Subclinical hypothyroidism occurs in an asymptomatic patient with a TSH > 4 mU/L with normal T4 and T3. Subclinical hypothyroidism is common in older patients. 10% of patients more than 55 years old have elevated TSH. The risk of progression…
Diagnosis TSH Free T4 Nota bene Thyrotoxicosis Low High Free T4 is normal in T3 thyrotoxicosis Primary hypothyroidism High Low Secondary hypothyroidism Low Low Steroids should be given before replacing thyroxine Sick euthyroid syndrome (non-thyroidal illness) Low (may be normal)…
Maturity-onset diabetes of the young (MODY) is an autosomal dominant form of diabetes that presents before the age of 25. It is caused by mutations in genes that play a role in beta-cell function. Some of these genes include HNF1A,…
Hypoglycaemia occurs when glucose concentration falls below 3.3 mmol The threshold for the onset of hypoglycemic symptoms varies with patients. Severe symptomatic hypoglycemia occurs in most adults at blood glucose levels ≤ 2.2-2.8 mmol Hypoglycemia in patients with diabetes is…
Hyperosmolar hyperglycemic state (HHS) commonly occurs in patients with type 2 diabetes who have concomitant illnesses, which cause reduced fluid intake. It is characterized by extreme hyperglycemia and hyperosmolarity without significant ketosis. The mortality rate is higher for HHS than…
DKA is an acute, major life-threatening complication of Diabetes characterized by hyperglycemia, ketoacidosis, and ketonuria. It occurs when there is absolute or relative insulin deficiency, which inhibits glucose entry into the cell. The liver then rapidly produces ketones as an…
The main goal of treating diabetes is to minimise the probability of complications while maximising the patient’s quality of life. When a new diagnosis of T2DM is made, a determination of how the patient is treated is based primarily on…
Diabetes can be screened using an HbA1C level, fasting plasma glucose, or an Oral Glucose Tolerance Test (OGTT). If fasting plasma glucose is used alone for screening, ≥ 2 abnormal readings are required to make the diagnosis. An HbA1C level…
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterised by insulin resistance and impaired insulin secretion leading to hyperglycaemia. It peaks between 60 and 70 years and is more common in men. Screening for type 2 diabetes Diagnosis…