2. Diabetes/Met Syndrome

Question 1

Lab criteria for T1DM?

Answer 1

• Random glucose of >200 + symptoms (polyuria, polydipia, unexplained wt loss)
• Fasting glucose of >125 on 2 occasions (8 hr fast)
• after 75 g glucose load, glucose >200 at 2 hrs.

Question 2

Lab criteria for T2DM?

Answer 2

same as T2DM?

Question 3

Definition of T1DM? prev? heritability?

Answer 3

insulin deficiency due to autoimmune response against beta cells in pancreas.
early onset.
lower prev: less than 1% of population
requires lifelong insulin replacement

Question 4

Definition of T2DM? prev? heritability?

Answer 4

adult onset
insulin resistance - initial excess production by pancreas followed by eventual loss in ability to secrete enough insulin.
higher prevalence (8-9% of the pop)
more heritable than T1DM

Question 5

Definition of gestational DM?

Answer 5

women without prior diabetes have high BG levels during preg (tri 3 especially) due to insulin resistance and some inability to secrete sufficient insulin.
resolves postpartum

Question 6

definition of impaired glucose tolerance (IGT)

Answer 6

pre-diabetic state
hyperglycemia characterized by insulin resistance, incr risk of vascular pathology, incr risk of T2DM
-BG over 140 in general puts you at risk for big vessel injury
-25% become diabetic over time
-damage to large vessels, not small vessels
-at risk to become diabetic if take meds that raise BG (steroids for asthma)

Question 7

definition of impaired fasting glucose

Answer 7

pre-diabetic state
fasting BG is consistently elevated above normal, but not high enough to be DM
associated with insulin resistance, incr risk of vascular pathology (less than with IGT) and incr risk for T2DM

Question 8

Definition of metabolic syndrome

Answer 8

Any 3 of these 5:

• abdominal circumference >102cm (men) 88 (women)
• TAG levels above 150
• HDL levels below 40 or 50
• BP anove 130/85
• fasting BG>100

Question 9

lab definition of gestational diabetes?

Answer 9

• fasting glucose >95

- after 100g glucose load, BG >180 at 1 hour time point or >155 at 2 hr time point

Question 10

plasma glucose comes from what two places?

Answer 10

either the diet or the liver

Question 11

lab criteria for impaired fasting glucose?

Answer 11

fasting glucose levels >100 on more than one occasion

Question 12

lab criteria for impaired glucose tolerance (IGT)

Answer 12

-BG over 140, 2 hrs after 75g glucose load

Question 13

risks associated with gestational diabetes?

Answer 13

• incr risk to dev T2DM after they deliver
• incr risk of pre-eclampsia
• incr risk of bigger infant

Question 14

extremely big picture: diabetes leads to what?

Answer 14

vascular injury, over time

Question 15

metabolic sx: generally think what?

Answer 15

BOGL: BP, obesity, glucose, lipids

Question 16

how urgent is it for a T1DM to have an eye exam? T2DM?

Answer 16

impt for both eventually, but T2DM should have one immediately because they have probably had high BG for a long time, may already have retinal damage.