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Flashcards in FINAL CLINICAL- Diabetes Deck (14)
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Diabetes is the fifth most common cause of death in the world!!
Around ______ people between 20 and 79 have their death attributed to diabetes

1 in 8 people

1

Type 1 diabetes is the autoimmune destruction of pancreatic B cells. What are present in 85-90% of people that cause destruction of these cells?

Islet cell antibodies
Flag to the immune system to destroy these.

2

How long is life expectancy said to be decreased by for people with type 1 diabetes?

Reduced by 20 years
It's becoming particularly common in children under 5 now

3

What happens in terms of insulin secretion in Type 2 diabetes?

Firstly HYPERINSULINAEMIA: body compensates for insulin resistance by increasing insulin secretion from Beta cells (lots of insulin)

Then HYPERGLYCAEMIA: resistance to insulin increases, beta cells can't produce enough insulin to keep up, glucose levels rise

This all leads to beta cell failure. Glucose levels really badly controlled. Person has to go from oral treatment to insulin injections. Type 2 diabetes present

4

How long is life expectancy reduced by for people with Type 2 diabetes?

By approx 10 years
10-15% of people with diabetes have Type 2

5

List 5 of the less severe signs and symptoms of diabetes?

Thirst
Polyuria (frequent weeing)
Lethargy
Visual disturbance (getting balance of fluid and glucose in eye: some patients say it's better some worse)
Urinogenital infection

6

List 3 of the more severe symptoms/ complications with diabetes?

Diabetic Ketoacidosis with type 1
Hyperosmolar hyperglycemic state with type 2
Diabetic foot ulcer
Diabetic retinopathy
Myocardial infarction

7

To confirm a diagnosis of diabetes, what should blood glucose be when fasting?

7.0 or over

8

To confirm a diagnosis of diabetes, what should blood glucose be 2 hours after a glucose load?

11.1 or over

9

We can use HbA1c to diagnose diabetes. What value must this be?

48 mmol/mol or over

Remember these units!!

10

What percentage of people are currently undiagnosed with diabetes?

50% of people.
The need for regular screening is therefore very important

11

How often should someone with diabetes be reviewed?

ANNUALLY- once a year

They do retinal (eye) screening, nephropathy screening (kidneys)
Hypertension screening, vascular disease examination (fatty deposits in blood vessels)

Neuropathic foot problems are often ignored- not good!!

12

In a trial, intensive insulin therapy was seen to cause a 1-3 fold increase in what?

Severe hypoglycaemia

The more hypos you have, the more the body starts to think this is normal so doesn't give out any signals before it- people can just fall unconscious unexpectedly

But this tighter control of blood glucose slowed the onset of retinopathy (eyes), nephropathy (kidneys), and neuropathy (feet)

13

What percentage of people with diabetes also have depression because of the effects it can have on emotions?

50%

5-10% on an antidepressant

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