L14: Diabetes Diagnosis And Management

Question 1

What is diabetes

Answer 1

A state of altered glucose haemostasis that leads to hypeglycaemia (high glucose) when left untreated and results in micro and macro vascular damage

Question 2

What is the oral glucose tolerance test

Answer 2

1. You give patient a milk to drink
2. Wait for 2 hours
3. Take glucose

Question 3

What happens in a normal glucose tolerance test

Answer 3

Blood glucose rises and then falls

Question 4

What happens to the oral glucose tolerance test in diabetes

Answer 4

Blood glucose is significantly above the threshol and stays high

Question 5

What is the renal threshold

Answer 5

When the glucose can become detected in the urine

Question 6

What is type 1 diabetes

Answer 6

1. An autoimmune condition when the beta cell in the pancreas are destoryed so they cannot release insulin
2. Insulin cant convert glucose to glycogen to become stored in the liver
3. There is high blood sugar as a result

Question 7

What symptoms does type 1 diabetes present with

Answer 7

Thirst
Polyuria
Weight loss
Blurred vision

Question 8

What is type 1 diabetes

Answer 8

When there is insulin but the body stops reacting to insulin so glucose cant be converted to glycogen to become stored

Question 9

If a type 1 diabetic patient is symptomatic what test can be diagnostic

Answer 9

Random plasma glucose more than 11.1mmol/l

Question 10

If a patient with type 2 diabetes is asymptomatic wgat is the diagnostic test we can carry out to diagnose

Answer 10

Fasting blood glucose above 7
Or 
2hour post oral glucpse tolerance test more than 11.1
Or 
Hba1c greater than 48mmol/mol

Question 11

What are the antibodies used in type 1 diabetes for diagnosis

Answer 11

Islet cell antibodies

Anitbodies to glutamic acid decarboxylase

Question 12

In which type of diabetes is ketones likelt to be present

Answer 12

Type 1

Question 13

How can we monitor diabetes

Answer 13

Capillary blood glucose testing
Urine testing
Hb1ac
Frucosamine

Question 14

Why is urine testing not reliable

Answer 14

If there is renal glycosuria then the renal threshold for glucose is lower therefore there can be glucose in the urine when infact the patient has normal glycaemia

Question 15

What is hb1ac

Answer 15

This is the glucose bound to the haemoglobin molcule non enzymeattically

Question 16

What pharmacological therapy is used in diabetes

Answer 16

Aspiring for secondary prevention
Inuslin with/without metformin in type 1
Oral hyperglycaemic agents in type 2 before progressing to inuslin
Blood pressure using anti hypertensives
Lipid management
Eye screening
Foot care

Question 17

What is the first line treatment for type 2 diabates

Answer 17

Metformin

Question 18

What is the first line treatment in type 1

Answer 18

Insulin

Question 19

How do we monitor patients

Answer 19

By doing 3 monthy hb1ac

Question 20

What agent is given to type 2 paitents before insulin

Answer 20

oral hypoglycaemic agents

Question 21

Who has to monitor with a capillary blood glucose test

Answer 21

All type 1 diabetes patients
And
Type 2 patients on insulin

Question 22

What are the ways in which insulin can be administered (regimes)

Answer 22

Once daily or twice daily basal insulin- intermediate or long acting insulin
Once or twice daily pre mixed insulin
Pre meal rapid acting insulin with once daily basal insulin
Mealtime rapid acting insulin only- only in gestational diabetes

Question 23

What are the types of insulin classed into

Answer 23

The duration of action

Question 24

What are the types of insulin

Answer 24

Rapid acting insulin
Short acting insulin
Intermediate acting insulin
Long acting insulin

Question 25

How do we administer insulin

Answer 25

Into the subcutaneous tissue

Question 26

What is it important to do when administering insulin

Answer 26

To rotate the sites to prevent lipodystrophy

Question 27

What are the new interventions for administering insulin

Answer 27

Insulin pumps