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Questions and Answers
What is the primary metabolic disorder associated with diabetes mellitus?
What significant long-term consequence is associated with diabetes mellitus?
Which of the following is true regarding the prevalence of diabetes in adults aged 20-79 globally as of 2019?
Which historical milestone is associated with the discovery of insulin?
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What is a common misconception about diabetes insipidus?
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What is the expected global rise in the number of adults living with diabetes by 2045?
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According to statistics in the UK, what proportion of people has diabetes?
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What is noted about the incidence of diabetes among live births?
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What is one possible consequence of infant exposure to cow's milk in relation to T1 diabetes?
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Which of the following is NOT listed as a risk factor for T2 diabetes?
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Which symptom is characteristic of T1 diabetes but may be absent in T2 diabetes?
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What mechanism leads to the impaired insulin production observed in T2 diabetes?
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What is a common co-morbidity observed alongside T2 diabetes at diagnosis?
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How does geography relate to the risk factors for T1 diabetes?
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Which factor is most associated with both the genetics and risk of developing T2 diabetes?
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What management strategy is essential to reduce the risk of macro-vascular disease in diabetes patients?
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Which of the following hormones is responsible for lowering blood sugar levels?
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What is a common symptom of hyperglycemia?
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Which condition occurs when there is insufficient insulin to allow glucose to enter cells?
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What percentage of diabetes cases does Type 2 diabetes typically represent?
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Which of the following is NOT a secondary cause of diabetes?
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What is a characteristic symptom of hypoglycemia?
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What role do the islet cells in the pancreas primarily serve?
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Which of the following statements is true regarding Type 1 diabetes?
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What percentage of pre-diabetics is estimated to progress to diabetes each year?
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Which of the following conditions is associated with increased cortisol production?
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What does the classification of diabetic retinopathy (DR) help determine?
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Which grading describes the absence of features of diabetic retinopathy?
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In the context of diabetic retinopathy, what is indicated by the presence of extensive micro-aneurysms?
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What is the primary feature of the proliferative phase of diabetic retinopathy?
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Which grading indicates severe non or pre-proliferative retinopathy with large blot hemorrhages?
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Which of the following is NOT a complication associated with R3A proliferative retinopathy?
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What is indicated by cotton wool spots in diabetic retinopathy?
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Which classification might indicate no recent hemorrhages or new vessels in treated diabetic retinopathy?
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What is a sign of diabetic maculopathy that indicates possible damage near the fovea?
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What should be assessed during management for patients with R2 and/or M1?
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What is the recommended follow-up for patients experiencing NVD/NVE as per R3A protocol?
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How frequently should a stable and treated patient under HES care be rescreened?
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Which finding necessitates a same-day referral following an optometrist examination under R3A complications management?
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When managing R3A, at what time frame should a review be conducted following the detection of NVD/NVE?
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Which examination technique is acceptable if the patient is being screened, as per the management of R3S?
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What should be monitored during follow-up for diabetic retinopathy patients?
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Study Notes
Diabetes Mellitus
- Diabetes Mellitus (DM) is a metabolic disorder characterized by defective insulin secretion, action, or both.
- DM causes systemic effects, including long-term organ dysfunction and failure.
- DM has been documented since 1550 BC, with evidence of its impact on organ function dating back to the 5th century AD.
- In 2019, approximately 463 million adults worldwide were living with diabetes.
- The International Diabetes Federation (IDF) predicts that by 2045, over 700 million people will be living with DM.
- DM caused 4.2 million deaths globally in 2019.
Diabetes: Classification & Risk Factors
- Diabetes comes in different types with varying causes and risk factors.
- Type 1 (T1) diabetes: typically occurs early in life (approx. 8% of cases), characterized by the destruction of pancreatic beta cells, resulting in a complete deficiency of insulin.
- Type 2 (T2) diabetes: typically occurs later in life (approx. 90% of cases), characterized by insulin resistance, leading to a gradual decline in insulin production.
- Gestational diabetes: develops during pregnancy, and may or may not resolve after delivery.
- Other rarer types of diabetes exist, including MODY (Maturity onset diabetes of the young), neonatal diabetes, and LADA (Latent Autoimmune Diabetes in Adults).
- Prediabetes: characterized by impaired glucose tolerance. 5-10% of individuals with prediabetes progress to diabetes each year.
Diabetes: Aetiology
- The primary causes of diabetes are often unknown, but current theories point to genetic predisposition and autoimmune responses.
- Secondary causes of diabetes can be related to pancreatic diseases, such as pancreatitis or cystic fibrosis.
- Hormonal imbalances, drug-induced effects, and even Alzheimer's disease can lead to diabetes.
Pancreas Anatomy & Function
- The pancreas has two main functions:
- Exocrine: secretes enzymes for digestion of proteins, fats, and carbohydrates.
- Endocrine: regulates blood glucose levels by producing and releasing hormones, including insulin (lowers blood sugar), glucagon (raises blood sugar), and somatostatin (controls sugar/salt).
Diabetic States
- Hyperglycemia: high blood glucose (>7 mmol/L) due to insufficient insulin, stress, poor health, or missed medication. Symptoms include increased urination, thirst, fatigue, and hunger.
- Hypoglycemia: low blood glucose (may occur from diabetic medication/insulin dose) with symptoms such as sweating, fatigue, dizziness, confusion, and even convulsions.
- Ketoacidosis: very high blood glucose (>15 mmol/L, more common in T1 diabetes) due to insufficient insulin allowing glucose to enter cells, leading to the body switching to burning fatty acids, producing toxic ketone bodies. Symptoms include vomiting, dehydration, sweet-smelling breath, hyperventilation, tachycardia, confusion, and disorientation.
Diabetes Management: Macro-vascular Disease
- Diabetes is associated with an increased risk of macro-vascular disease, including cardiovascular disease (CVD), myocardial infarction (MI), and stroke.
- Macro-vascular disease is characterized by chronic inflammation and damage to arterial walls, leading to atherosclerosis (arterial narrowing).
- Management strategies for DM and DR focus on blood pressure control, aspirin use, and smoking cessation.
Diabetic Retinopathy: Classification & Grading
- Diabetic retinopathy is classified into stages based on the types of features and their location.
- Non-proliferative retinopathy: characterized by leakage of vessels, often leading to haemorrhages, exudates, and oedema.
- Proliferative retinopathy: characterized by the retina's attempt to re-vascularize, leading to new vessel growth (NVD/NVE/NVI) and complications such as pre-retinal/vitreous haemorrhage, retinal detachment, and neovascular glaucoma.
- Diabetic Maculopathy: involves the macula, with features including exudates, oedema, and retinal thickening.
Diabetic Retinopathy: Management
- Patients with R2 retinopathy (moderate) or M1 maculopathy (mild) are reviewed in a specialized clinic to monitor progression and determine if further intervention is needed.
- Patients with R3A retinopathy (active) are referred for prompt treatment.
- Optometrists play a crucial role in detecting and managing diabetic retinopathy.
- Timely referral is essential for optimal management of DR and prevention of complications.
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Description
Explore the essential facts about Diabetes Mellitus, including its types, historical significance, and global impact on health. This quiz delves into the differences between Type 1 and Type 2 diabetes, as well as the associated risk factors and statistics. Test your knowledge and learn about this widespread metabolic disorder.
