Beetus 3 Flashcards

1
Q

What causes DM I?

A
  • autoimmune destruction of ß cells

- often has certain genetic markers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are DM I pts prone to?

A
  • DKA

- metabolic derangements associated with hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

DM I pts require this

A

Exogenous insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes DM II?

A

Combo of

  • insulin resistance
  • lack/failure of production of insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

DM II: onset

A

Adult onset hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

DM II: DKA

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

DM II can often be corrected by:

A
  • diet
  • exercise
  • oral hypoglycemic agents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

DM I: age of onset

A

Usu under 20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

DM II: age of onset

A

Usually over 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Proportion of cases: DM I vs. II

A

DM I: 5%

DM II: 95%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

DM I: onset

A

Abrupt (Acute/subacute)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

DM II: onset

A

Gradual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

DM I: etiologic factors

A
  • possible viral/autoimmune

- destruction of islet cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

DM II: etiologic factors

A
  • obesity associated

- dec affinity of insulin receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Risk factors: DM I

A

Presence in 1st degree relative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

These groups have a 3x greater likelihood of DM II

A

Black, native american, asian

17
Q

DM II risk factors

A
  • positive family hx
  • ethnicity
  • obesity and hyperlipidemia
  • increased age
  • previous impaired fasting glucose or gestational DM
  • HTN
  • smoking
18
Q

Key predictors for increased risk for DM II

A
  • over 55
  • BMI over 30
  • family hx of DM
19
Q

Gestational diabetes

A
  • associated with pregnancy

- returns to normal postpartum

20
Q

DM classification is based upon

21
Q

IFG =

A

Impaired fasting glucose

22
Q

IFT =

A

Impaired fasting tolerance

23
Q

FPG =

A

Fasting plasma glucose test

24
Q

IGT =

A

Impaired glucose tolerance

25
What is IGT?
- Ability to regulate a sudden oral glucose load - drink 75g glucose dissolved in 300 ml water - blood tested before test and 2 hrs post
26
When would an IGT test be performed?
- IFT seen on fasting plasma glucose test | - need follow-up testing
27
OGTT =
Oral glucose tolerance test
28
Normal OGTT
Below 140 mg/dL
29
Prediabetes OGTT
140 - 199 mg/dL
30
Diabetes OGTT
≥ 200 mg/dL
31
What is used for long term assessment of blood glucose levels?
HbA1c (hemoglobin A1c test)
32
What does HbA1c test reveal?
average blood glucose over a period of 2-3 months
33
What does HbA1c measure?
Number of glucose molecules attached to hemoglobin
34
Normal A1c results
Less than 5.7%
35
Prediabetes A1c results
5.7-6.4%
36
Diabetes A1c
6.5% or higher
37
How does HbA1c complement finger sticks?
- finger sticks are day to day snapshots | - HbA1c is a bigger picture
38
Summary: dx of DM
- HbA1c - FPG (fasting plasma glucose) - OGTT (2 hour glucose tolerance test)