Diabetes & Endocrinology Cheat Sheet

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T1DM
50% concordance in monozygotic twins

IGT
FPG <7 OGTT 7.8-11.1 HbA1C 42-47

IFG
FPG 6.0-6.9
OGTT <7.8

Diabetes
Iatrogenic causes:
Steroids
Thiazides
Tacrolimus
Atypical anti psychotics

T1DM
Increased prevalence in Finland (20/100,000)

Biguanides
Increased glucose uptake
Decreased gluconeogenesis
Increased insulin sensitivity

Sulphonylureas
Enhance endogenous insulin secretion
SE: Weight gain, hypos

Alpha glucosidase inhibitors
Act to reduce glucose absorption

Alpha glucosidase inhibitors
Side effects:
Bloating
Diarrhoea
Oral hypoglycaemic agent

Glitazones
Side effects:
Weight gain
Oedema
Bladder cancer
Oral hypoglycaemic agent

Sulphonylureas
Side effects:
Weight gain
Hypo risk
Oral hypoglycaemic agent

Biguanides
Side effects:
Nausea
Diarrhoea
Oral hypoglycaemic agent

Diabetic nephropathy
Hypertension
Proteinuria
Declining renal function
Kimmelstein wilson lesion (nodular glomerulosclerosis)

ACE inhibitors
The drug of choice in the management of diabetic nephropathy

SIADH
Clinically euvolaemic
Hyponatraemia (dilutional)
Low plasma osmolality
High urine osmolality
High urinary Na+ excretion

SIADH
Management:
Fluid restriction
Demeclocycline

Diabetic insipidus
Hypernatraemia
High plasma osmolality
Low urine osmolality

Cranial diabetes insipidus
>3L urine production/24 hours
Urine osmolality <600 Urine osmolality increases to >600 after desmopressin

Osteomalacia
Symptoms:
Waddling gait
Low legs
Bone pain
Myalgia

Osteomalacia
Decreased PO4
Increased ALP
Slightly decreased Ca2+

Looser zones
Seen on xray in osteomalacia

Osteomalacia
Causes:
Vitamin D deficiency
Chronic renal failure
Malabsorption
Vitamin D resistant rickets

Osteomalacia
Treatment:
Vitamin D supplements
Calcium supplements

Clonidine/pentolinium supression test
In patients with phaeochromocytoma, this is not supressed in the suppression test

Phaeochromocytoma
Alpha blockers – phenoxybenzamine
Beta blockers – propanolol

Phenoxybenzamine
Alpha blocker used to treat phaeochromocytoma

MEN type 1
Associations:
Parathyroid hyperplasia/adenoma
Pancreatic tumours
Pituitary prolactinoma

MEN type 2a
Thyroid medullary carcinoma
Phaeochromocytoma
Parathyroid hyperplasia

MEN type 2b
Thyroid medullary carcinoma
Phaeochromocytoma
Marfanoid syndrome
Mucosal neuromas

Conn’s syndrome
Decreased K+
Increased urinary K+
Increased aldosterone
Suppressed renin

Osteoporosis
DEXA scan T score = <-2.5

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