I

A
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22
Q

….. is considered the major factor in the pathophysiology of type 1 DM.

A

Autoimmunity

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23
Q

Approximately 85% of type 1 DM patients have circulating ……. and the majority also has detectable …….. before receiving insulin therapy.

A
  • islet cell antibodies,
  • anti-insulin antibodies
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24
Q

The most commonly found islet cell antibodies are those directed against ……

A

glutamic acid decarboxylase (GAD), an enzyme found within pancreatic beta cells

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25
Q
  • Type 1 DM is the result of destruction of insulin secreting beta cells of the islets of Langerhans in the pancreas.
  • As beta-cell mass declines, insulin secretion decreases until the available insulin no longer is adequate to maintain normal blood glucose levels
A

..

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26
Q

Antibodies in Type I DM

A
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27
Q

Disease Stages in Type I DM

A
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28
Q

Paracrinopathy In DM

A
29
Q

After …….. of the beta cells are destroyed, hyperglycemia develops and diabetes may be diagnosed.

A

80-90%

30
Q

Patients need exogenous insulin to:

A

NPRD

1) Normalize lipid and protein metabolism.
2) Prevent ketosis.
3) Reverse this catabolic condition.
4) Decrease hyperglucagonemia.

31
Q

Etiology of Type I DM

A
32
Q

Type 1 DM results from ……

A

a. Autoimmune destruction of the beta cells of the pancreas

b. Genetic predisposition

c. Environmental component

33
Q

From 90% to 95% of young children with type 1 DM carry ……..

A
  • HLA-DR 3
    OR
  • HLA-DR 4.
34
Q

Carriage of both haplotypes (i.e. DR 3 / 4 heterozygotes) confers the ……. susceptibility.

A

Highest

35
Q

Extragenetic factors in DM I

A

Extra genetic factors may contribute Potential triggers for immunologically
mediated destruction of the beta cells include :

  • Viruses (e.g., enterovirus, mumps, rubella, and Coxsackie virus B4).
  • Toxic chemicals.
  • Exposure to cow’s milk in infancy.
  • Cytotoxins.
36
Q

Pathophysiology of DM II

A
37
Q

Type 2 diabetes is characterized by a combination of ……..

A

Type 2 diabetes is characterized by a combination of
- Peripheral insulin resistance.
- Inadequate insulin secretion by pancreatic beta cells

38
Q

For type 2 diabetes mellitus to occur, both insulin resistance and inadequate insulin secretion must exist.

A

For example, all overweight individuals have insulin resistance, but diabetes develops only in those who cannot increase insulin secretion sufficiently to compensate for their insulin resistance.

39
Q

what is IR Attributed to?

A

elevated levels of free fatty acids and pro inflammatory cytokines in plasma

40
Q

what does IR Lead to?

A
41
Q
  • In the progression from normal to abnormal glucose tolerance, ……… increase first.
  • Eventually, ……… develops as suppression of hepatic gluconeogenesis fails.
A
  • postprandial blood glucose levels
  • fasting hyperglycemia
42
Q
A

..

43
Q

Pathophysiology & Etiology of Type II DM (PPT)

A
44
Q

Natural History of Type II DM

A
45
Q

Sequence of PP Hyperglycemia & Fasting Hyperglycemia in Type II DM

A
46
Q

Etiology of Type II DM

A
47
Q

Major risk factors for type 2 DM

A
48
Q

CP of DM

A
  • Asymptomatic
  • Classic symptoms
  • Symptoms of complications
49
Q

Asymptomatic DM

A

in 1/3 of cases.

50
Q

Classic Symptoms of DM

A
51
Q

Complications of DM

A

Acute & Chronic

52
Q

Acute Complications of DM

A
  • Diabetic comas
  • Infections
  • Complication related to systems ( on top of atherosclerosis )
    1) Acute Myocardial Infarction ( painless )
    2) Cerebral Stroke & Acute neuropathy
    3) Acute Renal Failure
    4) Intermittent Claudication
53
Q

Chronic Complications of DM

A
54
Q

DDx of DM

A
55
Q

DDx of reducing substance in urine

A
56
Q

DDx of loss of weight inspite of good appetite

A
  • Malabsorption syndrome
  • Parasitic infestation
  • Thyrotoxicosis
57
Q

Compare Between Type I & II DM

A
58
Q

Investigations in DM

A

Investigations
- To Diagnose DM
- To Diagnose type of DM
- To monitor diabetic Complication
- To monitor diabetic patients

59
Q

Investigations to Diagnose DM

A
60
Q

Prognosis of IGT

A
  • 1/3 remain IGT
  • 1/3 develop frank DM
  • 1/3 return to normal plasma glucose
61
Q

Investiations to Diagnose type of DM

A
62
Q

Investigations To monitor diabetic Complication

A
  • Retinopathy: Fundus Exam.
  • Nephropathy : urine analysis for microalbuminuria
  • ECG
  • Lipid profile
63
Q

Investigations to monitor diabetic patients

A

Glycosylated proteins

64
Q

what are Examples of Glycosylated proteins?

A
  • HBA1C (3 Months)
  • Fructosamine (Glycosylated albumin) (3 Weeks)
65
Q

Target of Hb A1C in diabeteics

A

< 7 %

66
Q

How is Hb A1C Formed?

A

Formed due to non-enzymatic glycosylation of amino acid valine & lysine in β chain of HbA

67
Q

Uses of Hb A1C

A

It gives an estimate of diabetic control for the preceding 3 months.

68
Q

Factors interfering with measurement of A1C

A
69
Q

what is Fructosamine? and what is it used for?

A
  • Fructosamine ( glycosylated albumin)
  • It gives an estimate of diabetic control for the preceding 3 Weeks.

Y3R5: Medicine I 🩺 (47 decks)

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