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Diabetes & Endocrinology > What is diabetes mellitus? > Flashcards

What is diabetes mellitus? Flashcards

1
Q

Define diabetes mellitus

A

a group of metabolic diseases of multiple aetiologies characterised by hyperglycaemia together with disturbances of CHO, fat and protein metabolism resulting from defects in insulin secretion, insulin action or both

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2
Q

Symptoms of hyperglycaemia

A

thirsty, tired, polyuria, blurred vision, weight loss, infection

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3
Q

Polydipsia

A

excessive thirst

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4
Q

2 metabolic decompensations of DM and are these more common in type 1 or type 2?

A

DKA
HHS
type 1

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5
Q

long term microvascular complications of DM

A

retinopathy
neuropathy
nephropathy

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6
Q

Long term macrovascular complications of DM

A

stroke
MI
PVD

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7
Q

What can we measure to diagnose diabetes?

A

blood glucose

HbA1c

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8
Q

What bodily fluid is used to measure diagnostic blood glucose levels?

A

venous plasma

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9
Q

Numbers for diagnosis of diabetes

A

blood glucose fasting >7mM, random > 11.1mM
OGTT 2h after 75g CHO >11.1mM
HbA1c > 48 mM

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10
Q

What is the diagnostic criteria for gestational diabetes?

A

different

not universally agreed

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11
Q

How are diagnostic diabetes criteria numbers picked?

A

microvascular and CV complications

increased premature mortality

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12
Q

How are intermediate hyperglycaemia numbers picked?

A

higher risk of future diabetes and adverse outcomes eg CVD

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13
Q

diagnosing diabetes - how many tests?

A

1 diagnostic lab glucose with symptoms

2 diagnostic lab glucose or HbA1c with no symptoms

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14
Q

What is HbA1c and what does it tell us?

A

glycated haemoglobin
indication of blood glucose levels over last 8-12 weeks
not accurate with acute changes

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15
Q

List some reasons why HbA1c cannot be used

A 
all children and young people 
pregnancy - current or recent <2 months
short duration of diabetes symptoms 
HIV 
pancreatic or renal disease 
patients on glucose rising medications eg CCS
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16
Q

Type 1 DM results of insulin deficiency

A

increased lipolysis
raised glucose from liver
reduced muscle glucose uptake
hyperglycaemia and DKA

17
Q

Clinical presentation of type 1 DM symptoms

A

short duration of thirst, tiredness, polyuria/nocturia, blurred vision, weight loss and abdominal pain

18
Q

Clinical presentation of type 1 DM on examination

A

ketones on breath
dehydration
low grade infections
increased resp rate, tachycardia, hypotension

19
Q

Is type 1 or type 2 DM more genetically determined?

A

type 2

20
Q

Effect of insulin insufficiency in type 2 DM

A

altered lipolysis
increased glucose from liver
decrease muscle glucose uptake

21
Q

Symptoms of type 2 DM

A

may have none
complications eg CVD
thirst, tired, weight loss, blurred vision, polyuria

22
Q

Signs of type 2 DM

A

not ketotic
overweight
low grade infection
micro/macro vascular complications

23
Q

risk factors for type 2 DM

A 
overweight 
FH 
>30 Asian, >40 European 
inactive 
gestational diabetes, big baby
previous high glucose
24
Q

Name 3 other types of diabetes (other)

A

gestational
recognised genetic syndromes eg MODY
secondary diabetes

25
Q

Pattern of inheritance for MODY

A

autosomal dominant

single gene defect

26
Q

What is very important in MODY history?

A

Family history - genetic testing

27
Q

2 types of MODY

A

glucokinase mutations

transcription factor mutations

28
Q

Glucokinase mutations

A

onset at birth and stable hyperglycaemia

diet treatment and complications rare

29
Q

Transcription factor mutations

A

adolescence/young adult
progressive hyperglycaemia with complications common
1/3 diet, 1/3 OHA, 1/3 insulin

30
Q

List some causes of secondary diabetes

A

CCS
pancreatic destruction eg CF, pancreactectoy, pancreatitis
rare endocrine disorders eg acromegaly
recognised genetic syndromes eg DIDMOAD

31
Q

When does gestational diabetes come on and what are the consequences?

A

2nd/3rd trimester

future risk of type 2 DM

32
Q

What is gestational diabetes linked with?

A

FH of type 2 DM

33
Q

Neonatal problems with type 2 DM

A

hypoglycaemia, macrosomia, respiratory distress

34
Q

Macrosomia

A

baby born bigger than expected eg big baby

Diabetes & Endocrinology (24 decks)

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