Diabetes

Question 1

target organs affected by DM

Answer 1

eyes, kidneys, heart, nerves, blood vessels

Question 2

how to screen for DM

Answer 2

fasting plasma glucose, or OGTT, or HBA1C done for everyone >45 or if 2 or more risk factors (sedentary, minority, family hx, gestational dm, htn, hyperlipidemia, hba1c > 5.7, polycystic ovary syndrome, cardiovascular disease, acanthosis nigricans) or BMI > 25

Question 3

patho type 1

Answer 3

autoimmune destruction of islets of langerhans cells in the pancreas leading to decreased secretion of insulin. Insulin uses glucose as the primary source of energy, if there is lack of insulin then glucose will not be used and the body uses fat and protein and glycogenolysis then hyperglycemia.

Question 4

patho type 2

Answer 4

insulin resistance with impaired beta cell function, increased hepatic glucose production, deceased glucose uptake. Insulin resistance is the decreased sensitivity of tissue to glucose uptake with a normal concentration of insulin. Progresses to more glucose intolerance

Question 5

Type 1 s/s initially

Answer 5

3 P’s, weight loss, fatigue, blurred vision –> abdominal pain, rapid breathing, hypotension, DKA

Question 6

Type 2 s/s initially

Answer 6

asymptomatic for years… 3 Ps, fatigue, slow healing wounds, frequent infections, neuropathy, weight loss

Question 7

DM Physical Exam

Answer 7

1) VS 2) Eyes with fundoscope exam for hemm or exudates. 3) Oral exam for fungal infections or lesions, gum disease 4) Thyroid exam 5) Cardiac 6) Skin for lesions, redness, irritation, infection, ulcers, acanthosis nigricans 7) Feet check reflexes and do monofilament