Year 2 - Week 3 - Diabetes Flashcards
What is diabetes mellitus?
Problem with regulation of blood glucose levels - generated from body’s inability to regulate serum glucose concentration with intake - stems from a failure to produce/lack of response to the insulin which controls this process.
How many people in the UK have diabetes mellitus?
What proportion of this is T2 diabetes?
4.9m - about 7.3% of UK pop
90% have T2 DM
What is T1 Diabetes?
An autoimmune mediated loss of pancreatic β-islet cells leading to absolute reduction in insulin production.
What is T2 Diabetes?
An acquired condition mediated through (a) reduction in insulin sensitivity or (b) an inadequate amount of insulin secretion - leading to inadequate serum glucose concentration control
What is gestational diabetes?
Disease of pregnancy where insulin production does not match the physiological requirements needed in pregnancy.
What occurs during hyperglycaemia?
Significant glycosuria + high osmotic pressure - osmotic diuresis occurs - causing dehydration.
Which is the most common disease often found in Ps with T1DM?
Thyroid disease
What is the triad of DKA?
Hyperglycaemia
Ketonaemiea
Acidosis
What are the management principles of DKA?
Rehydration of the patient (helps clear the ketosis) + insulin . May need to correct electrolyte imbalances.
Which medication puts T2DM Ps more at risk of DKA?
SGLT-2 inhibitors
What level does HbA1c have to be at to be diagnosed with T2DM?
How many readings at this level are needed if
- symptomatic?
- asymptomatic?
> 48 mmol/mol
1 reading if symptomatic
2 readings if asymptomatic
What reading in fasting plasma glucose indicates T2DM?
> 7mmol/L
Which factors can cause HbA1c to be falsely low?
Rapid rise in blood sugar (T1DM, acute illness, drugs - steroids)
Increased red cell turnover
Blood transfusion
Pregnancy
HIV infection (drugs may result in red blood cell destruction)
CKD (reduced red blood cell lifespan)
Which factors can cause HbA1c to be falsely high?
Splenectomy
Reduced reticulocytes (aplastic anaemia)
Increased glycation
What is the glycemic index?
A measure of how food can affect how quickly blood glucose levels rise
