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Questions and Answers
What is a key component necessary for diagnosing Diabetic Ketoacidosis (DKA)?
Which blood gas result would indicate acidaemia in a patient suspected of having DKA?
What is the minimum level of ketonaemia required for DKA diagnosis?
In the context of DKA, what does a venous bicarbonate (HCO3) level below 15.0 mmol/L signify?
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Which level of blood glucose is indicative of severe hyperglycaemia related to DKA?
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What substance, discovered by Sir Edward Albert Sharpey-Schafer, plays a crucial role in the regulation of blood sugar levels?
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Which therapy was NOT mentioned as a treatment for diabetes before the discovery of insulin?
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What percentage of young people with new onset Type 1 Diabetes Mellitus (T1DM) are expected to present with Diabetic Ketoacidosis (DKA)?
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Which researchers are credited with the discovery of insulin in 1922?
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What does the term 'insula' refer to in relation to insulin?
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What role does injectable pancreatic extract have in the treatment of diabetes prior to insulin?
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Which of the following is NOT a characteristic of Type 1 Diabetes Mellitus (T1DM)?
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What is a key characteristic of Type 1 Diabetes Mellitus?
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What is the classification of Georgette Eliot in the clinical case presented?
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What age group can Type 1 Diabetes Mellitus appear in?
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Which of the following statements is true about Type 2 Diabetes?
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What causes diabetic ketoacidosis (DKA) in Type 1 Diabetes Mellitus?
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Which of the following symptoms is commonly associated with diabetic ketoacidosis?
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What distinguishes Type 2 Diabetes from Type 1 Diabetes?
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What is a common early sign of diabetic ketoacidosis?
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Which of the following statements accurately differentiates the two types of diabetes?
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Study Notes
Diabetes Classification
- Diabetes is a chronic metabolic disease characterised by high blood glucose levels, caused by defects in insulin secretion or insulin action.
- Type 1 Diabetes is caused by the autoimmune destruction of pancreatic beta cells, which produce insulin.
- Type 1 Diabetes requires insulin for survival and can occur at any age.
- Type 2 Diabetes is characterised by resistance to insulin's action and impaired insulin production.
- Type 2 Diabetes has a strong genetic propensity and can be unmasked by lifestyle factors, such as obesity and lack of exercise.
Treatment for Diabetes before 1919
- Oatmeal, milk, rice, potatoes and even opium were used as potential treatments for diabetes.
- Treatment for diabetes before 1919 focused on dietary changes.
- In 1919, injectable pancreatic extract (Insulin) emerged as a potential treatment.
Discovery of Insulin
- Sir Edward Albert Sharpey-Schafer, an English physiologist, discovered insulin in 1910.
- Insulin was named after the Latin word "insula," meaning island, referencing the insulin-producing islets of Langerhans in the pancreas.
- Frederick Banting and Charles Best, a medical student, are credited with the discovery of insulin in 1922, supervised by J.J.R Macleod.
Differences Between Type 1 and Type 2 Diabetes
HbA1c vs Glucose for Screening and Diagnosis of Diabetes
- HbA1c and glucose levels are used for screening and diagnosing diabetes.
Clinical Presentation of Type 1 Diabetes Mellitus
- Approximately 25-30% of young people with new onset Type 1 Diabetes will present with Diabetic Ketoacidosis (DKA).
Antibodies in Type 1 Diabetes Mellitus
- Antibodies are present in Type 1 Diabetes.
Case 1: Georgette Eliot
- 44-year-old woman brought into A&E with a fractured humerus after falling while riding a horse.
- Georgette has Type 1 Diabetes and Childhood asthma.
- On admission, Georgette's blood glucose was 14.2 mmol/l.
- She was kept Nil by mouth for 24 hours.
Clinical Vignette: Georgette Eliot
- High blood glucose levels and ketones of 5.6 suggest Diabetic Ketoacidosis (DKA).
Definitions and Diagnosis
- Diabetic Ketoacidosis (DKA) consists of the biochemical triad of ketonaemia (ketosis), hyperglycaemia and acidaemia.
- DKA is diagnosed when blood glucose is greater than 11.0 mmol/l, ketonaemia greater than 3.0 mmol/l or significant ketonuria, and venous pH less than 7.3 and/or bicarbonate (HCO3-) less than 15.0 mmol/l.
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Description
Explore the classification of diabetes, including Type 1 and Type 2, and their underlying causes. Additionally, delve into the historical treatments for diabetes before the discovery of insulin in 1919. Test your knowledge of both the disease and its early management strategies.
