lecture 16

Question 1

“diabetes” means, “mellitus” means

Answer 1

siphon , from honey

Question 2

diabetes mellitus cause by what

Answer 2

insufficiency in production of insulin

Question 3

most common endocrine disorder is

Answer 3

diabetes

Question 4

what is an example of a primary symptom of diabetes

Answer 4

urinary frequency

Question 5

how does a lack of insulin lead to high blood glucose levels

Answer 5

insulin removes blood glucose from blood - so blood glucose levels are high since no insulin to remove it

Question 6

who was first person to recieve insulin and when

Answer 6

14yr old leonard thompason in 1922

Question 7

type 1 diabetes is due to

Answer 7

a loss of insulin production

Question 8

type 2 diabetes is due to

Answer 8

insulin resistance - the cells in the body dont recognise and respond to insulin the way they should
or insufficient secretion of insulin

Question 9

what is hyperglycaemia

Answer 9

high blood glucose levels

Question 10

what causes hyperglycaemia

Answer 10

a loss of insulin - insulin stimulates glucose uptake into the cells and inhibits glucose production. Therefore more left/let into blood.

Question 11

where is glucose released from

Answer 11

the liver

Question 12

insulin can cause dyslipidaemia - what is dyslipidaemia

Answer 12

respression of the breakdown of glycerin and fatty acids

Question 13

explain why t1dm occurs ( in terms of cells )

Answer 13

beta cells (in pancreas) produce insulin. These are destroyed by immune system as it detects them as foreign so destroys them. This means that they can no longer produce insulin -> T1DM

Question 14

% of people with T1DM

Answer 14

5-10

Question 15

peal age for T1DM diagnosis

Answer 15

10-14

Question 16

T2DM occurs when

Answer 16

the body becomes insulin- resistant and pancreatic beta cells cant release the sufficient insulin to compensate for this.

Question 17

what is the main cause of T2DM

Answer 17

lifestyle: obesity, lack of exercise, diet ( some genetic factors too)

Question 18

how is T2DM often discovered if people dont recognise symptoms

Answer 18

routine medical screenings - often later in life

Question 19

when does gestational diabetes develop

Answer 19

in the 2nd trimester - goes away after baby born

Question 20

cause of gestational diabetes

Answer 20

not clear - thought to be hormone changes durin pregnancy which block the insulin.

Question 21

prevalence of diabetes

Answer 21

4.4 mil people in UK

Question 22

undiagnosed T2DM figure

Answer 22

1.2 mil

Question 23

what are most cases of type 2 associated with

Answer 23

ageing population and increasing numbers of overweight/obese people

Question 24

Who is more likely to get T2DM fromm an earlier age

Answer 24

Black african , African Carribbean, South Asian backgrounds

Question 25

Tests for diagnosing diabetes

Answer 25

fasting glucose/random glucose test glucose tolerance test Hba1c

Question 26

best test for diabetes and why

Answer 26

Hba1c - measures amount of glycate haemoglobin in the blood - this indicates how high the blood glucose levels have been over the past 3-4 month period (since this is the average life-time of red blood cells). This shows how well blood glucose is being controlled >= 48mmol/mol(6.5%) indicates T2DM

Question 27

explain the fasting glucose test

Answer 27

no food or drink (except water) for 8-10 hours normal plasma glucose: 3.9-5.4 mol/l pre diabetic: 5.5-6.9mmol/l diabetic>7mmol/l

Question 28

explain random glucose test

Answer 28

regardless of when last person ate/drank - a random plasma glucose of 11.1mmol/l indicates diabetes

Question 29

explaination of the oral glucose tolerance test

Answer 29

fast for 8 hrs then plasma glucose measured immediately before and 2 hours after drinking 75g glucose in water: after the 2 hrs >=11.1mmol/l -> diabetes 7.9-11mmol/l-> impaired glucose test

Question 30

Hba1c in type 1

Answer 30

not used for diagnosis as changes can occur very wuickly - since its taken over 3 months then it wont be accurate as it couldve came on recently and since values not too far off then it would be missed.

Question 31

blood glucose and blood vessel relationship

Answer 31

high blood glucose can damage your blood vessels or veins so big problem if left untreated.

Question 32

how is diabetes diagnosed ?

Answer 32

presence of acute hyperglycaemia and an abnormal blood test OR in asymptomatic patient with 2 abnormal blood tests on seperate days In type 2 - asymptomatic patients are diagnosed through screening of high risk groups

Question 33

Acute diabetes symptoms

Answer 33

frequent urination - due to high blood glucose - amount of glucose exceeds capacity of the kidneys so it cant reabsorb it so it goes back into urine - this pulls water with it so pee more. Frequent urination leads to dehydration and polydipsia(thirst) poor wound healing - blood vessels damaged blurry vision - dehydration and glucose in eye increased apetite - due to lack of glucose uptake so cant be used for energy UTI - high glucose in pee provides ideal growth conditions weight loss - breaks down fat since it cant break down glucose

Question 34

Diabetic ketoacidosis

Answer 34

life threatening complication of T1DM- lack of insulin limits the use of glucose as an energy source, enhances free fatty acid release from adipocytes allowing them to be converted to ketone bodies in the liver- these can serve as an energy source. The ketones cause the pH ofthe blood to become acidic. Liver synthesises more glucose so blood glucose rises. This passes in urine and takes water and sodium with it leading to dehydration.

Question 35

what life factors causes dka development

Answer 35

time of diagnosis, during illness, during growth spurt/puberty or when insulin isnt being taken correctly

Question 36

why do type 2 diabetics not usually get dka

Answer 36

metabolic changes arent severe enough

Question 37

microvascular vs macrovascular

Answer 37

microvascular - damage to small blood vessels (capillaries) macrovascular - damage to larger blood vessels (arteries and veins)

Question 38

comorbidities associated with diabetes

Answer 38

diabetic retinopathy - leading cause of blindness diabetic nephropathy - leading cause of end stage renal disease ( caused by microvascular damage) diabetic neuropathy - leading cause of non- traumatic lower extremity amputation - causes sensory loss stroke - 2-4 fold increase in CV mortality and stroke Cardiovascular disease - 8/10 individuals with diabetes die from CV events

Question 39

what causes diabetic feet

Answer 39

nerve damage or poor blood flow to feet - cuts and blisters can become serious infections which heal poorly leading to amputations

Question 40

Increased risk of dementia caused by

Answer 40

diabetes

Question 41

how to prevent actue and chronic complications

Answer 41

maintain good control of blood glucose levels