Uro/Endo week: Diabetes

Question 1

Main hallmark of diabetes

Answer 1

Hyperglycaemia

Question 2

Definition of Type 1 and 2 diabetes

Answer 2

Type 1: primary insulin deficiency

Type 2: insulin resistance, subsequent beta cell failure

Question 3

What test to do to diagnose diabetes.

Significant value that indicates diabetes

Answer 3

HbA1C test

> 48mmol/mol means diabetes mellitus

Question 4

Difference between type 1 and 2 diabetes in terms of

• age of onset
• abrupt/gradual onset of symptoms
• ketosis
• presence of complications at diagnosis
• country epidemiology

Answer 4

Type 1:

• young onset
• abrupt onset of symptoms
• prone to ketosis (sweet smelling breath)
• complications absent at diagnosis
• more common in North Europeans

Type 2:

• middle/late age onset
• progressive onset of symptoms
• ketosis resistant
• complications present at diagnosis
• more common in Asia, Africa

Question 5

Which gene complexes are type 1 diabetes linked to

Answer 5

HLA-DR3 or HLA-DR4

Question 6

How sulfonylureas work

Example

Answer 6

stimulates insulin release from pancreatic beta cells

eg gliclazide

Question 7

How biguanides work

Example

Answer 7

reduces hepatic glucose production, decreases insulin resistance

eg metformin

Question 8

How meglitinides work

Example

Answer 8

stimulates insulin release from pancreatic beta cells

eg repaglinide

Question 9

How thiazolidinediones (TZDs work

Example

Answer 9

insulin-sensitising agent

eg pioglitazone

Question 10

How alpha-glucosidase inhibitors work

Example

Answer 10

delays carbohydrates digestion to decrease post-meal glucose peak
(no effect on insulin)

eg acarbose

Question 11

Microvascular diabetic complications

Answer 11

• retinopathy
• nephropathy
• neuropathy, peripheral vascular disease

Question 12

Macrovascular diabetic complications

Answer 12

atherosclerosis leading to stroke, IHD, PVD

Question 13

What must be controlled to improve microvascular complications

Answer 13

blood glucose

Question 14

What types of treatment may cause hypoglycaemia

Answer 14

• insulin

- sulfonylurea

Question 15

2 Complications of insulin therapy

Answer 15

• hypoglycaemia

- lipohypertrophy at injection site

Question 16

Symptoms of hyperglycaemia

Answer 16

o	Extreme thirst, hunger
o	Excess urination
o	Dry mouth
o	Blurred vision
o	Drowsiness
o	Headache

Question 17

Risk factors for diabetic foot ulcer formation

Answer 17

• Diabetic neuropathy
• Structural foot deformity  excessive plantar pressure
• Peripheral arterial occlusion disease

Question 18

Which diabetics get ketoacidosis?

Why?

Answer 18

T1DM

Ketogenesis is inhibited by even tiny amounts of insulin