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25 Cards in this Set
- Front
- Back
- 3rd side (hint)
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When does diabetes mellitus occur? I.e. pancreas?
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Occurs when the pancreas is unable to secrete adequate insulin to prevent hyperglycaemia of a pre-defined level.
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What is the fasting plasma glucose diagnostic criteria for diabetes?
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> 7.0 mmol/L
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What is the fasting plasma glucose diagnostic criteria for impaired fasting glucose?
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5.6 - 6.9 mmol/L (ADA)
OR 6.1 - 6.9 mmol/L + normal OGTT (WHO) |
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What is the two-hour plasma glucose after 75g OGTT diagnostic criteria for diabetes?
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>11.1 mmol/L
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What is the two-hour plasma glucose after 75g OGTT diagnostic criteria for impaired glucose tolerance?
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7.8 - 11.0 mmol/L (ADA)
7.8 - 11.0 mmol/L + fasting plasma glucose < 7.0 (WHO) |
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What is the proposed Hba1c diagnostic criteria for diabetes?
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>6.5% 48mmol/mol
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What is the random plasma glucose diagnostic criteria for diabetes?
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Classic symptoms of hyperglycaemia or hyperglycaemic crisis and a random plasma glucose >11.1 mmol/L.
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How was the plasma glucose cut-off point for diabetes set?
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They were derived from epidemiological studies examining incidences of diabetes specific complications. The plasma glucose cut off point is set at the level where the incidence of microvascular complication increases.
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Why is the HbA1c tested every three months?
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The average life span of red blood cells is 120 days. Therefore HbA1c reflects the average plasma glucose of the preceding 2-3 months.
Glycated haemoglobin A1c is the product of a non-enzymatic glycation process. |
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In 2012, is HbA1c currently subsidised by medicare as a diagnostic test for diabetes mellitus?
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No.
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What is pre-diabetes?
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A broad term used to describe a condition in which blood glucose levels on formal lab testing are elevated above the normal range but do not satisfy the diagnostic criteria for DM. Includes IFG and IGT.
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What are the problems associated with IGT?
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Immediate increased risk for both fatal and non-fatal cardiovascular disease.
6 fold relative risk of progressing to diabetes annually. More common in WOMEN. |
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What are the problems associated with IFG?
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Immediate increased risk for both fatal and non-fatal cardiovascular disease.
4.7 fold relative risk of progressing to diabetes annually. More common in MEN. |
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How should pre-diabetes be managed?
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Intensive lifestyle management.
Weight reduction. Low-fat, low GI load. High fibre. Regular physical activity. Reduce cardiovascular disease risk factors: - lipid abnormalities - BP abnormalities - stop smoking Metformin 850mg only after 6 months lifesttyle changes. Perform OGTT every 1-3 years. |
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What is type 1 diabetes caused by?
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Beta cell destruction leading to absolute insulin deficiency.
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What is type 2 diabetes caused by?
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Insulin resistance and relative insulin deficiency.
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What is gestational diabetes?
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Relative insulin deficiency in mid to late gestation.
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What endocrinopathies can cause diabetes
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Acromegaly
Cushing's syndrome MEN1 Hyperthyroidism |
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What infections can cuase diabetes?
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Congenital rubella
CMV |
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What drugs can cause diabetes?
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Glucocorticoids
Thiaziedes Phenytoin |
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What diseases of the exocrine pancreas can cause diabetes?
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Pancreatitis
Trauma Pancreatectomy Neoplasia Cystic fibrosis Haemochromatosis |
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What is gestational diabetes mellitus?
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Relative insulin deficiency in mid to late gestation.
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What is the pathogenesis of type 1 diabetes?
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Type 1A: antibody positive.
Type 1B: antibody negative. Destruction of beta cells mediated by subsets of innate T cells. |
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What are the genetic risk factors for developing type 1 diabetes?
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HLA region on chromosome 6p21.3 containt genes that code for MHC class II moleculres which are responsible for presenting antigens to T cells and triggering the AI process. Certain HLA alleles increase the risk of type 1 diabetes.
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Environment also plays a role, but the exact triggers aren't known.
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What autoimmune diseases are associated with type 1 diabetes?
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Autoimmune thyroid disease. Therefore did TFTs at diagnosis and screen every 1-2 years.
Antibodies: TPO-Ab, TG-Ab. Coeliac disease. Screen at diagnosis and 2 yearly intervals. Antibodies: Anti-endomysial antibody, tissue transglutaminase antibody. |
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