Understanding diabetes mellitus

Which of the following is true regarding insulin resistance?

• High HOMA-IR indicates a person is developing insulin resistance that causes B cell depletion

• High HOMA-B indicates that high amount of insulin is needed for balanced blood sugars level

• HOMA-IR is an estimate of tissue insulin resistance

• HOMA-B is an estimate of tissue insulin resistance

A low dose of ______________ with insulin are usually used to treat a patient with hepatocyte nuclear factor 1- β (HNF-1β) gene mutation.

• Corticosteroids

• Sulphonylureas

• Phaeochromocytoma

• Biguanides

A person with normal levels of ketones in the bloodstream but having severe hyperglycaemia and osmolality of 340 mOsm/kg is likely to have _______________________________

• Diabetic ketoacidosis (DKA)

• Hyperosmolar hyperglycaemic syndrome (HHS)

• Hyperketonaemia

• Acute hypoglycaemia

New researches on bariatric surgery highlighted about these intestinal hormones secretion that play important roles in type 2 diabetes treatment. All of the following is true EXCEPT:

• GLP-1 hormone secretion that signals hunger increases

• Ghrelin hormone secretion that signals hunger is increased post-bypass

• GLP-1 hormone secretion that signals satiety increases

• Ghrelin hormone secretion that signals hunger is reduced post-bypass

A reduced flexibility in muscle, skin, tendons and ligaments are examples of musculoskeletal problems caused by damage on ______________________.

• Retinal

• Connective tissue proteins

• Peripheral vessels

• Kidney - nephropathy

A 40 year old obese adult went to hospital for medical check-up as she suspected herself having diabetes. She was diagnosed of getting diabetes type II after went through some tests. What are the following test results confirm that she is a diabetes type II patient?

• Her fasting glucose level is 5.5 mmol/L.

• Oral glucose tolerance test (OGTT) shows her plasma glucose is more than 11mmol/L after two hours.

• HbA1c is more than 6.5%.

• Her random plasma glucose is less than 7.8 mmol/L.

Recently, Lala felt uncomfortable due to some symptoms and she figure out that those symptoms indicate she is at high risk of getting Type I diabetes. What are Lala’s symptoms?

• Uncontrolled thirst

• Acanthosis nigrican

• Frequent urination

• Fruity smell of breath

Type II diabetes patient can control their plasma glucose level through management of diet and exercise. However in what condition, insulin therapy is needed?

• Have diabetic ketoacidosis

• Allergic to sulfonylurea Agent

• Weight loss after taking oral agent

• Renal problem

Which is the following statement regarding insulin therapy incorrect?

• Insulin that is administered through subcutaneous way usually involve rapidly-acting insulin.

• The insulin pump mimics the function of pancreas by delivering insulin into portal circulation.

• “Twice-daily-fixed-dose insulin regimen” is injected before breakfast and before evening meal for those with fixed routine.

• The insulin types can be given alone or in combination according to lifestyle, including mealtime routine.

Type I and Type II diabetes are polygenic , but diabetes may arise from a less common monogenic form. Which is the following statement regarding monogenic form diabetes incorrect?

• MODY can cause early –age diabetes that is associated with kidney problem.

• Specific medical treatments such as insulin therapy is not needed in some patients.

• MODY 1 is caused by dysregulated functions of GLUT 2 glucose transport and lipid metabolism.

• Monogenic form diabetes is usually occur before the age of 1 year.