diabetes physician Interview Questions and Answers
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What are the key differences between type 1 and type 2 diabetes?
- Answer: Type 1 diabetes is an autoimmune disease where the body's immune system attacks and destroys insulin-producing beta cells in the pancreas. This results in an absolute insulin deficiency. Type 2 diabetes, on the other hand, is characterized by insulin resistance, where the body's cells don't respond properly to insulin, and often a relative insulin deficiency. Type 1 usually develops in childhood or adolescence, while type 2 typically develops in adulthood, though it's increasingly common in younger individuals. Type 1 requires lifelong insulin therapy, while type 2 may be managed initially with lifestyle modifications and oral medications, with insulin sometimes becoming necessary later.
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Describe the diagnostic criteria for diabetes.
- Answer: Diagnosis of diabetes is based on several criteria. A fasting plasma glucose level ≥126 mg/dL (7.0 mmol/L), a 2-hour plasma glucose level ≥200 mg/dL (11.1 mmol/L) during an oral glucose tolerance test (OGTT), or a random plasma glucose level ≥200 mg/dL (11.1 mmol/L) in a patient with classic symptoms (polyuria, polydipsia, polyphagia, unexplained weight loss) are all diagnostic. An HbA1c level ≥6.5% (48 mmol/mol) is also diagnostic. These tests should be confirmed on a subsequent day.
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Explain the role of HbA1c in diabetes management.
- Answer: HbA1c measures the average blood glucose level over the past 2-3 months. It's a crucial indicator of long-term glycemic control and is used to assess the effectiveness of diabetes treatment. Targeting an HbA1c below 7% is generally recommended for most adults with diabetes, though individual targets should be individualized based on patient factors like age, comorbidities, and personal preferences.
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What are the common acute complications of diabetes?
- Answer: Common acute complications include diabetic ketoacidosis (DKA), a life-threatening condition characterized by high blood glucose, ketones in the urine and blood, and metabolic acidosis; and hyperosmolar hyperglycemic state (HHS), a less common but equally serious condition seen more frequently in type 2 diabetes, characterized by extremely high blood glucose, severe dehydration, and altered mental status. Hypoglycemia, or low blood glucose, is also a serious acute complication, which can cause confusion, seizures, and loss of consciousness.
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What are the long-term complications of diabetes, and how can they be prevented or managed?
- Answer: Long-term complications affect various organs. These include cardiovascular disease (heart attack, stroke, peripheral artery disease), nephropathy (kidney disease), neuropathy (nerve damage), retinopathy (eye disease), and foot ulcers. Prevention and management focus on achieving and maintaining good glycemic control, managing blood pressure and lipids, and adopting a healthy lifestyle that includes regular exercise, a balanced diet, and smoking cessation. Regular check-ups and screenings for complications are also vital.
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