Session 1 Flashcards
What are the main differences between Type 1 and Type 2 diabetes?
- Type 1: cannot produce insulin due to beta cell failure (autoimmune attack which destroys beta cells); normally in younger people (below 30); rapid onset; in late presentation vomiting may occur because of ketoacidosis; have high glucose and ketones in urine and no insulin; treatment - inject insulin
- Type 2: insulin resistance - insulin is produced but the tissues are resistant (linked to obesity) (Type 2 later can have reduced beta cell function - insulin deficiency); many asymptomatic - picked up at routine health checks; older, overweight/obese patients; high glucose in blood/urine, no urinary ketones; treat with diet, exercise, drugs (eg a-glucosidase inhibitors and SGLT2s) and later insulin
Describe Diabetes
The blood glucose is too high (hyperglycaemia) which leads to the damage of small and large blood vessels, causing premature death from cardiovascular diseases
What is the typical triad of symptoms for diabetes?
- Polydipsia
- Polyuria
- Weight loss
What other symptoms is presented with diabetes mellitus?
- Blurring of vision
- Urogenital infections eg thrush
- Tiredness
- Weakness
- Lethargy
(Due to inadequate energy utilisation)
What tests are used to diagnose diabetes?
- Fasting glucose
- Oral glucose tolerance test
- HbA1c
What are some acute complications of diabetes?
- Hyperglycaemia: type 1- diabetic ketoacidosis
type 2 - hyperosmolar non-ketotic syndrome - Hypoglycaemia: coma
Give some examples of chronic complications of diabetes
- Macrovascular (eg cerebrovascular, cardiovascular, peripheral vascular): stroke, heart attack, intermittent claudication (cramping pain), gangrene
- Microvascular: retinopathy (blindness), nephropathy, neuropathy (foot ulceration)
What is the normal level of glucose in the fasting blood plasma?
- 5 mmol/L
What is the normal level of amino acids in fasting blood plasma?
- 2 mmol/L
What is the normal level of triacylglyerides in fasting blood plasma?
- 2 mmol/L
What is the normal level of cholesterol in the fasting blood plasma?
- 5 mmol/L
What is the normal level of fatty acids in fasting blood plasma?
- 0.5 mmol/L
What is the normal level of lactate and pyruvate in the fasting blood plasma?
- <1 mmol/L
What is the normal levels of bicarbonate and CO2 in the fasting blood plasma?
- 27 mmol/L
What is the normal level of urea in the fasting blood plasma?
- 5 mmol/L
What is the normal level of ammonium in the fasting blood plasma?
- 0.025 mmol/L
What is the body composition of a 70kg male?
- Carbohydrate: 1%
- Lipid: 16%
- Protein: 16%
What is the body composition of a 55kg female?
- Carbohydrate: 1%
- Lipid: 25%
- Protein: 15%
What is the normal dietary intake?
- Carbohydrate: 15%
- Lipid: 8%
- Protein: 5%
What is energy used for?
- Transport work across cell membranes
- Electrical work
- Mechanical work
- Biosynthetic work
- Osmotic work
(TEMBO)
What is the daily energy expenditure used for?
- Basal metabolic rate (BMR)
- Voluntary physical activity
- Diet-induced thermogenesis
How is BMI calculated?
- BMI = Weight (kg)/height (m)2
Define obesity
- The accumulation of excess body fat with a BMI above 30 that has an adverse effect of health and leads to reduced life expectancy and/or increased health problems
Define homeostasis
- A dynamic equilibrium that maintains a stable internal environment
