What is DM? Flashcards
What is DM?
Group of metabolic diseases of multiple aetiologies characterised by hyperglycaemia together with disturbances of carbohydrates, fat, and protein metabolism resulting from defects in insulin secretion, insulin action or both
What at symptoms of hyperglycaemia?
thirst Urinating a lot blurred vision tiredness Weight loss Infections
What are the long term microvascular complications of DM?
Retinopathy
Neuropathy
Nephropathy
What are the long term macrovascular complications of DM?
Stroke
MI
PVD
How is someones long term glucose controlled monitored?
Measure HbA1c
What is the diagnostic value for HbA1c for DM?
> 48 mmol/mol
What is the diagnostic value for fasting glucose test in DM?
> 7.0 mmol/mol
What is the diagnostic value for random glucose in DM?
> 11.1 mmol/mol
What is the diagnosis criteria for DM?
One diagnostic lab glucose plus symptoms
Two diagnostic lab glucose or HbA1c without glucose
What does HbA1c measure?
The level of glycosylated haemoglobin in the blood
What does HbA1c give an indication of?
Blood glucose over the past 8-12 weeks
Glucose control in the body
When can HbA1c not be used?
In all children and young people Pregnancy Short duration of DM symptoms Patients at high risk of DM who are acutely unwell Acute pancreatic damage or surgery Renal failure HIV patients Patients taking medications which may cause rapid glucose rise
What are the 2 types of DM?
Type I
Type II
Which is the only hormone that lowers BG?
Insulin
What is there a destruction of in Type I?
Beta cells
What type of condition is type I?
Autoimmune
When will most people have presented with Type I?
By the age of 30
What occurs in type I DM?
There is loss of insulin production by beta cells
What is the result of glucose not being taken up by tissues?
The tissue will send out help signals to produce more and more glucose
Is there any mechanism to switch off gluconeogenesis?
No
What is the clinical presentation of type I DM?
Thirst Tiredness Polyuria Weight loss Blurred vision Abdominal pain
What may be seen on examination in type I DM?
Ketones on bereath Dehydration Increased RR Tachycardia Low grade infection - thrush
How does type II DM develop time wise?
Over a period of time
When does Type II diabetes occur?
When insulin production cannot overcome insulin receptor resistance
Which is more genetically determined type I or type II?
Type II
What are the typical symptoms of type II DM?
Thirst Tiredness Polyuria Sometimes weight loss Blurred vision
What are signs of type II DM?
Not ketotic
Usually overweight but not always
Low grade infection e.g thrush
What are the risk factors for type II DM?
Overweight FH Previous history with gestational DM Inactive lifestyle Lack of exercise Previous high blood glucose
What are the other types of DM apart from type I and II?
MODY
Secondary
Gestational
What can cause secondary DM?
Drug therapy e.g corticosteroids
Pancreatic destruction
Recognised genetic syndrome
Rare endocrine disorders e.g cushings
What causes gestational DM?
Increasing insulin resistance in pregnancy
What does gestational diabetes increase the risk of?
Type 2 later in life
When does gestational DM usually occur?
In 2nd/3rd trimester
What are the babies like in gestational DM?
Big babies
What type of inheritance is MODY?
Autosomal dominant
