Diabetes Mellitus Flashcards
Type 1 diabetes makes up what percentage of all diabetes cases?
5-10%
Type 2 diabetes makes up what percentage of all diabetes cases?
>90%
What are the 2 recognized states of prediabetes?
- Impaired Glucose Tolerance (IGT)
- Impaired Fasting Glucose (IFG)
In the US, the CDC estimates how many Americans have diabetes?
25.8 million
Describe the “honeymoon” period in insulin therapy.
a phenomenon where endogenous insulin secretion increases for a short period of time after a newly diagnosed patient is started on insulin therapy.
When about _________% of a patient’s beta cells have been destroyed, clinical diabetes results.
60-80%
Describe why severe insulin deficiency can lead to DKA.
- the liver is unable to utilize glucose even though glucose levels are high
- so the liver begins to metabolize fat for energy
- the fatty acids from fat metabolism are broken down and create ketones in the process
- large amounts of ketones lower blood pH (due to their acidity)
What percentage of total diabetic patients are thought to be undiagnosed?
about 27%
At the time of diagnosis, what percentage of beta cell function is believed to be lost in patients with type 2 diabetes?
50%
What effects does insulin have on adipose cells?
- facilitates uptake of glucose for energy
- suppresses lipolysis of triglycerides into glycerol and free fatty acids
What is the impact of insulin resistance on adipose cells in a person with type 2 diabetes?
- glucose absorption is decreased
- lipolysis of tryglycerides into glycerol and fatty acids is no longer suppressed
- results in rising levels of free fatty acids that impact liver function and glucose uptake in skeletal muscle
Because of their size, skeletal muscles account for about _______% of the glucose uptake that occurs in the body.
80%
What does MODY stand for?
Maturity-Onset Diabetes of the Young
What does LADA stand for?
Latent Autoimmune Diabetes in Adults
According to the ADA, what is the criteria for testing asymptomatic individuals for diabetes?
- All adults who are overweight (BMI>25) and who have one or more risk factors:
- physical inactivity
- first degree relative
- high-risk race
- GDM (or >9 lb baby)
- hypertension (>140/90)
- HDL <35 and/or triglyceride >250
- PCOS
- A1c >5.7%, IGT, IFG on previous test
- other risk factors for insulin resistance
- history of CVD
- In the absence of above, begin testing at 45 years
- If normal, repeat test at 3 year intervals
What lab values indicate impaired fasting glucose (IFG)?
- 100-125 FPG
- 5.7% - 6.4% A1c
What lab values indicate impaired glucose tolerance (IGT)?
- 140-199 2-hr PPG (OGTT)
- 5.7% - 6.4% A1c
What is the definition of metabolic syndrome?
The presence of at least 3 of the following:
- elevated FPG
- hypertension
- low HDL
- elevated triglycerides
- abdominal obesity
What percentage of the US population can be classified as having metabolic syndrome?
up to 34%
What are some of the characteristics of MODY?
Maturity-Onset Diabetes of the Young
- it is an uncommon, atypical type 2 diabetes
- presents at an early age (usually before age 25)
- characterized by impaired insulin secretion and insulin resistance
Describe LADA.
Latent Autoimmune Diabetes in Adults
- sometimes referred to as type 1.5 diabetes
- present clinically as having type 2 diabetes, but autoimmune antibodies characteristic of type 1 diabetes are present
- these patients typically require insulin after several years
What does AACE require in order to confirm a diagnosis of diabetes?
One of these 3 criteria must be met and then confirmed on a repeated test:
- FPG > 126 mg/dL
- OGTT > 200 mg/dL
- A1c > 6.5%
Is routine CAD screening recommended for asymptomatic diabetes patients?
No.
How often should a lipid profile test and urinalysis be perfomed in patients with diabetes?
at least annually
