What is diabetes?

Question 1

Why does diabetes develop?

Answer 1

Insufficient insulin to maintain glucose homeostasis

Failure of insulin synthesis, release or activity

Question 2

Is Type 1 DM due to absolute insulin deficiency or relative insulin deficiency?

Answer 2

Absolute insulin deficiency

Question 3

Is Type 2 DM due to absolute insulin deficiency or relative insulin deficiency?

Answer 3

Relative insulin deficiency

Question 4

What is diabetes mellitus a group of?

Answer 4

A group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.

Question 5

What four criteria may diabetes be diagnosed on? (4)

Answer 5

HbA1c
Fasting glucose
2-hour glucose in Oral Glucose Tolerance Test
Random gucose

(a repeat confirmatory test is required in most cases)

Question 6

What levels of HbA1c = diabetes?

Answer 6

48mmol/mol and above

Question 7

What levels of HbA1c = “impaired” or “pre-diabetes”?

Answer 7

42-47mmol/mol

Question 8

What levels of HbA1c = normal?

Answer 8

41mmol/mol and under

Question 9

What levels of fasting glucose = diabetes?

Answer 9

7.0 mmol/L and above

Question 10

What levels of fasting glucose = “impaired! or “pre-diabetes”?

Answer 10

6.1-6.9 mmol/L

Question 11

What levels of fasting glucose = normal?

Answer 11

6.0mmol/L and below (according to WHO guidelines)

Question 12

What levels of 2-hr glucose in OGTT = diabetes?

Answer 12

11.1mmol/L and above

Question 13

What levels of 2-hr glucose in OGTT = “impaired” or “pre-diabetes”?

Answer 13

7.8-11.0mmol/L

Question 14

What levels of 2-hr glucose in OGTT = normal?

Answer 14

7.7mmol/L and below

Question 15

What levels of random glucose = diabetes?

Answer 15

11.1mmol/L and above

Question 16

What does WHO say T1DM is?

Answer 16

pancreatic beta cell destruction /

insulin is required for survival… usually characterised by the presence of anti-GAD/ anti-islet cell antibodies….

Question 17

Pathogenesis of T1DM:

Answer 17

Cell failure

Absolute insulin deficiency

Question 18

Pathogenesis of T2DM:

Answer 18

Hyperinsulinaemia + insulin resistance

Question 19

Clinical presentation of T1DM:

Answer 19

pre-school and pre-puberty
small peak in late 30s
usually lean
ACUTE onset
severe symptoms
severe weight loss
ketonuria (with or without metabolic acidosis)
no evidence of microvascular disease at diagnosis
immediate and permanent requirement for insulin