Diabetes Mellitus Quiz

Definition and Classification

• Diabetes mellitus is a group of metabolic disorders characterized by high blood sugar levels (hyperglycemia) resulting from defects in insulin secretion, insulin action, or both.
• Classified into two main categories:
  1. Type 1 Diabetes (T1D): Insulin deficiency due to autoimmune destruction of pancreatic beta cells.
  2. Type 2 Diabetes (T2D): Insulin resistance and impaired insulin secretion.

Pathophysiology

• Glucose Metabolism: Insulin regulates glucose uptake in cells, especially in muscles and liver.
• Insulin Resistance: Decreased insulin sensitivity in T2D, leading to increased glucose production in liver and decreased glucose uptake in muscles.
• Beta-Cell Dysfunction: Decreased insulin secretion in T2D, leading to hyperglycemia.

Signs and Symptoms

• Common Symptoms:
  • Polyuria (frequent urination)
  • Polydipsia (excessive thirst)
  • Polyphagia (increased hunger)
  • Fatigue
  • Blurred vision
• Long-term Complications:
  • Microvascular: retinopathy, nephropathy, neuropathy
  • Macrovascular: cardiovascular disease, peripheral artery disease

Diagnosis and Screening

• Diagnostic Criteria:
  • Fasting plasma glucose ≥ 126 mg/dL
  • 2-hour plasma glucose ≥ 200 mg/dL during an oral glucose tolerance test
  • Hemoglobin A1c (HbA1c) ≥ 6.5%
• Screening Recommendations:
  • Universal screening for adults ≥ 45 years old
  • Earlier screening for individuals with risk factors (e.g., obesity, family history)

Management and Treatment

• Lifestyle Modifications:
  • Healthy diet
  • Regular physical activity
  • Weight loss (if overweight or obese)
• Pharmacological Therapy:
  • Oral medications (e.g., metformin, sulfonylureas)
  • Insulin therapy (for T1D and some T2D cases)
• Self-Monitoring of Blood Glucose:
  • Regular monitoring of blood glucose levels
  • Adjusting diet, physical activity, and medication as needed