Diabetes Screening and Haemochromatosis Lecture Notes

Flashcards covering screening protocols for Type 2 Diabetes, diagnostic blood glucose and HbA1c thresholds, secondary causes of hyperglycemia, and clinical management of haemochromatosis.

Risk assessment for Type 2 Diabetes should be conducted every __________ in individuals over the age of 40.

3 years

Individuals from high prevalence ethnic groups, such as ATSIS and Pacific Islanders, should begin diabetes screening starting from age __________.

18 years

If a venous fasting blood glucose level is between $5.5-6.9\,mmol/L$, the next diagnostic step is to perform an __________ with $75\,g$ of glucose.

OGTT (oral glucose tolerance test)

During an OGTT, a 2-hour glucosaemia level of $7.8 - 11.0\,mmol/L$ is classified as __________.

impaired OGTT

Type 2 Diabetes is likely if the venous fasting glucose is __________ or higher.

$$7.0\,mmol/L$$

A 2-hour glucose level of __________ or higher during an OGTT confirms a diagnosis of Diabetes Type 2.

$$11.1\,mmol/L$$

An HbA1c level of __________ is classified as high risk or diabetes possible.

$$6.0-6.4\% \text{ (42-46 mmol/mol)}$$

The Medicare Benefits Schedule item number __________ allows for diagnostic use of HbA1c once every 12 months.

66841

Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) cannot be diagnosed using __________.

HbA1c

Secondary causes of hyperglycaemia include endocrine disorders such as Cushing's, Acromegaly, Hyperthyroidism, and __________.

Pheochromocytoma

The antipsychotic drug __________, thiazide diuretics, and oestrogen are known drug-induced causes of hyperglycaemia.

Olanzapine

Hereditary haemochromatosis is often referred to as __________ because iron deposits in the pancreas cause diabetes.

Bronze diabetes

In hereditary haemochromatosis, the serum transferrin saturation is typically more than __________.

$$70\%$$

Haemochromatosis can cause a loss of sex drive due to pituitary function impairment, which reduces the production of __________ and __________.

FSH; LH

The HFE gene mutations most commonly linked to iron overload are __________ and H63D.

C282Y

Secondary iron overload should be considered if the HFE gene test results are __________.

negative

Diagnostic ferritin thresholds for iron overload are over $300\,\mu g/L$ in men and over __________ in young women.

$$200\,\mu g/L$$

The first-line iron removal treatment for haemochromatosis is __________.

Phlebotomy

Iron-chelating drugs used for treatment include Deferoxamine, Exjade, and __________.

Feriprox

The target ferritin level during the maintenance phase of iron removal therapy is __________.

$$50-100\,\mu g/L$$

During the induction phase of phlebotomy, treatment should be paused if haemoglobin levels drop below __________.

$$11\,g/dl$$

__________ is a skin condition characterized by dark, velvety patches on the neck or armpits, signaling high insulin levels.

Acanthosis Nigricans