Pathophysiology of diabetes Flashcards
What is diabetes?
A disease characterised by hyperglycaemia caused by either lack of insulin or a reduction in the effectiveness of insulin.
What are the types of diabetes?
Type 1 and type 2
Gestational diabetes - develops in pregnancy
diabetes secondary to other situations such as pancreatitis or pancreatic cancer.
What is type 1 diabetes?
A form of diabetes mellitus that results from autoimmune destruction of insulin producing beta cells in pancreas. Results in complete lack of insulin, cells cannot take up glucose in blood.
What is type 2 diabetes?
Body becomes resistant to effects of insulin as well as a relative lack of insulin.
What are the risk factors for type 2 diabetes?
- obesity and inactivity
- family history
- ethnicity
- history of gestational diabetes
- poor dietary habits
What are some symptoms of type 1 diabetes?
- polyuria (production of lots of dilute urine)
- polydispia (excessive thirst)
- weight loss
- increased appetite
- excessive tiredness
What symptoms are more likely in patients with type 2 diabetes?
- infections
- poor wound healing
- blurred vision
What are the short-term blood glucose levels of type 1 diabetes fasted and 90 minutes after food?
fasted - 4-7 (preferably 5-7)
90 minutes after food - 5-9
What are the short-term blood glucose levels of type 2 diabetes fasted and 90 minutes after food?
fasted 4-7
90 minutes after food <8.5
what are the normal, pre-diabetes, and diabetes long-term measurements of HBA1C?
normal - 42mmol/mol (6%)
pre-diabetes - 42-48mmol/mol(6-6.4%)
diabetes - >48mmol/mol (>6.5%)
How is type 1 diabetes diagnosed?
Diagnosed in patient’s presenting with hyperglycaemia (random plasma glucose more than 11mmol/L)_ and the symptoms related to type 1 diabetes
How is type 2 diabetes diagnosed?
Usually diagnosed by HbA1c of 48mmol/mol or more. Can also be diagnosed by a fasting plasma glucose of 7.0mmol/L or more.
What is the most common method for checking blood glucose levels?
The finger prick test is the most common and accurate for use in healthcare setting. Requires patient to prick the skin every time they want to check their levels. Newer technology allows for reduction in this as a small sensor is attached to the body which can be linked to a smartphone or other device to allow for easier testing
What are some complications of diabetes?
- hypoglycaemia
- hyperglycaemia and diabetic ketoacidosis
- mascrovascular complications
- microvascular complications
What is hypoglycaemia?
Blood glucose less than 4mmol/L due to excessive breakdown of blood glucose. More common in type 1.
What are some symptoms of hypoglycaemia?
- shakiness
- nervousness or anxiety
- sweating, chills and clamminess
- irritability or impatience
- confusion
- palpitations
- dizziness
- blurred vision
- hunger and nausea
What are the causes of hypoglycaemia?
- medication
- too much exercise
- not enough food
What is the treatment for hypoglycaemia?
- food or drink containing sugar
- long-acting ‘starchy’ carbohydrate food
- injection of glucagon
- IV glucose infusion
What is hyperglycaemia?
Blood glucose levels over 8-9mmol/L.
What are the symptoms of hyperglycaemia?
- blurry vision
- difficulty concentratin
- frequent urination
- headaches
- fatigue
- high blood glucose
What are the causes of hyperglycaemia?
- stress
- illness
- eating too much
- lack of exercise
- dehydration
- missing doses of diabetes medication
What is diabetic ketoacidosis?
It is a result of severe hyperglycaemia. When cells can’t use glucose for energy, they start to metabolise fat to fatty acids. The liver converts fatty acids into acid ketones.
What are symptoms of DKA?
vomiting, thirst, dehydration, weakness, sweet smelling breath, collapse and coma
What is the treatment for DKA?
- IV fluids to treat dehydration
- IV insulin to treat hyperglycaemia
