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Questions and Answers
What is a potential long-term consequence of untreated Type 2 Diabetes Mellitus?
Which symptom is NOT commonly associated with diabetes mellitus?
What primarily characterizes Type 1 Diabetes Mellitus?
Which test is NOT typically used for diagnosing Diabetes Mellitus?
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What effect does acanthosis nigricans have on the body?
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What characterizes gestational diabetes mellitus?
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Which of the following is a risk factor for Type 2 Diabetes Mellitus?
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Which condition could develop due to diabetes-related complications?
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Which method is considered the gold standard for the detection of glucose?
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What is the role of mutarotase enzyme in glucose testing?
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What does a normal HbA1c level range from?
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In a ketone test, what does a purple color reaction indicate?
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What is the normal reference range for the C-peptide test?
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What hormone is primarily involved in increasing glucose levels in response to hypoglycemia?
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Which condition is characterized by impaired receptor binding and usually occurs in neonates?
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What does the Oral Glucose Tolerance Test (OGTT) involve?
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What is considered a capillary blood glucose level above normal?
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Which method is considered the method of choice for measuring glucose due to its higher specificity?
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What is the primary function of hormones produced by the exocrine pancreas?
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What does the glucose challenge test (GCT) utilize for its screening purpose?
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In the alkaline copper reduction method, which reagent gives a blue color?
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Study Notes
Diabetes Mellitus Overview
- Chronic condition characterized by insufficient insulin production from the pancreas.
- Results in hyperglycemia, which is a high level of glucose in the blood.
- Hypoglycemia indicates low blood sugar levels.
Type 1 Diabetes Mellitus (DM)
- Also known as insulin-dependent, juvenile, or childhood onset diabetes.
- Usually diagnosed around 9 years of age; symptoms include thirst and weight loss.
- Represents 0-15% of the total population.
- Involves destruction of beta cells in the pancreas that produce insulin, leading to lack of glucose entry into cells.
- Ketones are produced as a last energy source due to beta cell destruction.
Immune Response in Type 1 DM
- Autoantibodies target and destroy insulin-producing beta cells.
- Presence of ketonuria indicates fat metabolism resulting from low insulin.
Type 2 Diabetes Mellitus (DM)
- Characterized by insulin resistance; glucose is present but not effectively used by the body.
- No ketonuria typically observed.
- Often develops in adults and is linked to obesity, genetic factors, lack of exercise, and conditions like PCOS.
- Represents about 80% of the diabetic population.
- Beta cells may be present but their function declines, potentially leading to kidney failure if untreated.
Pathophysiology of DM
- Both type 1 and type 2 diabetes result in hyperglycemia.
- Untreated type 2 diabetes can lead to non-ketotic hyperosmolar state and dehydration due to excessive glucose production.
Symptoms and Diagnostic Criteria
- Common symptoms include:
- Polydipsia (increased thirst)
- Polyphagia (increased hunger)
- Polyuria (increased urination)
- Diagnostic tests include:
- HbA1c (glycosylated hemoglobin), which monitors long-term glucose levels.
- Fasting blood sugar, Oral Glucose Tolerance Test (OGTT), and random plasma glucose levels.
Pre-Diabetes Indicators
- Acanthosis nigricans (darkening of skin) can signal pre-diabetes.
- Individuals over 45 years old should be tested for diabetes every 3-6 months.
Gestational Diabetes Mellitus (GDM)
- Glucose intolerance occurring during pregnancy.
- Diagnosed using OGTT; caused by metabolic hormonal changes associated with pregnancy.
- Risks for babies include being overweight, hypoglycemia, and jaundice.
- Mothers may face premature births and increased risk for type 2 diabetes post-pregnancy.
Specific Causes of Diabetes Mellitus
- Genetic defects such as Maturity Onset Diabetes of the Young (MODY) have a strong familial correlation.
- Other causes include diseases affecting the exocrine pancreas and endocrinopathies like Cushing's disease.
- Drug or chemical induced DM often involves hypoglycemic episodes.
Blood Sugar Monitoring and Testing Protocol
- Fasting periods vary: typically 8-10 hours for blood tests.
- Capillary blood glucose > 140 mg/dl indicates potential diabetes.
- OGTT involves drinking glucola and testing blood within a set timeframe after consumption.
Diagnostic Methods for Diabetes
- Various enzymatic and oxidation methods are used for glucose measurement, including:
- Glucose oxidase
- Hexokinase (gold standard)
- HbA1c testing requires EDTA-venous whole blood; its formation is proportional to plasma glucose levels.
- High-Pressure Liquid Chromatography (HPLC) is the gold standard for HbA1c detection.
Testing Parameters and Ranges
- Fast Blood Sugar (FBS) levels < 126 mg/dl indicate normal.
- OGTT < 200 mg/dl and random plasma glucose < 200 mg/dl are considered normal.
- HbA1c levels:
- Normal: 4.2-6.2%
- Pre-diabetes: 5.7-6.4%
- Diabetes: > 6.5%
- Fructosamine normal range is 205-285 mm/l.
Ketone Testing
- Ketone bodies indicate fat metabolism during energy deficiency.
- Tests for acetoacetate and β-hydroxybutyrate utilize fresh serum or urine samples.
Observable Signs of Hypoglycemia
- Symptoms manifest when blood glucose levels drop to 50-55 mg/dl; treatment may require rapid glucose administration.
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Description
Explore the fundamentals of Diabetes Mellitus, including its types, particularly Type 1 which is insulin-dependent and often diagnosed in childhood. Understand the role of insulin and the impact of hyperglycemia and hypoglycemia on the body, alongside the function of beta cells in the pancreas.
