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Week 14: Diabetes > Classification, Screening and Diagonsis > Flashcards

Classification, Screening and Diagonsis Flashcards

1
Q

5 types of diabetes

A 
Type 1
Type 2
Gestational Diabetes
Monogenic Diabetes
Secondary diabetes (medication/drug related, exocrine pancreas related, endocrinopathy related, infection related, etc)
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2
Q

Type 1 DM

A

Autoimmune or non-autoimmune mediated destruction of beta cells
Risk factors: genetic predisposition and environmental factors

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3
Q

3 proteins/antibodies you can look for in the lab to test for T1D

A

C-peptide
Anti-GAD Ab
Anti-ICA Ab

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4
Q

Type 2 DM

A

Insulin resistance due to obesity, abnormal insulin receptors, adipokines, inflammation, beta cell defects, and metabolic syndrome
Risk factors: genetic**, family history, ethnicity, obesity, poor diet, sedentary, smoking

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5
Q

Special Lab investigations for T2D

A

Creatinine/eGFR
UACR
Lipid panel
Diabetic eye exam

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6
Q

Gestational DM

A

Glucose intolerance that develops or is first recognized during pregnancy
From insulin resistance due to placental secretion of diabetogenic hormones (GH, CRH, hPL)
Pancreas predisposed to diabetes is unable to keep up with insulin demand

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7
Q

Risk factors for gestational diabetes

A 
Maternal age > 37
Ethnicity
Pre-pregnancy weight >80kg/ BMI over 28
Family Hx in 1st degree relative
History of macrosomia/polyhydramnios/unexplained stillbirth
PCOS
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8
Q

3 Investigations for gestational DM

A

Oral glucose tolerance test
Urine protein dipstick
Urine ketones

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9
Q

Monogenic diabetes

A

Single gene variants causing defects in glucose-induced insulin release
Risk factors: family history
Use genetic testing

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10
Q

How do cyclosporine, phenytoin and thiazides cause diabetes?

A

Interfere with insulin release from beta cells

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11
Q

How do glucocorticoids, niacin, and anti-viral protease inhibitors cause diabetes?

A

Induce insulin resistance

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12
Q

How do anti-psychotics cause diabetes?

A

Weight gain +/- beta cell dysfunction

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13
Q

2 genetic causes and 5 acquired causes of exocrine pancreas-related diabetes

A

Genetic: CF, hemochromatosis
Acquired: pancreatitis, trauma, infection, pancreatic cancer, pancreatectomy

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14
Q

5 causes of endocrinopathy-related diabetes

A 
Acromegaly (excess growth hormone)
Cushing's syndrome (excess cortisol)
Cushing's disease (excess ACTH)
Ectopic Cushing's syndrome (excess ACTH)
Pheochromocytoma
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15
Q

Cushing’s syndrome vs disease

A

Syndrome: excess cortisol from any cause
Disease: excess ACTH from pituitary gland

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16
Q

5 viruses that can cause infection-related diabetes

A 
Congenital rubella
Coxsackievirus B
Cytomegalovirus
Adenovirus
Mumps
17
Q

Should you screen for T1D?

A

No

Because there are no interventions to prevent or delay T1DM

18
Q

Should you screen for T2D?

A

You can screen for T2D using a FPG and/or A1C every 3 years in people 40+ or in individuals at high risk on a risk calculator (33% chance of developing diabetes over 10 years)

19
Q

Risk factors for T2DM

A 
Age 40+
1st degree relative with T2DM
High risk population (African, Asain, Arab, Hispanic, Indigenous, South Asian, low SES)
History of pre-diabetes/gestational diabetes
End organ damage
Vascular risk factors
Associated diseases
Some meds
20
Q

3 main microvascular end organ damages

A

Retinopathy
Neuropathy
Nephropathy

21
Q

3 main macrovascular end organ damages

A

Coronary
Cerebrovascular
Peripheral

22
Q

Numbers to diagnose diabetes

A

Fasting plasma glucose: 7.0+
A1C: 6.5+
2 hour plasma glucose in a OGTT: 11.1+
Random PG: 11.1+
These values are greater than or equal to
No symptoms you need 2 of them, with symptoms only need one

23
Q

What is the prediabetes FPG and A1C

A

FPG: 6.1 to 6.9
A1C: 6.0 to 6.4%

24
Q

What is the normal values for FPG and A1C

A

FPG: under 5.6
A1C: under 5.5%

25
Q

When should you screen a pregnant woman for gestational diabetes?

A

Between 24 to 28 weeks

26
Q

3 complications in gestational DM

A

High birth weight
Increased risk for c section
Neonatal hypoglycemia

Week 14: Diabetes (10 decks)

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