1. Introduction to Patients with Diabetes Flashcards Preview

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Flashcards in 1. Introduction to Patients with Diabetes Deck (27)
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1
Q

Approximately how much of the UK NHS budget is spent on diabetes a year?

A

10% of it, £11 billion.

2
Q

What is the leading cause of blindness in working age?

A

Diabetes.

3
Q

How much does type I diabetes reduce life expectancy by?

A

5-15 years.

4
Q

How much does type II diabetes reduce life expectancy by?

A

5-10 years.

4
Q

What is diabetes?

A

Consistently high blood glucose that leads to damage of the small and large blood vessels, causing premature death from cardiovascular diseases.

5
Q

Describe how the body lowers blood glucose after eating.

A

Signals sent to the pancreas.
Pancreas releases insulin.
Insulin binds to cell surface receptors so glucose can pass into the cells.
Less glucose is in the blood now.

6
Q

Which cells release insulin?

A

Islet cells in the pancreas, B-cells.

7
Q

What two main reasons causes blood glucose to rise?

A

Inability to produce insulin due to beta cell failure.

Or adequate insulin production but insulin resistance means it’s ineffective (linked to obesity).

8
Q

What causes type I diabetes?

A

Autoimmune beta cell destruction, genetically predisposed to it.

9
Q

What is the clinical presentation of diabetes mellitus?

A

Symptoms of hyperglycaemia: polyuria, polydipsia, blurring of vision, urogenital infections.
Symptoms of inadequate energy utilisation: tiredness, weakness, lethargy and weight loss (type I).

10
Q

What causes type II diabetes?

A

The pancreas doesn’t produce enough insulin (deficiency) or there is a resistance to insulin of the cells.

11
Q

How can diabetes be diagnosed?

A

Symptoms and one abnormal test or asymptomatic and two abnormal tests from the following:
Fasting glucose levels
Oral glucose tolerance test
HbA1c test

12
Q

What percentage of type I diabetics are diagnosed under the age of 30?

A

90%.

13
Q

What is the clinical presentation of type I diabetes?

A

Rapid onset of symptoms: weight loss, polyuria and polydipsia. If left, vomiting and ketoacidosis.
Normally young patient, under 30 years old.

14
Q

How can type I diabetes be diagnosed?

A

Elevated venous plasma glucose levels.

Presence of ketones, measured using a ‘ketostik’.

15
Q

How is type I diabetes treated?

A

With exogenous insulin, given via subcutaneous injections several times a day by pens or pumps.

16
Q

When was insulin discovered?

A

1921-1922.

17
Q

What percentage of type II diabetics are overweight?

A

90%.

18
Q

How can type II diabetes be prevented?

A

Keep BMI between 20 and 25 kg/m2.

Avoid weight gain over 5kg during adult life.

19
Q

What are the risk factors of insulin resistance in type II diabetes?

A

Obesity (85% of risk of developing type II diabetes), muscle and fat deposition, elevated circulating free fatty acids, physical inactivity and genetic influences.

20
Q

What are the symptoms in type II diabetes?

A

May be asymptomatic, no urinary ketones.

May have polyuria, polydipsia or weight loss.

21
Q

What happens if type II diabetes is left untreated?

A

Become more badly hyperglycaemic, inadequate energy utilisation, worsening of complication of the disease (to do with damage to vessels).

22
Q

How is type II diabetes managed?

A

Lifestyle factors, non insulin therapies (metformin, sulphonylureas etc.) or insulin.

23
Q

What are some acute complications of diabetes?

A

Hyperglycaemia: ketoacidosis in type I patients, hyperosmolar non-ketotic syndrome (very raised blood glucose but no ketones) in type II patients.
Hypoglycaemia: coma.

24
Q

What are some chronic complications of diabetes?

A

Macrovascular disease: stroke, heart attack, intermittent claudication (not enough blood to lungs) and gangrene.
Micro vascular disease: retinopathy, nephropathy and neuropathy.

25
Q

What can neuropathy lead to?

A

Ulcers, a wound is not felt and is unnoticed so can get infected and lead to an ulcer.

26
Q

What can retinopathy lead to?

A

Blindness.