Week 5: Endocrine Flashcards
Impaired fasting glucose
6.1-6.9
impaired glucose tolerance
7.8-11.0
Prediabetes
HbA1c 42-47
WHO diabetes
Signs + symptoms with: FPG 7.0+ OGTT 11.1+ HbA1c 48+ Random 11.1+
Normal glucose
FPG <6.0
OGTT <7.8
HbA1C<42
T1D aims for glucose
4-8mmol/L
Freestyle libra criteria
Prick 8x/day Previous private succes with flash (Hba1C) Reduced hypo awareness Pregnancy Disability that impairs testing CF related diabetes on insulin insulin dependent on haemodialysis work impairs finger prick emotional/social factors CI prick
Lipohypertrophy in diabetes
sores on fingers due to repeated finger pricks - sore/unsightly
DVLA and diabetes
inform if on insulin or hypoglycaemic inducing meds (or have reduced hypo awarenss). Taxi driver/HVG drivers need annual medicals
Diabulaemia
reduced insulin admin to avoid gaining weight
Can’t have HbA1C
Recent onset (<2 months), children, pregnancy, or in recent glucose raise (infection/steroids)
HbA1C impaced in
haemolytic anaemia, sickle cell, recent transfusion, liver disease, CKD4/5, ID anaemia, macrocytic anaemia.
Alternative is fructosamine assay for monitoring (but not diagnosis)
Secondary causes of diabetes
Pancreatic disease
Endocrinopathies (acromegaly, cushings, pheochromocytoma)
Drug induced (glucocorticoids, thiazides, beta blockers)
Infections (congenital rubella, CMV, mumps)
Gsestational DM
Glucose transporters
GLUT 2 allows beta cells to sense glucose
GLUT 4 is involved in insulin mediated uptake in skeletal muscle
Ketoacidosis
Hyperglycaemia in acidosis and ketosis. Common in first diagnosis, infection or poor insulin control (but MI can precipitate).
Hyperglycaemia gives polyuria and polydipsia (predisposes to AKI and electrolyte
