What is diabetes mellitus Flashcards
What hormone dominates the absorptive state (after a meal)
Insulin
What is insulins affect on adipose tissue
Reduces lipolysis
What is the effect of insulin on the liver
Reduced glucose production
What is the effect of insulin on muscle
Increased glucose uptake
What are symptoms of hyperglycaemia
Polydipsia, polyuria, blurred vision, weight loss and infections
Why does hyperglycaemia lead to polydipsia and polyuria
Excess glucose in the blood needs to be excreted out so micturition occurs more and more fluid is required for that to occur
What is a diagnostic fasting blood glucose value
More than or equal to 7 mmol/l
What is a diagnostic random blood glucose value
More than or equal to 11.1 mmol/l
What is a diagnostic HbA1c
more than or equal to 48mmol/mol
What is required to diagnose diabetes
One diagnostic lab glucose with symptoms
2 Diagnostic lab glucose or HbA1c without symptoms
What infection is common in diabetic patients
Thrush - high blood glucose allows the thrush causing bacteria to flourish
What does HbA1c show
Gives indication of blood glucose levels over last 8-12 weeks
When is HbA1c contraindicated
Children
pregnancy
Short duration of symptoms
People who are ill
Patients on medication which causes glucose rises such as corticosteroids
Pancreatic damage
Renal failure
HIV
What is intermediate hyperglycaemia fasting glucose value
6-1.7mmol/l
What is intermediate hyperglycaemia glucose tolerance test value
7.8 - 11mmol/l
What is HbA1c of intermediate hyperglycaemia
42-47mmol/mol
What happens in type one diabetes
At some point in the individuals life they start creating autoantibodies which attack the beta cells of islets of langerhans which produce insulin
What is the clinical presentation of type one diabetes (symptoms)
Thirst
tiredness
polyuria/nocturia
weight loss
blurred vision
What is seen on examination of type one diabetics
Ketone breath (smells like nail polish)
Dehydration
raised resp rate, tachycardia and hypotension
infections such as thrush
What age is type one diabEtes more commonly seen in
Younger patients
What increases risk of type one diabetes
other autoimmune conditions and family history of other autoimmune conditions
When can C peptide be measured reliably and what is C peptide
3 years after diagnosis and it is produced as a biproduct of insulin after it has been cleaved
What does high levels of C peptide suggest
Patient probably does not have type one diabetes mellitus
Type 2 diabetes has a high genetic risk
if both parents have it there is a 75% risk the child will develop it
