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Diabetes Mellitus

1. Define Diabetes Mellitus


Chronic hyperglycaemia due to insulin deficiency or insulin resistance or both
2. Differences between type 1 and type 2 diabetes
3. The genetic predisposition to diabetes mellitus is associated with certain genetic markers.
What are these two genetic markers? HLA DR3, HLA DR4
4. What is the triad of symptoms?
5. Why do you get polyuria?
6. Why do you feel thirsty?
7. Why is there weight loss?
8. What other symptoms do patients of type 2 diabetes present with? lack of energy, persistent
infections, particularly thrush infections of the genitalia, slow healing minor skin damage,
visual problems..
9. Tests for diabetes mellitus? fasting, random, oral glucose tolerance, HbA1c
10. What is HbA1c?
11. Why do you get ketoacidosis in type 1 diabetes?
12. Why do you get high glucose levels due to a lack of insulin? The lack of insulin causes
decreased uptake of glucose into adipose tissue and skeletal muscle, decreased storage of
glucose as glycogen in muscle and liver and increased gluconeogenesis in liver. the high blood
glucose will lead to the appearance of glucose in the urine (Glycosuria)
13. How to manage type 2 diabetes? diet, oral hypoglycaemic drugs
14. List and describe the oral hypoglycaemic drugs used for type 2 diabetes. sulphonylureas,
metformin
15. Describe action of sulphonylureas. increase insulin release from remaining Beta cells,
decrease insulin resistance
16. Describe action of metformin. reduces gluconeogenesis
17. What are the macrovascular complications of diabetes. Stroke, MI, poor circulation to
periphery
18. Why do you get stroke, MI, poor circulation?
19. What are the microvascular complications of diabetes? retinopathy, nephropathy,
neuropathy, diabetic feet
20. Why do you get each of these complications?

21. What is the Basal Metabolic Rate (BMR) ? - measure of the basal energy required to maintain
life
22. What are the major tissues contributing to the BMR? skeletal (30%), central nervous
system(20%), liver (20%), heart (10%)
23. Fat is needed for the absorption of fat soluble vitamins from the gut. What are these 4
vitamins? A,D,E and K
24. How to calculate BMI/.
25. Why is using a waist to hip ratio used in preference to BMI as a measure of obesity and risk of
CVD?
26. What two conditions are caused by protein/energy malnutrition? kwashiorkor, marasmus
27. Difference between kwashiorkor and marasmus?
28. Why do you get oedema in kwashiorkor?
29. Why is the abdomen distended in kwashiorkor? Hepatomegaly and/or ascites (Accumulation
of fluid in peritoneal cavity)
30. Define homeostasis. control of the internal environment within set limits and is a dynamic
equilibrium rather than a fixed steady state.
31. What is the equation linking creatine and creatine phosphate?
Creatine + ATP Creatine phosphate + ADP (catalysed by creatine kinase)
32. how can creatine phosphate act as a small store of free energy in muscle cells (Skeletal and
cardiac) when the conc of ATP is high , it can be used to drive the synthesis of creatine
phosphate from creatine. ATP can then be regenerated by the reverse reaction when its
concentration falls.
33. How is creatinine produced and excreted?
34. What is the rate of production of creatinine proportional to? concentration of creatine in
muscle and this is related to skeletal muscle mass
35. What does an abnormally high blood creatinine and low urinary creatinine concentration
indicate about kidney function? reduced kidney function

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