Beetus 3

Question 1

What causes DM I?

Answer 1

• autoimmune destruction of ß cells

- often has certain genetic markers

Question 2

What are DM I pts prone to?

Answer 2

• DKA

- metabolic derangements associated with hyperglycemia

Question 3

DM I pts require this

Answer 3

Exogenous insulin

Question 4

What causes DM II?

Answer 4

Combo of

• insulin resistance
• lack/failure of production of insulin

Question 5

DM II: onset

Answer 5

Adult onset hyperglycemia

Question 6

DM II: DKA

Answer 6

not as likely to have DKA or metabolic derangements associated with hyperglycemia as a DM I pt

Question 7

DM II can often be corrected by:

Answer 7

• diet
• exercise
• oral hypoglycemic agents

Question 8

DM I: age of onset

Answer 8

Usu under 20

Question 9

DM II: age of onset

Answer 9

Usually over 40

Question 10

Proportion of cases: DM I vs. II

Answer 10

DM I: 5%

DM II: 95%

Question 11

DM I: onset

Answer 11

Abrupt (Acute/subacute)

Question 12

DM II: onset

Answer 12

Gradual

Question 13

DM I: etiologic factors

Answer 13

• possible viral/autoimmune

- destruction of islet cells

Question 14

DM II: etiologic factors

Answer 14

• obesity associated

- dec affinity of insulin receptors

Question 15

Risk factors: DM I

Answer 15

Presence in 1st degree relative

Question 16

These groups have a 3x greater likelihood of DM II

Answer 16

Black, native american, asian

Question 17

DM II risk factors

Answer 17

• positive family hx
• ethnicity
• obesity and hyperlipidemia
• increased age
• previous impaired fasting glucose or gestational DM
• HTN
• smoking

Question 18

Key predictors for increased risk for DM II

Answer 18

• over 55
• BMI over 30
• family hx of DM

Question 19

Gestational diabetes

Answer 19

• associated with pregnancy

- returns to normal postpartum

Question 20

DM classification is based upon

Answer 20

IFG test

Question 21

IFG =

Answer 21

Impaired fasting glucose

Question 22

IFT =

Answer 22

Impaired fasting tolerance

Question 23

FPG =

Answer 23

Fasting plasma glucose test

Question 24

IGT =

Answer 24

Impaired glucose tolerance

Question 25

What is IGT?

Answer 25

• Ability to regulate a sudden oral glucose load
• drink 75g glucose dissolved in 300 ml water
• blood tested before test and 2 hrs post

Question 26

When would an IGT test be performed?

Answer 26

• IFT seen on fasting plasma glucose test

- need follow-up testing

Question 27

OGTT =

Answer 27

Oral glucose tolerance test

Question 28

Normal OGTT

Answer 28

Below 140 mg/dL

Question 29

Prediabetes OGTT

Answer 29

140 - 199 mg/dL

Question 30

Diabetes OGTT

Answer 30

≥ 200 mg/dL

Question 31

What is used for long term assessment of blood glucose levels?

Answer 31

HbA1c (hemoglobin A1c test)

Question 32

What does HbA1c test reveal?

Answer 32

average blood glucose over a period of 2-3 months

Question 33

What does HbA1c measure?

Answer 33

Number of glucose molecules attached to hemoglobin

Question 34

Normal A1c results

Answer 34

Less than 5.7%

Question 35

Prediabetes A1c results

Answer 35

5.7-6.4%

Question 36

Diabetes A1c

Answer 36

6.5% or higher

Question 37

How does HbA1c complement finger sticks?

Answer 37

• finger sticks are day to day snapshots

- HbA1c is a bigger picture

Question 38

Summary: dx of DM

Answer 38

• HbA1c
• FPG (fasting plasma glucose)
• OGTT (2 hour glucose tolerance test)