Diabetes Mellitus Diagnosis Quiz

Benefits of Early Diabetes Diagnosis

• Early diagnosis of diabetes mellitus can prevent or delay the onset of serious complications like cardiovascular disease, kidney failure, and nerve damage.
• Improved management strategies can be implemented sooner, leading to better long-term health outcomes and quality of life.

Diagnostic Tests for Diabetes Mellitus

• Fasting Blood Glucose Test: Measures glucose levels after fasting for at least 8 hours.
• Oral Glucose Tolerance Test (OGTT): Measures blood sugar levels before and after consuming a glucose-rich drink, assessing how well the body processes sugar.
• Hemoglobin A1c Test: Indicates average blood glucose levels over the past 2-3 months, used for both diagnosis and monitoring of diabetes.

Consequences of Delaying Diabetes Diagnosis

• Delayed diagnosis can lead to progressive complications that could have been avoided with early intervention, resulting in increased healthcare costs and decreased patient well-being.

Non-Contributing Factors to Importance of Glucose Testing

• Personal lifestyle choices, like diet and exercise, do not diminish the necessity of glucose testing; rather, they are integrated into managing diabetes effectively.

True Statements about Glucose Tests in Management

• Regular glucose testing is crucial for monitoring blood sugar levels and adjusting treatment plans, enabling patients to maintain target glucose ranges and reduce long-term complications.

Urine

• Urine is a fluid excreted by mammals, including humans.
• It is formed in the kidneys (renal glomeruli).
• Urine undergoes chemical changes before it is excreted.
• Healthy urine excretion is about 1.5 L per day.

Physical Properties of Urine

• Normal urine volume is between 0.4-2.0 L/day.
• Polyuria (excess urine) can indicate diabetes or chronic renal failure.
• Oligouria (low urine) can indicate dehydration or acute renal failure.
• Normal urine appearance is clear, colorless, and yellow with a urine-like odor.
• Cloudy urine can indicate the presence of pus cells, bacteria, salt, or epithelial cells.
• Orange urine can indicate dehydration or carotenoid ingestion.
• Green-yellow urine can indicate jaundice.
• Red urine can indicate blood, drugs, or other substances.
• Dark brown-black urine can indicate methemoglobin, alkaptonuria, melanoma, or black water fever.
• Smoky urine can indicate glomerulonephritis.
• Fruity odor can indicate diabetic ketoacidosis.
• Ammoniacal odor can indicate contaminated or long-standing exposed urine.
• Mousy odor can indicate phenylketonuria.
• Burnt sugar odor can indicate maple syrup urine disease.
• Urine deposits can indicate crystals, salts, cells, or blood clots.
• Normal urine pH is between 4.6-7.0.
• Acidic urine can indicate ketosis, metabolic and respiratory acidosis, and excessive meat or fruit consumption.
• Alkaline urine can indicate respiratory and metabolic alkalosis, urinary tract infection, or a vegetarian diet.

Chemical Properties of Urine

• Normal protein levels in urine are less than 200 mg/day.
• Proteinuria is the presence of excess protein in the urine.
• Glomerular proteinuria indicates increased glomerular permeability due to conditions like glomerulonephritis.
• Tubular proteinuria indicates decreased tubular reabsorption with normal glomerular permeability due to conditions like chronic nephritis.
• Normal urine contains no glucose.
• Glucosuria indicates the presence of glucose in the urine.
• Glucosuria can be caused by uncontrolled diabetes, gestational diabetes, Fanconi’s syndrome, or diabetic ketoacidosis.
• Normal urine contains no ketones.
• Ketonuria indicates the presence of ketones in the urine.
• Ketonuria can be caused by uncontrolled diabetes, starvation, prolonged vomiting, glycogen storage disease, or unbalanced diet.
• Normal urine contains no nitrites.
• Nitrites in urine indicate a urinary tract infection (UTI).
• Normal urine contains no bilirubin.
• Bilirubin in urine indicates hepatic and post-hepatic jaundice.
• Normal urobilinogen levels are up to 1mg/dl.
• High urobilinogen levels (above 2mg/dl) can indicate jaundice.
• Normal urine contains no blood.
• Hematuria indicates the presence of blood in the urine.
• Hematuria can be caused by acute and chronic glomerulonephritis, trauma, cystitis, renal calculi, tumors, bleeding disorders, or hemophilia.
• Hemoglobinuria indicates the presence of hemoglobin in the urine.
• Hemoglobinuria can be caused by hemoglobinopathies, malaria, or transfusion reactions.

Proteins

• Normally, less than 200 mg of protein is excreted in the urine daily.
• Proteinuria is the condition of more than 200 mg of protein excreted daily.
• Glomerular proteinuria is due to increased glomerular permeability, leading to the filtration of high molecular weight proteins (e.g. glomerulonephritis).
• Tubular proteinuria is caused by decreased tubular reabsorption with normal glomerular permeability, leading to the excretion of low molecular weight proteins (e.g. chronic nephritis).

Nephrotic Syndrome

• This syndrome is characterized by significant protein loss in urine, leading to hypoproteinemia.
• Increased protein excretion in urine can be classified into two types:
  • High molecular weight protein excretion: related to Glomerular proteinuria.
  • Low molecular weight protein excretion: related to Tubular proteinuria.