Endocrinology & Diabetes — Flashcards

Flashcard 61: What is the fasting plasma glucose range for Impaired Fasting Glycaemia (IFG) ?

Answer: • 6.1-6.9 mmol/l • Pre-diabetic

Flashcard 62: What is the normal (non-diabetic) HbA1c range? (IFCC units)

Answer: Normal: <42 mmol/mol (6.0%)\nPrediabetes: 42–47 mmol/mol (6.0–6.4%)\nDiabetes: ≥48 mmol/mol (6.5%)

Extra: In most guidelines (NICE/WHO), a normal HbA1c is considered below 42 mmol/mol (6.0%). The diagnostic threshold for diabetes is ≥48 mmol/mol (6.5%). \n\nNote: HbA1c targets for patients *with* diabetes are generally higher (e.g., 53 mmol/mol), but 'normal' glycemic control refers to the non-diabetic range.

Flashcard 63: What is the HbA1c threshold for Diabetes?

Answer: ≥ 6.5% (48 mmol/mol)

Extra: ADA criteria for Diabetes diagnosis: - HbA1c ≥ 6.5% - Fasting Plasma Glucose (FPG) ≥ 126 mg/dL (7.0 mmol/L) - 2-hour Plasma Glucose ≥ 200 mg/dL (11.1 mmol/L) during OGTT - Random Plasma Glucose ≥ 200 mg/dL in a patient with classic symptoms of hyperglycemia or hyperglycemic crisis.

Flashcard 64: What should people with Impaired Fasting Glucose (IFG) be offered ?

Answer: • Oral Glucose Tolerance Test (OGTT)

Flashcard 65: What should all diabetic patients with a urinary ACR of 3mg/mmol be started on?

Answer: • ACE inhibitors • ARBs

Flashcard 66: What is the pre-diabetes glycaemic control HbA1c range?

Answer: 42-47 mmol/mol (6.0-6.4%)

Extra: Note: In the US (ADA guidelines), the pre-diabetes range starts slightly lower at 5.7% (39 mmol/mol).

Flashcard 67: What is the management of DKA?

Answer: 1. 0.9% Saline 2. IV Insulin infusion 3. 10% Dextrose infusion (once blood glucose <14 mmol/l) 4. Potassium

Flashcard 68: The causes of _____ anion gap metabolic acidosis may be remembered with the mnemonic MUDPILES: M = Methanol (toxic alcohol → formic acid) U = Uremia (renal failure → retention of uremic toxins) D = Diabetic ketoacidosis (DKA) (accumulation of ketones) P = Propylene glycol I = Isoniazid or Iron overdose L = Lactic acidosis E = Ethylene glycol (toxic alcohol → oxalic acid) S = Salicylates (aspirin overdose)

Answer: raised

Flashcard 69: _____ is caused by increased production/ingestion of H+ or loss of HCO3-

Answer: Metabolic acidosis

Flashcard 70: What is the initial investigation for Carcinoid Syndrome?

Answer: • Urinary 5-hydroxyindoleacetic acid