History
Who discovered insulin?
Frederick Banting and Charles Best.
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Which diabetes medication may cause genital mycotic infections because it increases glucose excretion in urine?
SGLT2 inhibitors.
A patient has fasting plasma glucose of 6.0 mmol/L on two separate tests. Does this meet the diagnostic criterion for diabetes?
No
Global Burden: How many adults worldwide had diabetes in 2024?
> 500 million
In which organ is insulin produced?
Pancreatic β-cells.
What is the main problem with insulin action in Type 2 diabetes?
Insulin resistance and relative insulin deficiency
A patient taking insulin suddenly becomes sweaty, shaky and confused. What should you suspect?
Hypoglycemia
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What proportion of adults with diabetes worldwide are estimated to be undiagnosed?
Approximately 4 in 10.
When was insulin first successfully used to treat diabetes?
1922
Why can a person with Type 2 diabetes feel hungry even when blood glucose is high?
Glucose cannot be effectively used by cells because of insulin resistance/relative insulin deficiency.
Why can metformin be temporarily stopped during certain acute illnesses or situations with significant renal dysfunction?
Because the risk of metformin-associated lactic acidosis can increase in severe conditions.
A patient has HbA1c of 6.7%, but fasting glucose is normal. Can diabetes still be diagnosed?
Yes, if the HbA1c result is confirmed/appropriate and diagnostic criteria are met.
What HbA1c threshold is used to diagnose diabetes in nonpregnant adults?
≥6.5% (48 mmol/mol).
How did doctors in ancient times identify diabetes?
By tasting the patient’s urine because it was sweet.
A patient with Type 1 diabetes stops insulin. Why can ketone bodies rapidly increase?
Severe insulin deficiency causes increased lipolysis and ketogenesis.
Which combination includes Metformin and a DPP-4 inhibitor?
Metformin + Sitagliptin.
A young patient has weight loss, polyuria, ketones in urine and high blood glucose. Which type of diabetes is more likely?
Type 1 diabetes.
If 9 out of 10 doctors recommend checking blood glucose, what does the 10th doctor recommend?
More research!
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Bonus for Luck!
Two patients have glucose of 15 mmol/L. One is producing almost no insulin; the other has high insulin levels but insulin resistance. Which mechanisms are different?
Absolute insulin deficiency in Type 1 vs insulin resistance with progressive β-cell dysfunction in Type 2.
A patient with Type 2 diabetes has heart failure and chronic kidney disease. Which modern drug class may provide cardiorenal benefit even beyond glucose lowering?
Dapagliflozin и Empagliflozin
A 32-year-old patient is diagnosed with Type 2 diabetes, but he is lean, has no metabolic syndrome, quickly requires insulin, and has positive GAD antibodies. What diagnosis should be considered?
LADA (Latent Autoimmune Diabetes in Adults).
A prevention program reduces diabetes incidence from 10% to 7%. What is the relative risk reduction?
30%.