Diabetes 1

Question 1

diabetes is the number one cause of what

Answer 1

non-traumatic amputation
kidney disease
blindness

Question 2

what is the cause of type 1 diabetes

Answer 2

auto-immune destruction of the pancreatic beta cells
or
A virus that causes beta cell destruction

Question 3

what is the cause of type 2 diabetes

Answer 3

insulin resistance in muscle and adipose tissue
progressive decline in pancreatic insulin secretion
unrestrained hepatic glucose production
hormonal deficiencies
most common form of diabetes

Question 4

what are the 3 signs of hyperglycemia

Answer 4

polyuria
polydipsia
polyphagia
fatigue

Question 5

what are some risk factors for becoming a type 2 diabetic

Answer 5

Overweight/obese
sedentary lifestyle
fam hx
cardiovascular disease
HTN
high triglycerides

Question 6

what are risk factors for gestational diabetes

Answer 6

history of gestional diabetes
history of infant with birthweight >9lbs
polycystic ovary syndrome

Question 7

When should you screen a person for diabetes?

Answer 7

asymptomatic people with BMI>or= 25kg/m in any adults who have one or more additional risk for DM
Testing should start at 45

Question 8

what do you do if the tests for diabetes are negative

Answer 8

test again at 3 year intervals

Question 9

what is the A1c of a normal person

Answer 9

less than 5.7%

Question 10

what is the A1C for a prediabetic

Answer 10

5.7-6.4%

Question 11

what is the A1C for a diabetic

Answer 11

> or= to 6.5%

Question 12

what is the fasting glucose level of a normal person

Answer 12

less than 100mg/dl

Question 13

what is the fasting glucose level of a pre-diabetic

Answer 13

100-125mg/dl

Question 14

what is the fasting glucose for a diabetic

Answer 14

> or=to 126mg/dl

Question 15

what is the OGTT for a normal person

Answer 15

<140

Question 16

what is the OGTT for a prediabetic

Answer 16

140-199

Question 17

what is the OGTT for a diabetic person

Answer 17

> or=to 200

Question 18

what is the level for a random glucose for a diabetic

Answer 18

> or=to 200

Question 19

what is the A1C goal for most diabetic patients

Answer 19

7%<

Question 20

what would you give a patient who is determined to have prediabetes with a IGT, IFG or A1C of 5.7-6.4%?

Answer 20

metformin

Question 21

What criteria would you use to determine when to use metfromin with a patient

Answer 21

BMI>35kg/m
60yo<
women with prior GDM

Question 22

What are macrovascular complications of diabetes

Answer 22

Coronary artery disease
HTN
Dyslipidemia

Question 23

what are microvascular complications

Answer 23

retinopathy
neuropathy
nephropathy

Question 24

what are you going to prescribe patients with coronary artery disease and diabetes

Answer 24

Asprin 81mg daily
men>50
women>60
with one risk factor of fam hx of CVD,HTN, smoking

Question 25

what are the treatment goals for diabetics with HTN

Answer 25

140/80 | ACE-1 or ARB

Question 26

what is the goal for diabetics with dylipidemia

Answer 26

LDL<100 | Start statins

Question 27

how would you manage a diabetic with retinopathy

Answer 27

manage HTN and glucose | laser treatment

Question 28

how would you manage a diabetic with neuropathy

Answer 28

``` peripheral manage HTN gabapentin, lyrica and cymbalta Autonomic: PDE-5 inhibitors reglan, erythromycin stool softeners ```

Question 29

What else is another big thing that you want to reduce a diabetics risk of infection

Answer 29

Annual influenza vaccine | pneuomococcal vaccine

Question 30

what are non-pharmacological therapy for diabetes

Answer 30

exercise 30min for most days of week change diet avoid sat fats, carbs, sugar increase fiber

Question 31

what are complications that are associated with GDM

Answer 31

``` macrosomia (large baby) need cesarean shoulder dystocia and birth trauma neonate metabolic problems perinatal mortality HTN/preeclampsia ```

Question 32

What are risk factors for GDM

Answer 32

``` >25 yo overweight Fam Hx of DM2 abnorm glucose metabol poor obstretic outcomes children >9lbs polycystic ovarian disease Latino/hispanic, non-black, asain, native american, pacific islander ```

Question 33

when do you screen for GDM

Answer 33

1st prenatal visit in a person with those risk factors | if a woman does not have known DM test using OGTT at 24-48 WEEKS

Question 34

What is 1st line for GDM

Answer 34

diet modification and insulin

Question 35

what oral agents can you NOT USE with GDM

Answer 35

biguanides and TZDs

Question 36

What orals can you use with GDM

Answer 36

sulfonylureas | glipizide and glyburide

Question 37

what do you do with a woman who does have GDM

Answer 37

test them 6-12 week postpartum | If a woman does have GDM they should be screened every 3years for development of DM or prediabetes

Question 38

when are type 1 DM diagnosed

Answer 38

3/4 are diagnosed before 18

Question 39

what are the goals of treatment for children who have type 1

Answer 39

more lax with their treatment because they are at greater risk of hypoglycemia

Question 40

what are the treatment goals for the elderly patients

Answer 40

functional cognitively intact life expectancy A1C<8

Question 41

what are difference of DM children respond to insulin compared to adults

Answer 41

changes in insulin sensitivity due to hormone changing growth patterns supervision at daycare