Diabetes Mellitus Overview
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Questions and Answers

Which of the following statements is true regarding Type 2 diabetes?

  • There is no connection between obesity and Type 2 diabetes.
  • Insulin resistance is a primary factor in Type 2 diabetes. (correct)
  • It is less common in individuals with a family history of diabetes.
  • It exclusively results from a lack of insulin production.

    • What primary characteristic differentiates Type 1 diabetes from Type 2 diabetes?

  • Type 1 diabetes involves damage to beta cells leading to insulin deficiency. (correct)
  • Type 1 diabetes is largely related to obesity.
  • Type 1 diabetes is associated with insulin resistance.
  • Type 1 diabetes typically occurs after the age of 40.

    • What is a common symptom of hyperglycemia in diabetes mellitus?

  • Hypoglycemic episodes.
  • Frequent urination (glucosuria). (correct)
  • Increased insulin secretion.
  • Weight gain.

    • Which diagnostic test is most commonly used to assess glucose levels in individuals suspected of having diabetes?

    <p>Hemoglobin A1c test.</p> Signup and view all the answers

    What is an essential management strategy for individuals with Type 2 diabetes?

    <p>Encouraging weight loss and regular physical activity.</p> Signup and view all the answers

    What body weight is typically associated with Type 1 diabetes?

    <p>Usually underweight</p> Signup and view all the answers

    At what age does Type 2 diabetes commonly onset?

    <p>Over 40 years</p> Signup and view all the answers

    Which of the following symptoms is particularly seen in Type 1 diabetes?

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

    What is a common diagnostic test used to determine if someone has overt diabetes?

    <p>Fasting plasma glucose level of ≥ 126 mg %</p> Signup and view all the answers

    What is the stability condition generally observed in Type 2 diabetes?

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

    Which treatment is typically necessary for Type 1 diabetes?

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

    What glycosylated hemoglobin (HbA1c) level is considered normal?

    <p>6 %</p> Signup and view all the answers

    Which of the following is an ineffective treatment option at the onset of Type 2 diabetes?

    <p>Oral hypoglycemic agents</p> Signup and view all the answers

    What is the primary method of managing type 1 diabetes?

    <p>Artificial insulin via injection with blood glucose monitoring</p> Signup and view all the answers

    Which strategy is NOT typically part of the initial treatment for type 2 diabetes?

    <p>Oral antidiabetic drugs</p> Signup and view all the answers

    What is the average glucose level considered acceptable for type 1 diabetes management?

    <p>80–120 mg/dl</p> Signup and view all the answers

    What is a common treatment option for type 1 diabetes?

    <p>Insulin pumps or synthetic insulin analogs</p> Signup and view all the answers

    Which of the following is a lifestyle modification recommended for managing diabetes-related risks?

    <p>Wearing diabetic shoes and socks</p> Signup and view all the answers

    Why might insulin therapy become necessary in type 2 diabetes?

    <p>Failure of oral medications due to further beta cell impairment</p> Signup and view all the answers

    What role does self-monitoring of blood glucose play in diabetes management?

    <p>It can help in maintaining target glucose levels.</p> Signup and view all the answers

    Which insulin types are commonly combined in type 1 diabetes treatment?

    <p>Regular and NPH insulin, or synthetic insulin analogs</p> Signup and view all the answers

    What is the primary underlying cause of hyperglycemia in diabetes mellitus?

    <p>Insulin deficiency or resistance</p> Signup and view all the answers

    Which factor is a significant predisposing factor for insulin resistance in Type 2 diabetes?

    <p>Central obesity</p> Signup and view all the answers

    What percentage of diabetes cases is classified as primary diabetes?

    <p>Over 95%</p> Signup and view all the answers

    What is a common contributing factor associated with the development of Type 2 diabetes?

    <p>Family history of diabetes</p> Signup and view all the answers

    What condition is generally observed as a secondary disturbance in diabetes mellitus?

    <p>Disturbance of protein and fat metabolism</p> Signup and view all the answers

    What is the typical age of onset for Type 1 diabetes?

    <p>&lt; 30 years</p> Signup and view all the answers

    Which of the following is a classic symptom of diabetes?

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

    What characteristic is true regarding Type 2 diabetes in comparison to Type 1 diabetes?

    <p>Individuals are usually overweight</p> Signup and view all the answers

    Which of the following glucose levels indicates overt diabetes during fasting?

    <p>≥ 126 mg %</p> Signup and view all the answers

    How does the stability of Type 1 diabetes generally compare to Type 2 diabetes?

    <p>Type 1 is unstable while Type 2 is stable</p> Signup and view all the answers

    Which method is typically NOT effective for controlling Type 1 diabetes?

    <p>Oral hypoglycemic agents</p> Signup and view all the answers

    What is the significance of measuring glycosylated hemoglobin (HbA1c) in diabetes management?

    <p>It indicates control over blood glucose for the preceding several weeks</p> Signup and view all the answers

    Which of the following urine tests is primarily used for ketone bodies?

    <p>Rothera's Na nitroprusside test</p> Signup and view all the answers

    What is the primary cause of diabetic ketoacidosis (DKA)?

    <p>Low insulin levels</p> Signup and view all the answers

    Which of the following symptoms is characteristic of diabetic ketoacidosis?

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

    What blood glucose level is generally considered indicative of hyperglycemia hyperosmolar state?

    <p>Above 300 mg/dl</p> Signup and view all the answers

    Which complication is more commonly associated with type 2 diabetes?

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

    What is the typical treatment for hypoglycemia?

    <p>Sugary drinks or food</p> Signup and view all the answers

    Which of the following might lead to hypoglycemia in diabetes patients?

    <p>Too much insulin</p> Signup and view all the answers

    What is the primary goal of patient education and self-monitoring in diabetes management?

    <p>To keep blood glucose levels within acceptable bounds</p> Signup and view all the answers

    Which of the following actions is typically recommended as the first treatment step for type 2 diabetes?

    <p>Increasing physical activity</p> Signup and view all the answers

    What is a potential consequence of untreated hypoglycemia?

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

    What happens to insulin production in type 2 diabetes over time?

    <p>It is initially moderately impaired and can deteriorate</p> Signup and view all the answers

    What physiological effect does high blood glucose have on the cells?

    <p>Osmotic withdrawal of water into the blood</p> Signup and view all the answers

    In the management of type 1 diabetes, what is the significance of combining regular and NPH insulin?

    <p>To normalize glucose levels more effectively</p> Signup and view all the answers

    What is a common outcome if oral medications fail in type 2 diabetes management?

    <p>Necessity of insulin therapy</p> Signup and view all the answers

    Which blood glucose level range is suggested for type 1 diabetes management?

    <p>80–120 mg/dl</p> Signup and view all the answers

    What lifestyle modifications can help control the risk of cardiovascular diseases in diabetes patients?

    <p>Eating a properly balanced diet</p> Signup and view all the answers

    When should insulin therapy be considered in type 2 diabetes management?

    <p>After all lifestyle changes have failed</p> Signup and view all the answers

    Study Notes

    Diabetes Mellitus

    • A disturbance of carbohydrate metabolism caused by insulin deficiency, resistance, or both, leading to hyperglycemia and possibly glucosuria.
    • The most common endocrine disease with a 1-2% prevalence.
    • Primarily caused by insulin deficiency or resistance.
      • Type 1: Insulin-dependent diabetes mellitus (IDDM), previously known as juvenile-onset.
        • Insulin deficiency caused by damage to the beta cells, resulting in hyperglycemia.
      • Type 2: Non-insulin-dependent diabetes mellitus (NIDDM), previously known as maturity-onset.
        • Insulin resistance &/or abnormal insulin structure, which in some cases becomes absolute, combined with relatively reduced insulin secretion.
    • Numerous theories about cause and mechanism of Type 2 Diabetes:
      • Central obesity (fat concentrated around the waist) predisposes individuals to insulin resistance.
        • It secretes adipokines that may affect glucose tolerance.
      • Obesity is found in about 55% of patients diagnosed with Type 2 Diabetes.
      • Family history: Type 2 Diabetes is more common in those with relatives who have had it.

    Diabetes Mellitus

    • A condition characterized by a disturbance in carbohydrate metabolism due to insulin deficiency, resistance, or both, leading to hyperglycemia and glucosuria. This also causes secondary disturbances in protein and fat metabolism
    • Diabetes mellitus is the most common endocrine disease with a prevalence of 1-2%
    • There are two main types of diabetes: type 1 and type 2.

    Type 1 Diabetes

    • Previously referred to as Insulin-Dependent Diabetes Mellitus (IDDM) or Juvenile-Onset Diabetes
    • Caused by insulin deficiency due to the destruction of beta cells in the pancreas.
    • Affects around 10% of all diabetic patients.
    • Typically diagnosed before the age of 30, with the most common age of onset being between 12 and 14 years
    • More prevalent in males.
    • Individuals are often underweight.
    • Characterized by severe and unstable diabetes.
    • Insulin is essential for treatment.
    • Oral hypoglycemic agents are ineffective.

    Type 2 Diabetes

    • Previously referred to as Non-Insulin-Dependent Diabetes Mellitus (NIDDM) or Maturity-Onset Diabetes
    • Caused by a combination of factors including:
      • Insulin resistance
      • Abnormal insulin structure
      • Reduced insulin secretion
    • Accounts for 90% of all diabetic patients
    • Typically diagnosed after the age of 40.
    • More prevalent in females.
    • Individuals are usually overweight.
    • Characterized by mild or moderate, and stable diabetes.
    • Initially may not require insulin.
    • Oral hypoglycemic agents can be effective at least initially.

    Theories Regarding Type 2 Diabetes

    • Central obesity is considered a major risk factor for insulin resistance
      • Abdominal fat is more hormonally active than subcutaneous fat.
      • Abdominal fat secretes adipokines, which may impair glucose tolerance.
    • Approximately 55% of patients diagnosed with type 2 diabetes are obese.
    • Family history strongly influences the likelihood of developing type 2 diabetes.

    Clinical Presentations

    • Often asymptomatic and discovered accidentally.
    • Classic symptoms include:
      • Polyuria (excessive urination)
      • Polydipsia (excessive thirst)
      • Polyphagia (excessive hunger, with weight loss especially in type 1)
      • Pruritis (itching, especially of the vulva and anal region)
      • Parathesia (numbness or tingling, especially of the hands and feet)
      • Premature loosening of teeth
      • Recurrent infections (e.g., boils)
    • Diabetes can also manifest through complications or a diabetic coma.

    Investigations

    • Plasma Glucose Testing:

      • Fasting glucose ( normal < 100 mg%)
      • 2 hours post-prandial glucose ( normal < 140 mg% )
      • Oral Glucose Tolerance Test (OGTT)
        • Impaired Glucose Tolerance(IGT):
          • Fasting Glucose (≥ 100 & < 126 mg%)
          • 2 hours post-prandial ( ≥ 140 & < 200 mg% )
        • Overt Diabetes:
          • Fasting glucose (≥ 126 mg%)
          • 2 hours post-prandial glucose (≥ 200 mg%)
          • Symptoms of diabetes and a random glucose concentration ≥ 200 mg/dl
      • Glycosylated Hemoglobin (HbA1c)
        • formed by the linkage of glucose to the beta-chains of Hemoglobin A
        • used to estimate diabetic control over the preceding 8-12 weeks
        • normal level is 6% of total Hb

    • Urine Analysis:

      • Glucose: using strips or, less commonly, solutions (e.g., Benedict's reagent)
      • Ketone bodies: using strips or Rothera's sodium nitroprusside test
      • Home Blood Glucose Monitoring (HBGM) or urine glucose testing is used to monitor treatment.

    Management

    • Patient education is paramount in the management of diabetes.
    • Dietary changes, sensible exercise, and self-monitoring of blood glucose levels are essential to maintain blood glucose within acceptable bounds.
    • Type 1 diabetes always requires insulin therapy via injection.
    • Blood glucose levels should be maintained as close to normal (80-120 mg/dl) as possible.
    • Some physicians may suggest a target range of 140-150 mg/dl for patients who experience frequent hypoglycemic episodes.
    • Treatment of type 2 diabetes often begins with lifestyle modifications, such as:
      • Increasing physical activity
      • Decreasing carbohydrate intake
      • Weight loss
    • Oral antidiabetic drugs may be introduced if lifestyle modifications are insufficient
    • Insulin therapy becomes necessary for patients with type 2 diabetes who fail to respond to oral medications or experience progressive impairment of beta cell insulin secretion
    • Patients with type 2 diabetes should also be evaluated for cardiovascular risk factors and treated accordingly.

    Insulin Therapy for Type 1 Diabetes

    • Treatment often involves a combination of regular insulin, NPH insulin, or synthetic insulin analogs (e.g., Humalog, Novolog, Lantus, Levemir)
    • Insulin pumps (e.g., FLEXIBLE-PUMP) are also an option for type 1 diabetes
    • Blood glucose monitoring is essential for all insulin-dependent patients.

    Acute Complications of Diabetes

    • Diabetic Ketoacidosis(DKA):
      • A serious and potentially life-threatening medical emergency.
      • Caused by low insulin levels, leading to the liver turning to fat for fuel (ketogenesis)
      • Elevated ketone bodies in the blood decrease blood pH, leading to metabolic acidosis.
      • Often presents with dehydration, rapid and deep breathing, and abdominal pain.
      • Can cause:
        • Hypotension
        • Shock
        • Renal failure
        • Brain edema
        • Death
      • More common in type 1 diabetes than type 2.
    • Hyperosmolar hyperglycemic state:
      • A serious condition with many similarities to DKA but a different origin and treatment.
      • Caused by very high blood glucose levels (> 300 mg/dl), leading to osmotic water movement from cells to the blood.
      • This causes increased blood osmolarity and the kidneys dump glucose into the urine.
      • Results in dehydration and potentially coma if fluid is not replaced.
      • More common in type 2 diabetes than type 1.
    • Hypoglycemia:
      • Defined as abnormally low blood glucose levels (below 70 mg/dl).
      • Can cause:
        • Agitation
        • Sweating
        • Symptoms of sympathetic nervous system activation
        • Altered or loss of consciousness, potentially leading to coma, seizures, brain damage, or death.
      • Caused by:
        • Too much or incorrectly timed insulin
        • Too much or incorrectly timed exercise
        • Insufficient food intake
      • Treated with sugary drinks or food, and in severe cases, with glucagon injection.

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    Description

    Test your knowledge on Diabetes Mellitus, a disturbance of carbohydrate metabolism characterized by insulin deficiency or resistance. This quiz covers Type 1 and Type 2 diabetes, their causes, and associated mechanisms. Learn about the impact of obesity and insulin on glucose tolerance.

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