16. Clinical Approach to DM and Hypoglycemia Flashcards
What presentations are similar with diabetes and syphilis
Thirst and frequency of urination
What is the most common cause of hyperthyroidism in the elderly **
Toxic nodular goiter
What is the more aggressive form of thyroid papillary ca?
Tall cell papillary ca
What does MODY stand for? and LADA?
MODY = maturity onset Diabetes of Youth LADA = Latent Autoimmune Adult Diabetes - patients who have antibodies and low C peptides (usually in adults)
Diagnosis of diabetes (lab values - 4)
Random plasma glucose >200mg/dL on 2 separate occasions + symptoms
FPG > 126mg/dL on 2 separate occasions
2hr plasma glucose > 200mg/dL
Hb A1C >6.5% ***
How long does the HbA1C give an avg gluocse for?
3 months
Natural hx of T2DM (course of disease)
Insulin resistance present in obese or people with impaired fasting glucose levels
Insulin levels increase to overcome resistance
B-cell function declines, can’t produce enough insulin to overcome the resistance –> blood glucose levels rise
What is the antibody seen in T1DM?
IA-2 antibody (islet antigen 2)
What reduces Hb A1C the most?
insulin
What is the first line of therapy in individuals with T2DM?
Lifestyle modifications
Long lasting insulin that is given is called what?
Glargine (Think: Garg’s mom takes this)
What is the no. 1 cause of blindness in US?
Diabetic retinopathy
Diabetic nephropathy has what clinical effects?
hypertension, proteinuria, nephrotic syndromes, and renal failure
No. 1 cause of end stage renal failure
What are the clinical effects of diabetic neuropathy?
Pain, paresthesia (pins and needles), hyperesthesia (excessive sensation), and weakness
Classifications for diabetic neuropathies
- acute
- predominately motor
- assymetrical neuropathy - symptoms in one hip due to encroachment of lateral femoral cutaneous n.
- cranial neuropathy - can cause double vision
- Chest pain from intercostal neuropathy