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Internal Med > Diabetes > Flashcards

Diabetes Flashcards

1
Q

3 main classes

A
  1. T1 - severe insulin def. - need insulin to live
  2. T2 - 90% - insensitive
  3. impaired glucose tolerance
    - high fasting glucose
    - 1-5% annual risk of dev. DM2
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2
Q

3 main classes

A
  1. T1 - severe insulin def. - need insulin to live
  2. T2 - 90% - insensitive
  3. impaired glucose tolerance
    - high fasting glucose
    - 1-5% annual risk of dev. DM2
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3
Q

pato of T1

A

autoiummune dest. of B-cells

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4
Q

3 main risks for DM2

A
  1. obesity - major
  2. genetics
  3. age
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5
Q

what is lack of compensation in DM2

A

don’t produce insulin when lacking leading to hyperglycemia and resistance to hyperglycemia

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6
Q

3 groups to test/screen

A
  1. anyone over 45 x 3 years
  2. start earlier of risk factors
  3. any one with Sx
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7
Q

3 main tests

A

any one on two sep days

  1. fasting plasma glucose
  2. random plasma glucose
  3. 2 hour post-prandial glucose
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8
Q

presentation of DM1

A
  • over days to weeks
  • can be after illness
  • often acute DKA
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9
Q

presentation of DM2

A
  • often found on screening
  • polyuria, polydipsia, fatigue, blurred vision, weight loss
  • may present with complications if haven’t been followed
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10
Q

5 main areas to focus on in assessement of DM patients

A
  1. feet
  2. vascular disease
  3. neuro disease
  4. eyes
  5. renal
  6. infectious
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11
Q

5 main goals of Tx

A
  1. glycemic control
  2. BP control
  3. optimze lipids
  4. smoking cessation
  5. daily ASA
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12
Q

what is general dosing of insulin

A

2/3 in AM
- half NPH, half reg
1/3 in evening

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13
Q

what is target A1C level

A
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14
Q

what is intensive mgmt

A

for those willing to monitor glucose levels

- need to be aware of hypo risk

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15
Q

what is inpatient mgmt

A

sliding scale

  • give with finger prick monitoring
  • along with intermediate acting
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16
Q

4 times that need to think about monitoring doses

A
  1. physical activity
  2. illness
  3. stress and changes in diet
  4. undergoing surgery
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17
Q

how to initiate oral therapy

A

start with one
- metformin or sulfonourea
if fails add another class
don’t give if can’t eat

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18
Q

2 main classes of complications

A
  1. macrovascular

2. microvascular

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19
Q

macro issues

A

atherosclerosis

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20
Q

3 main manifestations of atherosclerosis

A
  1. CAD - most common cause of death
  2. PVD
  3. CVA
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21
Q

4 main micro manifestations

A
  1. nephropathy
  2. retinopathy
  3. neuropathy
  4. diabetic foot
22
Q

nephropathy

A

see deck

23
Q

prev of retinopathy

A

75% after 20 years

24
Q

2 main types

A
  1. non-proliferative
    - hemmorages, exudates
  2. proliferative
    - new vessel formation
    - detachment and hemmorage
    - can cause blindness
25
Q

4 types of neuropathies

A
  1. peripheral
    - stocking glove - leads to ulcers
  2. CN complications
    - most often CN3
    - pupils spared
  3. mononeuropathies
    - ulnar and peroneal common
  4. autonomic
    - impotence in men
    - neurogenic bladder
    - gastroparesis
    - constipation/diarreha
26
Q

issues in diabetic foot

A

artery ischemia + can’t feel

- repreated injures that can’t heal

27
Q

pato of T1

A

autoiummune dest. of B-cells

28
Q

3 main risks for DM2

A
  1. obesity - major
  2. genetics
  3. age
29
Q

what is lack of compensation in DM2

A

don’t produce insulin when lacking leading to hyperglycemia and resistance to hyperglycemia

30
Q

3 groups to test/screen

A
  1. anyone over 45 x 3 years
  2. start earlier of risk factors
  3. any one with Sx
31
Q

3 main tests

A

any one on two sep days

  1. fasting plasma glucose
  2. random plasma glucose
  3. 2 hour post-prandial glucose
32
Q

presentation of DM1

A
  • over days to weeks
  • can be after illness
  • often acute DKA
33
Q

presentation of DM2

A
  • often found on screening
  • polyuria, polydipsia, fatigue, blurred vision, weight loss
  • may present with complications if haven’t been followed
34
Q

5 main areas to focus on in assessement of DM patients

A
  1. feet
  2. vascular disease
  3. neuro disease
  4. eyes
  5. renal
  6. infectious
35
Q

5 main goals of Tx

A
  1. glycemic control
  2. BP control
  3. optimze lipids
  4. smoking cessation
  5. daily ASA
36
Q

what is general dosing of insulin

A

2/3 in AM
- half NPH, half reg
1/3 in evening

37
Q

what is target A1C level

A
38
Q

what is intensive mgmt

A

for those willing to monitor glucose levels

- need to be aware of hypo risk

39
Q

what is inpatient mgmt

A

sliding scale

  • give with finger prick monitoring
  • along with intermediate acting
40
Q

4 times that need to think about monitoring doses

A
  1. physical activity
  2. illness
  3. stress and changes in diet
  4. undergoing surgery
41
Q

how to initiate oral therapy

A

start with one
- metformin or sulfonourea
if fails add another class
don’t give if can’t eat

42
Q

2 main classes of complications

A
  1. macrovascular

2. microvascular

43
Q

macro issues

A

atherosclerosis

44
Q

3 main manifestations of atherosclerosis

A
  1. CAD - most common cause of death
  2. PVD
  3. CVA
45
Q

4 main micro manifestations

A
  1. nephropathy
  2. retinopathy
  3. neuropathy
  4. diabetic foot
46
Q

nephropathy

A

see deck

47
Q

prev of retinopathy

A

75% after 20 years

48
Q

2 main types

A
  1. non-proliferative
    - hemmorages, exudates
  2. proliferative
    - new vessel formation
    - detachment and hemmorage
    - can cause blindness
49
Q

4 types of neuropathies

A
  1. peripheral
    - stocking glove - leads to ulcers
  2. CN complications
    - most often CN3
    - pupils spared
  3. mononeuropathies
    - ulnar and peroneal common
  4. autonomic
    - impotence in men
    - neurogenic bladder
    - gastroparesis
    - constipation/diarreha
50
Q

issues in diabetic foot

A

artery ischemia + can’t feel

- repreated injures that can’t heal

Internal Med (29 decks)

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