Diabetes Diagnosis and Complications Quiz
22 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What fasting plasma glucose level is indicative of a definitive diabetes diagnosis?

  • 200 mg/dL
  • 126 mg/dL (correct)
  • 150 mg/dL
  • 100 mg/dL

    • What is the necessary condition for a diagnosis of prediabetes based on HgbA1C results?

  • Exactly 6.5%
  • Greater than 8.0%
  • Between 5.7% and 6.4% (correct)
  • Less than 5.6%

    • Which complication is characterized by insulin deficiency and high levels of ketones in the blood?

  • Type 2 Diabetes
  • Hyperglycemia
  • Galactosemia
  • Diabetic Ketoacidosis (correct)

    • Based on recent statistics, what percentage of individuals with prediabetes is expected to develop type 2 diabetes?

    <p>15-30%</p> Signup and view all the answers

    What is a common hormonal response when plasma glucose levels fall between 65-70 mg/dL?

    <p>Glucagon is released</p> Signup and view all the answers

    What level of plasma glucose is considered hyperglycemia?

    <p>Above 100 mg/dL</p> Signup and view all the answers

    Which of the following is a classic symptom of Type 1 diabetes?

    <p>Increased thirst</p> Signup and view all the answers

    What is a key laboratory finding in Diabetic Ketoacidosis?

    <p>Presence of ketones in urine</p> Signup and view all the answers

    Which demographic is most commonly affected by Type 2 diabetes?

    <p>Adults over 20 years old</p> Signup and view all the answers

    What was the approximate percentage of undiagnosed diabetes in 2019?

    <p>7.3%</p> Signup and view all the answers

    Which of the following factors contributes to the development of Type 2 diabetes?

    <p>Genetic predisposition</p> Signup and view all the answers

    What percentage of diabetes cases does Type 1 diabetes generally account for?

    <p>10-20%</p> Signup and view all the answers

    What physiological condition results from an imbalance of hormones leading to elevated plasma glucose levels?

    <p>Hyperglycemia</p> Signup and view all the answers

    Which hormone inhibits insulin secretion and increases plasma glucose levels?

    <p>Somatostatin</p> Signup and view all the answers

    According to the reference range provided, what is the threshold for increased plasma glucose levels?

    <blockquote> <p>100 mg/dl</p> </blockquote> Signup and view all the answers

    Which of the following conditions results from fat metabolism and is characterized by the presence of ketones in the urine?

    <p>Diabetic Ketoacidosis</p> Signup and view all the answers

    What action does ACTH stimulate regarding glucose levels?

    <p>Stimulates cortisol release</p> Signup and view all the answers

    What is a common result of increased blood glucose in relation to urine output?

    <p>Polyuria</p> Signup and view all the answers

    Which type of diabetes is primarily characterized by an autoimmune response leading to beta-cell destruction?

    <p>Type 1 Diabetes</p> Signup and view all the answers

    What metabolic condition is a result of faulty glucose metabolism and characterized by increased blood lipids?

    <p>Hyperlipidemia</p> Signup and view all the answers

    As of 2007, what was the estimated prevalence of diabetes in the United States?

    <p>23.6 million individuals</p> Signup and view all the answers

    What is the effect of increased glucose levels on insulin secretion?

    <p>It inhibits insulin secretion.</p> Signup and view all the answers

    Study Notes

    Carbohydrates

    • Carbohydrates are compounds that provide chemical energy to cells.
    • They are primarily sugars and starches.
    • Carbohydrates are a primary energy source for the brain, erythrocytes, and retinal cells.

    Carbohydrate Structure and Classification

    • Carbohydrates contain carbon (C), hydrogen (H), and oxygen (O).
    • "-ose" suffix signifies a sugar.
    • Classification is based on:
      • Number of sugar units (monosaccharides, disaccharides, oligosaccharides, polysaccharides)
      • Size of the base carbon chain (trioses, tetroses, pentoses, hexoses)
      • Location of the carbonyl group (aldehyde or ketone)
      • Stereochemistry of the compound

    Classification of Carbohydrates (continued)

    • Trioses - 3 carbons
    • Tetroses - 4 carbons
    • Pentoses - 5 carbons (e.g., DNA)
    • Hexoses - 6 carbons (e.g., glucose)

    Location of Carbonyl Group

    • Aldose: carbonyl group at end (aldehyde group)
    • Ketose: carbonyl group in the middle (ketone group)

    Number of Sugar Units

    • Monosaccharides: one sugar unit (e.g., glucose, fructose, galactose)
    • Disaccharides: two sugar units (e.g., maltose, lactose, sucrose)
    • Oligosaccharides: 3-10 sugar units
    • Polysaccharides: >10 sugar units (e.g., starch, glycogen, cellulose)

    Chemical Properties of Carbohydrates

    • Reducing carbohydrates: contain ketone or aldehyde groups (e.g., glucose, maltose)
    • Non-reducing carbohydrates: do not contain ketone or aldehyde groups (e.g., sucrose)

    Carbohydrate Metabolism

    • Begins in the mouth with salivary amylase breaking down polysaccharides
    • Monosaccharides are absorbed by the gut and transported to the liver.
    • Glucose is the only carbohydrate that is directly used for energy or stored as glycogen.
    • Pathways of glucose metabolism
      • Liver and muscle glycogen storage
      • Conversion to amino acids and proteins
      • Conversion to fats
    • Ultimate goal is metabolism to CO₂ and H₂O

    Glucose Breakdown (Glycolysis, Glycogenolysis, Glycogenesis)

    • Glycolysis: Conversion of glucose to lactate or pyruvate, providing energy.
    • Glycogenesis: Conversion of glucose to glycogen for storage (primarily in liver and muscle). Excess glucose is stored as glycogen.
    • Glycogenolysis: Breakdown of glycogen to glucose when blood glucose levels are low.

    Glucose Formation (Gluconeogenesis)

    • Gluconeogenesis: Formation of new glucose from non-carbohydrate sources (e.g., amino acids, glycerol, fatty acids)
    • Occurs primarily in the liver.
    • Important in starvation and weight loss
    • Protects the body, especially the brain.

    Carbohydrate Metabolism (Lipolysis, Lipogenesis)

    • Lipogenesis: Conversion of carbohydrates to fatty acids. Excess glucose is stored as fat.
    • Lipolysis: Decomposition of fat.

    Regulation of Plasma Glucose

    • Glycogenolysis: Released glucose into the blood (quick response).
    • Gluconeogenesis, and lipolysis: Longer response. Release glucose into the blood.
    • Glycogenesis: Liver stores glucose.
    • Insulin decreases glucose levels
    • Glucagon increases glucose levels.
    • Epinephrine and Cortisol increase glucose levels.
    • ACTH increases glucose levels

    Hormones Affecting Glucose Levels

    • Insulin: decreases blood glucose by facilitating glucose entry into cells and promoting glycolysis.
    • Glucagon: increases blood glucose by stimulating glycogenolysis and gluconeogenesis.
    • Epinephrine and Cortisol: increase blood glucose by stimulating glycogenolysis, gluconeogenesis, and lipolysis.
    • Adrenocorticotropic Hormone (ACTH): increases blood glucose by stimulating the adrenal cortex to release cortisol

    Other Hormones Affecting Glucose Levels

    • TSH (thyroid-stimulating hormone): increases glucose absorption from intestines.
    • Somatostatin: inhibits insulin, thus increasing glucose.

    Types of Diabetes

    • Type 1 Diabetes: Insulin-dependent diabetes mellitus (IDDM), autoimmune destruction of islet beta cells; usually in children and adolescents
    • Type 2 Diabetes: Non-insulin-dependent diabetes mellitus (NIDDM), insulin resistance; usually in adults; related to obesity, lack of exercise, diet, and genetic factors
    • Secondary Diabetes: due to other conditions such as genetic defects, pancreatic disease, endocrinopathies or drug-induced
    • Gestational Diabetes (GDM): glucose intolerance during pregnancy, usually resolves after delivery but increases risk of later diabetes

    Diabetes Diagnosis Criteria

    • Symptoms of diabetes plus random plasma glucose >200 mg/dL.
    • Fast blood glucose >126 mg/dL
    • 2-Hour glucose > 200 mg/dL during an oral glucose tolerance test (OGTT)
    • Hemoglobin A1c (HbA1c) > 6.5%. Confirmed on repeat measurement

    Prediabetes

    • Fasting glucose between 100-125mg/dL
    • 2-hr GTT results between 140-199mg/dL
    • HbA1c between 5.7-6.4%

    GDM Testing

    • Moms screened at weeks 24-28
    • 2-hr GTT, fasting, 1 hour, and 2 hours after 75-g glucose load
    • Diagnosis: Fasting >92mg/dl, 1 hour >180mg/dl, and 2 hour >153mg/dl

    Hypoglycemia

    • Plasma glucose level falls below 60 mg/dL
    • Release of glucagon, epinephrine, cortisol, and growth hormone.
    • Treatment varies with cause (small, frequent meals, low in carbs, high in protein).

    Lab Findings for Hypoglycemia

    • Low plasma glucose levels
    • Glucose.
    • Insulin level

    Galactosemia

    • Caused by a deficiency in galactose-1-phosphate uridyltransferase.
    • Results in the inability to convert galactose to glucose or lactose to glucose.
    • Symptoms: failure to thrive, mental retardation, cataracts, and death.

    Laboratory Testing Considerations for Glucose

    • Reference values depend on various factors, including the type of specimen (venous/capillary, serum/plasma/whole blood), how it was collected (fasting/random/after meal)
    • Reference range for glucose (serum/plasma): 74-100 mg/dL. Whole blood is 65-95mg/dl.
    • Specimen collection methods
      • Serum, plasma, whole blood
      • Point-of-care
      • Results are 10-15% lower for whole blood than serum/plasma due to dilution by cells

    Glucose - Specimen Collection and Testing

    • CSF specimens: Analyzed ASAP; 60-70% of current blood glucose level.
    • 24-hour urine: A small amount of glucose is lost daily (<500 mg/24 hr).
    • Preservation: Perform testing <1hr; Separate plasma from cells <1hr; Refrigerate (slows down glucose utilization by cells).
    • Additive: Sodium fluoride inhibits glycolysis.
    • Anticoagulant: Potassium oxalate
    • Enzymatic methods: Glucose Oxidase or Hexokinase

    Fasting Glucose Levels

    • FBS is the most frequently ordered screening test for glucose metabolism
    • Fasting values of >126 mg/dL indicate diabetes.
    • FBS should be repeated on another day to confirm the diagnosis.
    • Borderline diabetes may have a normal FBS; needs a challenge test to show abnormality.

    Glucose Tolerance Test (GTT)

    • Purpose: diagnose hyperglycemia/diabetes and evaluate symptoms of hypoglycemia.
    • Phlebotomist Responsibilities: Confirm fasting, draw baseline sample, administer glucose solution, schedule/collect timed blood specimens; Ensure consistency of tubes and specimen type; Venipuncture or dermal puncture; Monitor patient.

    Oral Glucose Tolerance Test (OGTT) and results

    • Blood glucose level drawn before drinking glucose drink
    • Glucose drink given.
    • Blood glucose level drawn again 2 hours later.
    • Glucose levels should return to normal levels after 2 hours.
    • If glucose levels are higher than 200 mg/dL, a fasting or random glucose level is needed to diagnose diabetes.

    Glycosylated Hemoglobin (HbA1c)

    • Glucose attaches nonenzymatically to hemoglobin molecules. Provides a time-averaged glucose reading reflecting the mean daily blood glucose levels over the previous 2-3 months.
    • Advantages: reflects time-averaged glucose, not subject to temporary variability related to diet or exercise, doesn't need fasting
    • Influenced by: Red blood cell lifespan, sickle cell disease, hemolytic diseases

    HbA1c Testing, Specimen and Methods

    • Specimen: EDTA whole blood.
    • Fasting not required.
    • Methods: Enzymatic (immunoassay, mass spectrometry, chromatography), HPLC, and electrophoresis
    • Reference range: 4.0-5.6%
    • For diagnosis of diabetes: >6.5%. Confirmed by repeat measurement.
    • For every 1% change in HbA1c, there is a 35mg/dL change in glucose.

    HbA1c Target Levels for Diabetes

    • Target <7% to control blood glucose.
    • Higher levels suggest better control.

    Ketones

    • Produced in the liver from stored lipids.
    • Metabolic byproducts of fatty acid breakdown.
    • Include acetone, acetoacetic acid, and β-hydroxybutyric acid (78%).
    • Increased in conditions like carbohydrate deprivation, starvation, fasting, prolonged vomiting.
    • Increased in diabetes.
    • Tested in fresh serum or urine.

    (Micro)albuminuria

    • Early sign of nephropathy (kidney damage) due to diabetes.
    • Caused by progressive changes in the kidneys.
    • Microalbumin to creatinine ratio of >30 mg/g is diagnostic.
    • Should be confirmed over a period of 3-6 months.
    • Random or timed collections (24-hour or 4-hour).

    Lactose Tolerance Test

    • Used to assess lactose malabsorption or lactase deficiency.
    • Patients given a lactose load, breath samples collected at timed intervals, and increased hydrogen levels indicate a diagnosis.
    • Similar to glucose tolerance test; a rise in glucose >30mg/dL over baseline rules out lactase deficiency.

    Glucose and HbA1C Decision Levels

    • Fasting glucose: Normal <99 mg/dL, Prediabetes 100-125 mg/dL, Diabetes ≥126 mg/dL
    • Two-hour oral glucose tolerance: Normal <140
    • HbA1C: Acceptable Control <7.0%, Normal <5.6%, Prediabetes 5.7%-6.4%

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Carbohydrates Student PDF

    Description

    Test your knowledge about diabetes diagnosis criteria and related complications. This quiz covers essential topics like fasting plasma glucose levels, HgbA1C results, and the hormonal responses to low glucose levels. Ideal for students and healthcare professionals alike.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser