What is Diabetes Flashcards
Diabetes Mellitus is characterised by
Hyperglycaemia
Hyperglycaemia symptoms (5)
Polydipsia Polyuria Blurred Vision Weight Loss Infections
Microvascular Complications of Hyperglycaemia
Retinopathy
Neuropathy
Nephropathy
Microvascular Complications of Hyperglycaemia
Stroke
MI
PVD
Diagnostic Glucose Levels (Venous Plasma) for Diabetes
Fasting >7mmol/l
Random >11.1mmol
Diagnostic Diabetes Glucose Levels for OGTT 2hr after 75g CHO
> 11.1mmol
Diagnostic Diabetes HbA1c
> 48mmol/mol
Intermediate Hyperglycaemia what is impaired fasting glucose result
6.1-7
Intermediate Hyperglycaemia HbA1c result
42-47
Criteria for Diagnosing Type 1 Diabetes
One Diagnostic Lab Glucose Plus Symptoms or Two Diagnostic Lab Glucose or HbA1c Levels without Symptoms
Symptoms of Type 1 Diabetes
Polydipsia Polyuria Blurred Vision Weight Loss Infection
What is HbA1c
Glycated Haemoglobin
Gives indication of blood glucose levels over last 8-12 weeks
Insulin dominates absorptive or fasting state
Absorptive State
Which hormone lowers blood glucose
Insulin
What does Insulin do in Adipose Tissue
Reduced Lipolysis
What does insulin do in liver
Reduces glucose production
What does insulin do in muscle
Increased glucose uptake
What is the risk of a child developing Type 1 diabetes if father has it?
6%
What is risk of child developing Type 1 Diabetes if mother has it
1%
What is risk of child developing Type 1 Diabetes if Sibling has it
8%
If both parents are type 1 diabetes what is risk of child getting it
30%
What is risk of monozygotic twins getting diabetes
30-50%
what is risk of non identical twin getting Type 1 diabetes
10%
Development of Type 1 Diabetes requires
Genetic pre disposition plus Trigger eg Viral Infection or Autoimmunity
Between a complete carb blow out and no food ingested what does blood glucose do normally
maintained over fairly tight range normally
Insulin dominates which state
Absorptive
What is the only hormone which lowers blood glucose
insulin
In Type 1 and 2 diabetes what does decreased insulin do to adipose tissue
increased lipolysis
In Type 1 and 2 diabetes what does decreased insulin do to liver
raised glucose production
In Type 1 and 2 diabetes what does decreased insulin do to muscle
reduced glucose uptake
Clinical presentation of Type 1 Diabetes symptoms
Short duration of
- Thirst
- Tired
- Polyuria/Nocturia
- Weight Loss
- Blurred Vision
- Abdominal Pain
Examination of Type 1 Diabetes signs
Ketones on Breath Dehydration Increased Resp Rate Tachycardia Hypotension Low Grade Thrush Balantitis
Which type of Diabetes is more common
Type 2
Risk of developing type 2 diabetes identical twin
90-100%
Risk of developing type 2 diabetes non identical twin
10%
Risk of developing type 2 diabetes one parent
15%
Risk of developing type 2 diabetes both parents
75%
Risk of developing type 2 diabetes sibling
10%
Type 2 Diabetes may have what in terms of symptoms
None or Typical Diabetes Symptoms
Type 2 Diabetes Signs
Not Ketotic
Usually Overweight
Low Grade Infections
Microvascular or Microvascular Complications
Risk Factors for Type 2 Diabetes
Overweight Fam History Over 30 if Maoiri/Asian/Pacific Island Over 40 if European Previous Gestational Diabetes Big Baby (more than 4g) Inactive Previous High BG/Impaired Glucose Tolerance
Maturity Onset Diabetes in Young Features (3)
Autosomal Dominant
Impaired beta cell function
Single gene defect
Glucokinase Mutations in Maturity Onset Diabetes in Young onset is at and features (4)
Birth with Stable Hyperglycaemia
Treat by Diet
Complications Rare
Transcription Factor Mutations in Maturity Onset Diabetes in Young onset is at and features (4)
Adolescence/Young Adult
Progressive Hyperglycaemia
Treat 1/3 Diet, 1/3 OHA, 1/3 Insulin
Complications Frequent
Secondary Diabetes Mellitus causes (8)
Drug therapy eg corticosteroids Haemochromatosis: excess iron cystic fibrosis chronic pancreatitis pancreactomy DIDMOAD Endocrine eg Cushings, Acromegaly, Phaeochromocytoma
What is gestational diabetes
Increasing Insulin resistance in pregnancy
Gestational Diabetes increases risk of
Type 2 Diabetes later in live
When does gestational diabetes occur
2nd/3rd trimester
what neonatal problems can happen due to gestational diabetes
Macrosomia
Resp DIstress
Neonatal Hypoglycaemia