What is Diabetes Mellitus? (including Epidemiology of Diabetes)

Question 1

what is the definition of diabetes mellitus

Answer 1

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

Question 2

what is polydipsia

Answer 2

excessive thirst

Question 3

what is polyuria

Answer 3

noun: polyuria

production of abnormally large volumes of dilute urine

Question 4

what are symptoms of hyperglycaemia

Answer 4

polydipsia
polyuria
blurred vision 
weight loss
infections 
tiredness

Question 5

what are long term complications of hyperglycaemia

Answer 5

microvascular e.g retinopathy, neuropathy,nephropathy

macrovascular e.g stroke, MI, PVD

Question 6

what can be measured in order to diagnose diabetes

Answer 6

blood glucose

HbA1c

Question 7

what is a HbA1c

Answer 7

a glycosylated haemoglobin molecule

Question 8

what is the relationship between HbA1c and glucose in the blood

Answer 8

the more glucose in the blood the more HbA1c will be present in the blood

Question 9

what is the diagnostic glucose level for fasting

Answer 9

> 7.0 mmol/l (or equal to)

Question 10

what is the diagnostic glucose level at random

Answer 10

> 11.1 mmol/l (or equal to)

Question 11

if glucose levels are >11.1mmol/l after an oral glucose tolerance test what does this indicate

Answer 11

diabetes

Question 12

what does a HbA1c level of 48mmol/mol indicate

Answer 12

diabetes

Question 13

what is gestational diabetes

Answer 13

high blood sugar that develops during pregnancy (usually disappears after birth)

Question 14

what are cases where HbA1c cannot be used for diagnosis of diabetes

Answer 14

1. children young people
2. pregnancy
3. short duration of symptoms
4. patients who are acutely ill
5. HIV
6. pancreatic damage

Question 15

what is the most common type of diabetes

Answer 15

type 2 (88%)

Question 16

what is the only hormone that lowers blood glucose

Answer 16

insulin

Question 17

what do alpha cells in the pancreas secrete

Answer 17

glucagon

Question 18

what is hyperglycaemia

Answer 18

abnormally high blood glucose level

Question 19

what is ketonaemia

Answer 19

presence of abnormally high ketone bodies in the blood

Question 20

what are the symptoms of untreated type 1 diabetes

Answer 20

thirst 
tiredness
polyuria/nocturia
weight loss
blurred vision 
abdominal pain

Question 21

what may be found on investigation that would support the diagnosis of type 1 diabetes

Answer 21

ketone breath 
dehydration 
increased RR
tachycardic
hypotension 
low grade infections e.g thrush

Question 22

what are the symptoms of undiagnosed type 2 diabetes

Answer 22

may have none 
thirst 
tiredness
polyuria/nocturia 
sometimes weight loss
blurred vision 
symptoms of complications e.g CVD

Question 23

what signs may be found on examination that would support a diagnosis of type 2 diabetes

Answer 23

NOT KETOTIC

usually overweight (not always)

low grade infections

type 2 DM may have microvascular/macrovascular complications at Dx

Question 24

what are risk factors for diabetes

Answer 24

overweight 
family history
inactive lifestyle 
previous high bld Glu
impaired Glu tolerance

Question 25

what are particular risk factors for diabetes in woman

Answer 25

history of diabetes in pregnancy (gestational diabetes)

had a big baby (more that 4kg)

Question 26

what ethnicities/age groups are more at risk of diabetes

Answer 26

> 30 yrs if Maori/Asian /Pacific island descent

> 40yrs if European

Question 27

what is the cause of Maturity Onset Diabetes in the Young (MODY)

Answer 27

autosomal dominant single gene defect which results in impaired beta cell function

Question 28

what is the function of Glucokinase

Answer 28

it is a gene that plays an important role in recognising how high blood glucose is in the body. It acts as the glucose sensor for the pancreas.

Question 29

what is secondary diabetes

Answer 29

diabetes that occurs as a result of another medical condition

Question 30

what can cause secondary diabetes

Answer 30

drug therapy-corticosteroids
pancreatic destruction
endocrine disorders e.g Cushing’s, Acromegaly, pituitary tumour