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OSCE Conditions > Diabetes > Flashcards

Flashcards in Diabetes Deck (15):
1

Pathophysiology of diabetes type 2

Resistance to insulin means it cannot work effectively and the body cannot utilise glucose
Beta cell function declines over time

2

Risk factors for type 2 diabetes

Obesity
Poor diet
Alcohol
Smoking
Hypertension
Family history

3

Symptoms of diabetes

Polyuria, polydipsia, weight loss
Others = fatigue, hunger, thrush, blurred vision

4

Investigations of diabetes

Fasting plasma glucose >7mmol/L
Random plasma glucose >11mmol/L
HbA1c >48mmol/L

5

Management of type 2 diabetes

Diet and lifestyle advice: weight loss, increased exercise

Pharmacological:
Metformin = 1st line agent
Sulphonureas eg. Glicazide

6

Mechanism of action of Metformin

Biguanide
Acts to increase sensitivity to insulin (unknown mechanism)
Increases skeletal and adipose glucose uptake.

Lowers CVS events, LDLs and VLDLs

7

ADRs of Metformin

GI disturbance
Lactic acidosis

8

Sulphonylureas mechanism of action

Acts as an insulin release stimulant:
Antagonises B-cell K+/ATP channels, depolarises cell, increases fusion rate of insulin vesicles

9

ADRs of sulphonylureas

Risk of hypoglycaemia
GI disturbance
Weight gain

10

Treatment of type 1 diabetes

Insulin injections - stimulate uptake of glucose, inhibits gluconeogenesis and glycogenolysis

Can use long acting or short acting

11

Give 2 different insulin regimes used in type 1 diabetes

Premixed regimen: 2 injections a day that are a mixture of long acting and fast acting insulins.

Basal bolus regimen: long acting insulins give basal level, then supplement with fast acting at meal times.
Gives better glucose control, but means more injections

12

Diabetes differential diagnosis

Metabolic syndrome
Endocrine tumour
Chronic pancreatitis
Renal glycosuria

13

Microvascular complications of diabetes

Retinopathy
Nephropathy
Neuropathy

14

Macrovascular complications of diabetes

Coronary artery disease
Peripheral arterial disease
Stroke

15

Pathophysiology of diabetes type 1

Autoimmune destruction of pancreatic B-cells, leading to insufficient insulin production