Diabetes Mellitus Overview
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Questions and Answers

What is the primary cause of insulin-dependent diabetes mellitus?

  • Obesity-related insulin resistance
  • Insulin receptor abnormality
  • Destruction of insulin-producing beta cells (correct)
  • Excessive glucagon production

Which of the following correctly describes the urine examination findings in diabetes mellitus?

  • Ketone bodies are not present in urine
  • Urine glucose levels are affected by kidney function only
  • Glycosuria occurs when plasma glucose exceeds 10 mmol/L (correct)
  • Glucose present in urine at all times

What is a common laboratory finding in G6PD deficiency?

  • Elevated glucose levels in plasma
  • Reduced hemoglobin levels only in plasma
  • Presence of Heinz bodies in red blood cells (correct)
  • Increased red blood cell production

In Von Gierke disease, which of the following metabolic disturbances is primarily observed?

<p>Inefficient lactate usage (D)</p> Signup and view all the answers

What is the threshold blood glucose level for diagnosing diabetes mellitus using fasting blood glucose (FBG)?

<p>8 mmol/L (D)</p> Signup and view all the answers

Which factor is primarily responsible for the accumulation of ketone bodies in diabetic ketoacidosis?

<p>Increased lipid and protein breakdown (C)</p> Signup and view all the answers

What role does hepatic fructokinase play in fructose metabolism?

<p>Catalyzes the conversion of fructose to fructose-1-phosphate (A)</p> Signup and view all the answers

What is a common treatment option for patients experiencing ketoacidosis?

<p>Injection of insulin (C)</p> Signup and view all the answers

Flashcards

Type 1 Diabetes

A condition characterized by the pancreas's inability to produce sufficient insulin, leading to high blood sugar levels. This type of diabetes is often linked to autoimmune destruction of insulin-producing cells.

Type 2 Diabetes

A condition where the body's cells become resistant to insulin's effects, resulting in high blood sugar levels. Often associated with obesity and lifestyle factors.

Glycosuria

The presence of glucose in the urine. This occurs when blood glucose levels exceed a certain threshold, indicating potential diabetes.

Ketonuria

The presence of ketone bodies in the blood and urine. Ketones are produced when the body breaks down fat for energy due to insufficient insulin.

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G6PD Deficiency

A deficiency in the enzyme glucose-6-phosphate dehydrogenase (G6PD), leading to red blood cell fragility and hemolysis. This disorder is particularly common in individuals of African descent.

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Von Gierke Disease

A rare genetic disorder characterized by the accumulation of glycogen in the liver and kidneys due to a deficiency of glucose-6-phosphatase. This leads to hypoglycemia, hyperlipidemia, and hyperuricemia.

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Fructosuria

A condition caused by a deficiency in the enzyme hepatic fructokinase, leading to the accumulation of fructose in the urine.

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Hepatic Fructokinase

The first enzyme in fructose metabolism that catalyzes fructose to fructose-1-phosphate. Deficiency in this enzyme leads to fructosuria.

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Study Notes

Diabetes Mellitus

  • Types:

    • Type II (85%): Peripheral tissue resistance to insulin's action, often linked to obesity. Glucose cannot enter cells without insulin.
    • Type I (15%): Autoimmune destruction of insulin-producing beta cells in the pancreas. Environmental factors like viral infections may be involved.
    • Type II often due to pancreatic disease (Cushing's syndrome, abnormal insulin receptor function)
  • Diagnosis (Urine Examination):

    • Glycosuria: Glucose presence in urine indicates elevated blood glucose levels (>10 mmol/L).
    • Ketones: Accumulation of ketone bodies (acetone, acetoacetate, B-hydroxybutyrate) in urine or blood points to ketoacidosis. This happens when no insulin is present, leading to increased lipid/protein breakdown and impaired glucose entry into cells.
  • Diagnosis (Blood Glucose Levels):

    • Measurement: Use tubes with fluoride (glycolysis inhibitors) and glucose oxidase enzyme strips.
    • Fasting Blood Glucose (FBG): Better for diagnosis than Random Blood Glucose (RBG).
    • Normal FBG: < 6 mmol/L
    • Borderline FBG: 6-8 mmol/L
    • Diabetic FBG: > 8 mmol/L
    • Oral Glucose Tolerance Test: Increased glucose level (>11 mmol/L) after 2 hours indicates diabetes.
  • Treatment:

    • Increased fluid intake (especially crucial in ketoacidosis).
    • Insulin injections or hypoglycemic tablets.

G6PD Deficiency

  • Mechanism:

    • Impairment of the pentose phosphate pathway affects G6P oxidation.
    • Reduced NADPH production by red blood cells leads to a lack of glutathione reduction.
    • This results in uncontrolled free radical damage and red blood cell membrane breakdown (hemolysis.)
  • Diagnosis:

    • Microscopic: Observe Heinz bodies (abnormal structures) and red blood cell fragmentation.
    • Quantitative Assay: Measure NADP+ to NADPH conversion using a spectrophotometer.
    • Screening: Use fluorescent procedures.

Von Gierke Disease

  • Mechanism:

    • Glycogen storage abnormality; restricted glucose release.
    • Inefficient lactate use in response to glucagon stimulation.
    • Increased purine breakdown in the liver.
    • Genetic defects affect glucose-6-phosphatase and glucose-6-translocase in liver, kidneys, and intestines.
  • Symptoms:

    • Hypoglycemia
    • Hyperlipidemia
    • Hyperuricemia (gout)
  • Treatment:

    • Constant carbohydrate intake throughout the day.

Fructosuria (Hepatic Fructokinase Deficiency)

  • Mechanism:

    • Hepatic fructokinase (ketohexokinase), the first enzyme in fructose metabolism, is deficient.
    • Fructose from the diet cannot be processed properly, leading to accumulation.
  • Metabolic Pathways Affected:

    • Impact on fructose metabolism pathways, though not specified detailed pathway disruptions. Glycine – Arginine | Alanine – Threonine.

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Description

This quiz covers the key aspects of Diabetes Mellitus, including its two main types and their characteristics. You'll learn about the diagnostic methods for diabetes, including urine and blood glucose analysis. Test your knowledge on how diabetes affects insulin and glucose metabolism.

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