What is diabetes? Flashcards
Why does diabetes develop?
Insufficient insulin to maintain glucose homeostasis
Failure of insulin synthesis, release or activity
Is Type 1 DM due to absolute insulin deficiency or relative insulin deficiency?
Absolute insulin deficiency
Is Type 2 DM due to absolute insulin deficiency or relative insulin deficiency?
Relative insulin deficiency
What is diabetes mellitus a group of?
A group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.
What four criteria may diabetes be diagnosed on? (4)
HbA1c
Fasting glucose
2-hour glucose in Oral Glucose Tolerance Test
Random gucose
(a repeat confirmatory test is required in most cases)
What levels of HbA1c = diabetes?
48mmol/mol and above
What levels of HbA1c = “impaired” or “pre-diabetes”?
42-47mmol/mol
What levels of HbA1c = normal?
41mmol/mol and under
What levels of fasting glucose = diabetes?
7.0 mmol/L and above
What levels of fasting glucose = “impaired! or “pre-diabetes”?
6.1-6.9 mmol/L
What levels of fasting glucose = normal?
6.0mmol/L and below (according to WHO guidelines)
What levels of 2-hr glucose in OGTT = diabetes?
11.1mmol/L and above
What levels of 2-hr glucose in OGTT = “impaired” or “pre-diabetes”?
7.8-11.0mmol/L
What levels of 2-hr glucose in OGTT = normal?
7.7mmol/L and below
What levels of random glucose = diabetes?
11.1mmol/L and above
What does WHO say T1DM is?
pancreatic beta cell destruction /
insulin is required for survival… usually characterised by the presence of anti-GAD/ anti-islet cell antibodies….
Pathogenesis of T1DM:
Cell failure
Absolute insulin deficiency
Pathogenesis of T2DM:
Hyperinsulinaemia + insulin resistance
Clinical presentation of T1DM:
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
