B2.048 Prework 2 Clinical Presentation

Question 1

what is the most common presentation of childhood DM1?

Answer 1

hyperglycemia without acidosis

Question 2

what is the second most common presentation of childhood DM1?

Answer 2

DKA

30% of patients

Question 3

what increases a patient’s likelihood of progressing to DKA?

Answer 3

<6 or from adverse socioeconomic backgrounds

Question 4

what types of patients will be diagnosed before the onset of clinical symptoms?

Answer 4

children with another close family member with DM1

Question 5

what are the diagnostic criteria for diabetes

Answer 5

fasting plasma glucose >126 mg/dL
random venous plasma glucous >200 mg/dL and classic symptoms
plasma glucose >200 mg/dL 2 hours after glucose load of 1.75 g/kg
A1c >6.5% (this criterion more useful in DM2)

Question 6

compare the diagnostic ability of A1c in children and adults

Answer 6

less well established for children

children may have lower values and still have DM1

Question 7

what are differences in body habitus in DM1 vs DM2 patients?

Answer 7

DM2 usually obese

DM1 only 25% overweight

Question 8

what are differences in age of onset in DM1 vs DM2 patients?

Answer 8

DM1 <10 years old

DM2 >10 years old

Question 9

what are differences in family history in DM1 vs DM2 patients?

Answer 9

DM1 10% have affected relative

DM2 75-90%

Question 10

what is acanthosis nigricans

Answer 10

sign of insulin resistance

dark patchy areas of skin

Question 11

what antibody is associated with DM1?

Answer 11

pancreatic antibodies against glutamic acid decarboxylase (GAD65)

Question 12

what are come other causes of diabetes? (not DM1 or DM2)

Answer 12

exocrine disease
endocrine abnormalities in glucose regulation (extra counter regulatory hormone release)
drug induced
monogenic