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Year 2- Endocrine System > What is Diabetes Mellitus? > Flashcards

What is Diabetes Mellitus? Flashcards

1
Q

What are some of the characteristics of diabetes mellitus?

A

Hyperglycaemia
Defects in insulin secretion, insulin action, or bothq

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2
Q

RECAP- name the only hormone which lowers BG

A

Insulin

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3
Q

How does insulin lower BG levels?

A

Insulin switches off hepatic glucose output
Increases the insulin uptake of fat and muscle cells

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4
Q

What role does insulin have in adipose tissue?

A

Reduces lipolysis

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5
Q

What role does insulin have in muscle tissue?

A

Increases glucose uptake

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6
Q

List some of the symptoms of hyperglycaemia.

A

Polydipsia, polyuria, blurred vision, weight loss, infections

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7
Q

What are some of the microvascular long term complications of hyperglycaemia?

A

Retinopathy
Neuropathy
Nephropathy

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8
Q

What are some of the macrovascular long term complications of hyperglycaemia?

A

Stroke
MI
PVD- peripheral vascular disease

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9
Q

What is used to diagnose diabetes?

A

Measuring blood glucose or HbA1c

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10
Q

If taking a fasting glucose level, what level is diagnostic of diabetes?

A

> 7.0mmol/l

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11
Q

If taking a random glucose level, what level is diagnostic of diabetes?

A

> 11.1mmol/l

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12
Q

If taking an Oral Glucose Tolerance Test, what level is diagnostic of diabetes taken 2hrs after 75g carbohydrate?

A

> 11.1mmol/l

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13
Q

If taking a HbA1c level, what level is diagnostic of diabetes?

A

> 48mmol/l

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14
Q

In the diagnosis of diabetes, if a patient has symptoms, how many diagnostic lab glucose reading must they have before a diagnosis is made?

A

1

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15
Q

In the diagnosis of diabetes, if a patient does not have any symptoms, how many diagnostic lab glucose reading must they have before a diagnosis is made?

A

2

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16
Q

What is the name given to the stage before diabetes, sometimes known as pre-diabetes?

A

Intermediate hyperglycaemia

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17
Q

What fasting glucose levels are indicative of intermediate hyperglycaemia/pre-diabetes?

A

6.1-7mmol/l

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18
Q

What HbA1c levels are indicative of intermediate hyperglycaemia/pre-diabetes?

A

42-47mmol/l

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19
Q

HbA1c?

A

Glucose bound to haemoglobin, an irreversible process. This blood test measures the levels of glucose bound to haemoglobin in the blood

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20
Q

What are the advantages of using a HbA1c test compared to fasting BG?

A

HbA1c can be taken immediately, no fasting required

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21
Q

List some of times in which HbA1c cannot be used for the diagnosis of diabetes mellitus.

A

-All children and young people
-Pregnancy
-Renal failure
-HIV infection
-Patients at high risk of diabetes who are acutely ill
-Patients on meds which can cause glucose spikes

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22
Q

What is more common- type 1 or type 2 diabetes?

A

Type 2

->if you got this wrong girl pls just drop out already x

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23
Q

What are some key points in history which help to determine which type of diabetes someone has?

A

-Age at diagnosis
-FH of diabetes
-Personal or familial history of autoimmune conditions
-Any hyperglycaemic symptoms

24
Q

Which type of diabetes is an autoimmune condition?

A

Type 1 diabetes

25
Q

What are some of the things you would examine or investigate to determine the type of a diabetes a patient has?

A

BMI
Ketones
Any sings of complications e.g. foot examination and retinal screening

26
Q

Which cells are destroyed via autoimmune destruction in type 1 diabetes?

A

Islet cells - the insulin producing cells in the pancreas

27
Q

Which auto antibodies can be measured and trigger the destruction of the insulin producing beta cells?

A

GAD antibodies- IAA, IA-2A, ZnT8

28
Q

What is type 1 diabetes characterised by?

A

Insulin deficiency

29
Q

What affect does this insulin deficiency have on the
- adipose tissue
-muscle
-liver

A

Adipose- increase lipolysis
Muscle- reduced glucose uptake
Liver- raised glucose production

30
Q

In type 1 diabetes, the body cannot use glucose as it’s normal source of energy to breakdown muscle and fat. What does this result in?

A

Ketones

31
Q

If type 1 diabetes is left untreated, what could develop?

A

Diabetic ketoacidosis (DKA)

32
Q

Who is type 1 diabetes more common in?

A

Children and younger adults

33
Q

In which type of diabetes is there a genetic link?

A

Both

Type 2 diabetes is a lot more inheritable…this contradicts another lecture but I would probs listen to this one

34
Q

What does the development of type 1 diabetes mellitus require?

A

Genetic predisposition
AND
Trigger e.g. viral infection

35
Q

What are some of the symptoms of type 1 diabetes?

A

Polydipsia
Polyuria/nocturia
Tiredness
Weight loss
Blurred vision
Abdominal pain

36
Q

What are some of the signs upon examination of type 1 diabetes?

A

Ketones on breath
Dehydration
May have increased RR, tachycardia, hypotension
Low grade infections e.g. thrush

37
Q

What can ketones on breath smell like?

A

Pear drops

38
Q

C-peptide levels can be used to confirm diagnosis of type 1 diabetes but is only reliable after 3yrs of diagnosis. What would the C-peptide levels be expected to be like at this point?

A

Undetectable
Low levels would suggest more recently diagnosed

39
Q

What happens in type 2 diabetes?

A

Increased cellular insulin resistance

40
Q

Initially if you have insulin resistance, how does the body try to compromise?

A

By producing more insulin

->this keeps insulin levels fairly steady for a period of time but eventually almost ‘burns out’ as body cannot keep producing so much insulin over a longer period of time

41
Q

Why is type 2 diabetes more common now?

A

-People heavier weight
-Ageing population and more common as we get older
-More sedentary lifestyle

42
Q

What are some of the symptoms of type 2 diabetes?

A

Polydipsia
Polyuria/nocturia
Tiredness
Sometimes weight loss but less common
Blurred vision

43
Q

What are some of the signs of type 2 diabetes?

A

Not ketotic
Usually overweight
Low grade infections e.g. thrush
Microvascular/macrovascular complications at diagnosis

44
Q

List some of the risk factors for type 2 diabetes.

A

Overweight
Family history
Older age
Previous history of gestational diabetes
Inactive life style
Previously high blood glucose

45
Q

What is a recognised genetic syndrome which can cause diabetes mellitus?

A

MODY- monogenic diabetes

46
Q

Gestational diabetes?

A

Diabetes during pregnancy

47
Q

Wat is MODY?

A

Autosomal dominant condition meaning there is impaired beta-cell function

48
Q

What is a key factor of a history that would point to MODY?

A

Family history of many family members having diabetes

49
Q

What happens in those with a glucokinase mutation?

A

Glucose levels from birth are always slightly higher

50
Q

What is the treatment for monogenic diabetes cause by a glucokinase mutation?

A

Diet treatment

51
Q

What is secondary diabetes mellitus?

A

Diabetes as a result of medications e.g. steroid use, pancreatic destruction, genetic syndromes, endocrine disorders

52
Q

Which endocrine disorders can cause secondary diabetes?

A

Cushing’s syndrome
Acromegaly
Pheochromocytoma

53
Q

What other condition can cause destruction of the pancreas and can cause secondary diabetes?

A

Haemochromatosis- excess iron deposition
Cystic fibrosis
Chronic pancreatitis
Pancreatectomy

54
Q

In which trimesters does gestational diabetes occur?

A

2nd-3rd

55
Q

Which neonatal problems can occur as a result of gestational diabetes?

A

Macrosomia
Respiratory distress
Neonatal hypoglycaemia

56
Q
A

Year 2- Endocrine System (27 decks)

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