Diabetes Mellitus Overview
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Questions and Answers

What is the primary metabolic disorder associated with diabetes mellitus?

  • Increased glucose tolerance
  • Defective insulin secretion or action (correct)
  • Inability to process lipids
  • Excessive insulin production

    • What significant long-term consequence is associated with diabetes mellitus?

  • Long-term organ dysfunction and failure (correct)
  • Heightened insulin sensitivity
  • Increased muscle mass
  • Enhanced cognitive function

    • Which of the following is true regarding the prevalence of diabetes in adults aged 20-79 globally as of 2019?

  • Only 1% of adults are affected.
  • All adults are at equal risk without age consideration.
  • Approximately 463 million were living with diabetes. (correct)
  • It is decreasing steadily.

    • Which historical milestone is associated with the discovery of insulin?

    <p>Insulin extraction by Banting, Best &amp; Macleod in 1921</p> Signup and view all the answers

    What is a common misconception about diabetes insipidus?

    <p>It is caused by excess glucose levels.</p> Signup and view all the answers

    What is the expected global rise in the number of adults living with diabetes by 2045?

    <p>Approximately 700 million</p> Signup and view all the answers

    According to statistics in the UK, what proportion of people has diabetes?

    <p>1 in 15</p> Signup and view all the answers

    What is noted about the incidence of diabetes among live births?

    <p>1 in 6 live births are affected.</p> Signup and view all the answers

    What is one possible consequence of infant exposure to cow's milk in relation to T1 diabetes?

    <p>Destruction of beta cells</p> Signup and view all the answers

    Which of the following is NOT listed as a risk factor for T2 diabetes?

    <p>High levels of exercise</p> Signup and view all the answers

    Which symptom is characteristic of T1 diabetes but may be absent in T2 diabetes?

    <p>Asymptomatic nature</p> Signup and view all the answers

    What mechanism leads to the impaired insulin production observed in T2 diabetes?

    <p>Increased demand for insulin</p> Signup and view all the answers

    What is a common co-morbidity observed alongside T2 diabetes at diagnosis?

    <p>High blood pressure</p> Signup and view all the answers

    How does geography relate to the risk factors for T1 diabetes?

    <p>Increased exposure to viruses in northern climates</p> Signup and view all the answers

    Which factor is most associated with both the genetics and risk of developing T2 diabetes?

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

    What management strategy is essential to reduce the risk of macro-vascular disease in diabetes patients?

    <p>Smoking cessation</p> Signup and view all the answers

    Which of the following hormones is responsible for lowering blood sugar levels?

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

    What is a common symptom of hyperglycemia?

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

    Which condition occurs when there is insufficient insulin to allow glucose to enter cells?

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

    What percentage of diabetes cases does Type 2 diabetes typically represent?

    <p>90%</p> Signup and view all the answers

    Which of the following is NOT a secondary cause of diabetes?

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

    What is a characteristic symptom of hypoglycemia?

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

    What role do the islet cells in the pancreas primarily serve?

    <p>Regulating blood glucose</p> Signup and view all the answers

    Which of the following statements is true regarding Type 1 diabetes?

    <p>It results from the destruction of pancreatic beta cells.</p> Signup and view all the answers

    What percentage of pre-diabetics is estimated to progress to diabetes each year?

    <p>5-10%</p> Signup and view all the answers

    Which of the following conditions is associated with increased cortisol production?

    <p>Cushing’s disease</p> Signup and view all the answers

    What does the classification of diabetic retinopathy (DR) help determine?

    <p>Speed of referral and degree of intervention</p> Signup and view all the answers

    Which grading describes the absence of features of diabetic retinopathy?

    <p>R0/M0</p> Signup and view all the answers

    In the context of diabetic retinopathy, what is indicated by the presence of extensive micro-aneurysms?

    <p>R2 - Moderate non or pre-proliferative retinopathy</p> Signup and view all the answers

    What is the primary feature of the proliferative phase of diabetic retinopathy?

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

    Which grading indicates severe non or pre-proliferative retinopathy with large blot hemorrhages?

    <p>R2 (Severe)</p> Signup and view all the answers

    Which of the following is NOT a complication associated with R3A proliferative retinopathy?

    <p>Non-proliferative changes</p> Signup and view all the answers

    What is indicated by cotton wool spots in diabetic retinopathy?

    <p>Ischemia signs</p> Signup and view all the answers

    Which classification might indicate no recent hemorrhages or new vessels in treated diabetic retinopathy?

    <p>R3S</p> Signup and view all the answers

    What is a sign of diabetic maculopathy that indicates possible damage near the fovea?

    <p>Exudates within 1DD of fovea</p> Signup and view all the answers

    What should be assessed during management for patients with R2 and/or M1?

    <p>Change in vision or symptoms</p> Signup and view all the answers

    What is the recommended follow-up for patients experiencing NVD/NVE as per R3A protocol?

    <p>Same-day referral</p> Signup and view all the answers

    How frequently should a stable and treated patient under HES care be rescreened?

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

    Which finding necessitates a same-day referral following an optometrist examination under R3A complications management?

    <p>Sudden loss of vision</p> Signup and view all the answers

    When managing R3A, at what time frame should a review be conducted following the detection of NVD/NVE?

    <p>Within 1 week</p> Signup and view all the answers

    Which examination technique is acceptable if the patient is being screened, as per the management of R3S?

    <p>Un-dilated examination</p> Signup and view all the answers

    What should be monitored during follow-up for diabetic retinopathy patients?

    <p>Changes in visual acuity or symptoms</p> Signup and view all the answers

    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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    Diabetes 1: Diabetes & Diabetic Retinopathy PDF

    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.

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