1 Diabetes mellitus: Epidemiology, classification, etiology and pathomechanism, diagnosis

What % of adults have T2DM

90

How has the incidence of DM changed

Increased in early 1990s & linked to chidhood obesity

How many deaths from DM in 2019 & what % occurred before age 70

• 1.5 mill

• 48%

Describe T1DM progression, when it develops, % in all cases of DM

• insulin production is absent due to pancreatic B cell destruction

• progresses subclinically over months, years

• usually develops in childhood or adolescence

• 10%

Which gene is suceptible in T1DM?

HLA-DR3

Which autoantigens may be present in T1

• glutamic acid decarboxylase

• insulin

Describe T2DM, progression,

• insulin resistance

• inability to suppress hepatic glucose prodxn & there’s impaired peripheral glucose uptake

• Insulin high in early disease then falls

Which races are susceptible

• african american

• hispanic

List the other types of diabetes

• Monogenic diabtes

• DM from pancreatic issues

• DM from endocrinopathies

• DM due to drugs

List 2 eg of monogenic DM

• Maturity onset diabetes of youth

• neonatal diabetes

List pancreatic issues that can cause DM

• cystic fibrosis

• pancreatitis

• pancreatectomy

• hemochromatosis

Which endocrinopathies can lead to DM?

• cushing syndrome

• acromegaly

Which drugs can cause DM

• glucocorticoids

• Beta blockers

List 4 lab tests for DM

• random glucose test

• oral glucose tolerance test (OGTT)

• fastin plasma glucose(FPG)

• Hba1C

How is FPG tested?

• after an 8-12 hour fast

• >/= 7.0 mmol is +

How is OGTT tested

• taken 2 hours after ingestion of a concentrated glucose solution

• >/= 11.1 mmol is +

What are the values for random glucose test and HbA1c that indicate DM?

• >/= 11 mmol RGT

• >/= 6.5% HbA1c

Which autoantibodies can be tested?

• anti islet cell Ab

• anti glutamic acid decarboxylase

• anti insulin