Diabetes

Question 1

Diabetic nephropathy

Answer 1

Leading cause of End Stage Renal Disease (ESRD) in US, occurs in 20-40% of patients with DM
Frequently coexists with diabetic retinopathy
Microalbuminemia is a risk factor for nephropathy and CVD

Question 2

Microalbuminemia

Answer 2

may progress to macroalbuminemia, with a steady decline in Glomerular Filtration Rate (GFR); ESRD can occur within 10 years in 50% of these patients

Question 3

Diabetic retinopathy

Answer 3

leading cause of blindness between ages 20-74 in US
Prevention is the best policy and may be accomplished with intensive glycemic control and BP control
Regular eye exams are essential in DM
Laser photocoagulation is useful for preserving vision in patients with diabetic retinopathy

Question 4

Recurrent infections

Answer 4

Defects in Cell Mediated Immunity (CMI) and phagocyte function lead to recurrent infections
PNA, UTI, and skin and soft tissue infections are more common in DM patients
Rare infections seen with greater frequency in DM include rhinocerebral mucormycosis, invasive otitis externa and P. aeruginosa

Question 5

PVD

Answer 5

eading cause of non-traumatic LE amputation in US
DFUs result from a combination of PVD, neuropathy, and poor wound healing*
~15% of DM2 patients develop a foot ulcer

Question 6

Metabolic syndrome

Answer 6

DM2 frequently occurs with the metabolic syndrome
Metabolic syndrome is defined as a constellation of abnormalities that confer increased risk of CVD and DM
Major features of the metabolic syndrome include central obesity, hypertriglyceridemia, low HDL cholesterol, hyperglycemia, and HTN

Question 7

Hemoglobin A1c

Answer 7

assess long term control of DM and is followed every 2-3 months
HBA1 occurs in 3 forms: A1a, A1b, A1c
The major form is A1c, in which glucose is added at the N-terminal valine of the beta chain

Question 8

Patients with hemoglobinopathies may lack

Answer 8

HB A (ex: Hb SS, Hb CC, or Hb SC)
Fructosamine may be used when a patient has one of the above hemoglobinopathies to assess diabetic control

Question 9

measured from serum

Answer 9

Fructosamine is glycosylated albumin

Question 10

Microalbuminuria,

Answer 10

detects early diabetic nephropathy

Question 11

In DM2, microalbuminuria should be measured

Answer 11

every year and in DM1, it should be measured every year after 5 years

Question 12

Diabetic ketoacidosis

Answer 12

life threatening complication of diabetes that occurs
due to the production of high levels of ketones in the blood.