DIABETES VIVA QUESTIONS

Q.1 For how many hours must a patient fast before giving sample for fasting blood glucose levels?

A: 8 hours

Q.2. Classify Diabetes Mellitus.

A:
Type 1 diabetes mellitus

Immune mediated

Idiopathic

Type 2 diabetes mellitus

Other specific types of diabetes

Genetic defects of islet ß-cell function

Genetic defects of insulin action

Diseases of the exocrine pancreas

Endocrinopathies

Drug- or chemical- induced diabetes

Infections

Uncommon forms of diabetes

Other genetic syndromes

Gestational diabetes mellitus

Q.3. What is the laboratory strategy to diagnose GDM?

A: One step approach: OGTT (75 g glucose)

Two step approach:

1. First OGTT with 50 g glucose load; cut-off value after 1 hour plasma glucose >7,8 mmol/L (>1,40 g/L)
2. Second OGTT with 75 g glucose load and evaluation as the standard OGTT

Q.4 What are the basic laboratory measures for screening of diabetes?
A: The basic laboratory measures for screening are: 1. Fasting capillary blood glucose 2. Glucosuria 3.
HbA1c 4. OGTT

Q.5. What is the ADA recommendation for measuring of HbA1c in a diabetic patient?

A: Every 3 months

Q.6. What are the confounders in the clinical interpretation of HbA1c?

A: Many hematologic diseases confound clinical interpretation of glycohemoglobin, regardless of the

analytic method. Some diseases (eg, hemolytic diseases and spherocytosis) shorten RBC cell survival and
lower glycohemoglobin (even in the absence of genetic hemoglobin variants). Conversely, other diseases
(such as iron deficiency or postsplenectomy syndrome) increase RBC survival and raise glycohemoglobin.

Q.7. For how much time period does fructosamine estimates diabetic control?

A: 1 to 3 week period

Q.8. What are the advantages of measuring fructosamine over HbA1c?

A: This shorter interval, compared with glycohemoglobin, reflects the more rapid turnover of serum
proteins, compared with RBC hemoglobin. And Fructosamine responds more quickly to changes in
plasma glucose than does glycohemoglobin. This is considered to be an advantage over
glycohemoglobin, because it allows the physician to adjust therapy earlier. Other major advantages of
fructosamine are: it avoids any confounding effects of abnormal RBC survival and is fructosamine's
simple, homogeneous assay: fructosamine reduces NBT, producing a purple substance. It is easy to
automate this assay on standard chemistry analyzers.

Q.9. What are the disadvantages of measuring Fructosamine?

A: It lacks standardization.It is difficult to produce primary reference material, which must have a known
stable quantity of fructosamine because it is difficult to glycate protein consistently and reproducibly.

Q.10. Which hormone is useful in detecting factitious hypoglycemia (self injection of insulin)?

A: C-peptide