40 Questions
What is the primary mechanism of beta cell destruction in type one diabetes?
T cell mediated destruction
What is the age range of peak onset for type one diabetes?
4-6 years
What is the most common type of diabetes?
Type two diabetes
What is the primary treatment for type one diabetes?
Lifelong insulin replacement
What is the name of the life-threatening complication of diabetes that can occur in type one diabetes?
Diabetic ketoacidosis
What is the association between type one diabetes and human leukocyte antigens?
HLA-DQ, HLA-DR3 or HLA-DR4
What is the common initial presentation of type one diabetes?
Diabetic ketoacidosis
What is the result of the T cell mediated inflammation in type one diabetes?
Loss of insulin production
What is diabetes?
A chronic disorder with elevated blood glucose levels
What is insulin resistance?
When peripheral tissues do not respond to insulin
Why is diabetes often referred to as a 'silent killer'?
Because it is often asymptomatic in the early stages
What is the term for frequent urination caused by hyperglycemia?
Polyuria
What is the term for increased thirst caused by hyperglycemia?
Polydipsia
What is the term for diabetes caused by low activity of anti-diuretic hormone?
Diabetes Insipidus
How is diabetes mellitus diagnosed?
By measuring plasma glucose level
What is the meaning of the term 'mellitus' in diabetes mellitus?
Sweet
What is a common symptom of DKA?
Abdominal pain
What is the result of high levels of ketone in the body?
An anion gap metabolic acidosis
Why is there a fruity smell on the breath of DKA patients?
Due to the production of ketone bodies
What is the effect of low insulin and high glucagon levels on fatty acid metabolism?
Increased utilization of fatty acids for energy production
Why is there a risk of hypophosphatemia in DKA?
Due to the shift of phosphate out of cells and into the extracellular fluid
What is the effect of the metabolism of fatty acids on acetyl-CoA?
Depletion of acetyl-CoA
Why is there a significant phosphate loss in the urine of DKA patients?
Due to the osmotic diuresis caused by the high glucose levels
What is the respiratory response to the acidosis in DKA?
Hyperventilation
Why is it necessary to fast for eight hours before measuring a patient's blood glucose level?
Because blood sugar levels are typically low when fasting
What is the diagnosis for a patient with a fasting blood glucose level of 126?
Diabetes
What is the purpose of measuring the plasma level of hemoglobin A1c?
To diagnose and monitor diabetes
What happens when glucose molecules are added to the beta chains of hemoglobin?
Non-enzymatic glycation occurs
What is the relationship between plasma glucose levels and hemoglobin A1c?
Higher plasma glucose levels result in higher hemoglobin A1c levels
What is the name of the reaction that occurs when glucose combines with amino acids in the beta chains of hemoglobin?
Non-enzymatic glycation
What is the site of glucose addition to the beta chains of hemoglobin?
Amino terminal
Why is hemoglobin A1c a useful indicator of diabetes?
It reflects average blood glucose levels over time
What is the typical presentation of diabetic neuropathy?
Sensory symptoms dominate
Which part of the body is most affected in diabetic neuropathy?
Feet and legs
How does the sensation in diabetic neuropathy typically change as you move up the leg?
It improves
What is the typical order of sensory loss in diabetic neuropathy?
Vibration, proprioception, and then pain, light touch, and temperature
What is a potential complication of autonomic neuropathy in diabetes?
Postural hypotension
What is a complication of diabetic neuropathy and peripheral vascular disease?
Diabetic foot disease
Why are regular foot exams important in diabetes patients?
To detect any injuries or ulcers early and prevent complications
What is a complication of poor wound healing in diabetic foot disease?
All of the above
Study Notes
Diabetes Overview
- Diabetes is a chronic disorder characterized by elevated blood glucose levels, caused by insufficient insulin production or insulin resistance.
- Many people with diabetes are unaware they have the condition, especially in the early stages, as it is often asymptomatic.
Type 1 Diabetes
- Type 1 diabetes is an autoimmune disorder, a type of hypersensitivity reaction, characterized by T cell-mediated destruction of beta cells.
- Inflammation of the pancreatic islets leads to a decrease in beta cells, resulting in a loss of insulin production.
- Associated with certain human leukocyte antigens (HLA) DR3 and DR4, and sometimes autoantibodies are detected in the serum.
Type 1 Diabetes Symptoms and Treatment
- Symptoms include polyuria, polydipsia, and glucosuria.
- Presentation often involves symptomatic hyperglycemia, and treatment requires lifelong insulin replacement.
- Diabetic ketoacidosis (DKA) is a life-threatening complication, common in type 1 diabetes.
Diabetes Diagnosis
- Diagnosis involves measuring plasma glucose levels: >200 mg/dL indicates diabetes, <100 mg/dL is normal, and 100-125 mg/dL is pre-diabetes.
- Fasting blood glucose levels are used for diagnosis, and hemoglobin A1c (HbA1c) levels are used for monitoring and diagnosis.
Diabetic Ketoacidosis (DKA)
- DKA is a life-threatening complication, more common in type 1 diabetes.
- Symptoms include abdominal pain, nausea, vomiting, dehydration, hyperglycemia, and hypercalemia.
- High levels of ketone bodies, acidic pH, and fruity breath odor are indicative of DKA.
Diabetic Neuropathy
- A common complication of diabetes, characterized by sensory symptoms, such as loss of vibration and proprioception, and motor symptoms, such as muscle weakness.
- Typically affects the feet and legs, with symptoms improving proximally.
- Autonomic neuropathy can lead to postural hypotension, gastroprasis, and diabetic foot disease.
Diabetic Foot Disease
- Combination of neuropathy and peripheral vascular disease leads to poor wound healing and increased risk of ulcers and infections.
- Regular foot exams are essential to detect injuries early and prevent complications.
Learn about Type 1 Diabetes, an autoimmune disorder characterized by T-cell mediated destruction of beta cells, inflammation of the pancreatic islets, and hypersensitivity reaction. Understand the basics of this disease.
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