What is Diabetes Mellitus?

Question 1

What are the symptoms of hyperglycaemia?

Answer 1

Polydipsia, polyuria, blurred vision, weight loss, infections

Question 2

What are some long-term complications of hyperglycaemia?

Answer 2

Retinopathy
Neuropathy
Nephropathy
Stroke
MI
PVD

Question 3

What are the diagnostic criteria for diabetes?

Answer 3

One diagnostic lab glucose test in the presence of symptoms
OR
Two lab tests without symptoms

Question 4

What is the fasting diagnostic minimum for diagnosis of DM?

Answer 4

> /= 7.0 mol/l

Question 5

What is the random diagnostic minimum for diagnosis of DM?

Answer 5

> /= 11.1 mmol/l

Question 6

What is HbA1c?

Answer 6

Glycated haemoglobin which gives n indication of blood glucose levels over the last 8-12 weeks

Question 7

Give some scenarios where HbA1c cannot be used for diagnosis of DM

Answer 7

All children and young people
Current or recent pregnancy
Short symptom history

Question 8

Which type of DM makes up almost 90% of cases?

Answer 8

Type II

Question 9

What is the increased risk of two monozygotic twins having Type I DM?

Answer 9

30-50%

Question 10

What can be said about the genetic predisposition in type I DM?

Answer 10

Genetic predisposition may often be present but is not enough to solely account for the development of type I, so it is likely that it is a combination of factors including environment and viral infection

Question 11

Which hormone dominated the absorptive/fed state?

Answer 11

Insulin - it is the only hormone which can lower BG

Question 12

Give a process controlled by insulin in relation to; the liver, muscle and adipose tissue

Answer 12

Causes reduced glucose production in the liver
Causes increased glucose uptake in the muscle
Causes reduced lipolysis in the adipose tissue

Question 13

What are some clinical symptoms of type I DM?

Answer 13

Short duration of;
Thirst
Tiredness
Polyuria/nacturia
Weight loss
Blurred vision
Abdominal pain

On examination;
Ketones on breath
Dehydration
May have increased RR, HR, HT
Low grade infections - thrush/balantis

Question 14

What is the increase in chance for an identical twin whose sibling has type II diabetes?

Answer 14

90-100% increase

Question 15

When there is a decrease in insulin production in Type II DM what are the effects on fat, muscle and the liver?

Answer 15

Altered lipolysis in fat
Increased glucose production in the liver
Reduced glucose uptake in muscle

Question 16

What are some clinical signs and symptoms of Type II DM?

Answer 16

May have no symptoms but may have;
Thirst
Tiredness
Polyuria/nocturia
Blurred vision

Signs;
Not ketotic
Usually overweight
Low grade infections

Question 17

Describe MODY - Mature Onset Diabetes in the Young

Answer 17

Autosomal dominant condition affecting around 5% of people with diabetes
Impaired beta-cecal function due to a single gene defect

Question 18

What can cause secondary DM?

Answer 18

Drug therapy e.g. corticosteroids 
Pancreatic destruction
-Haemochromatosis
-Chronic pancreatitis
-Pancreatectomy
Recognised genetic syndromes - DIDMOAD
Rare endocrine disorders e.g. Cushing, Acromegaly, Pheochromocytoma

i.e. anything which images the pancreas has the potential to cause diabetes

Question 19

What is gestational diabetes?

Answer 19

Hyperglycaemia of pregnancy where there is an increase in insulin resistance during pregnancy and 50% will develop type iI later in life