Diabetes Mellitus Flashcards
when did the dx criteria for DM change?
1997
what is the fasting BG level for diagnosing DM?
126 mg/dl
which ethnicity is most affected by DM?
african american
what is type 3 DM?
maturity onset diabetes of youth
genetic insulin receptor syndromes
what are secondary DM problems?
pancreatitis pancreatic CA Cushings hemochromatosis acromegaly
which cells secrete glucagon?
alpha cells in the islets of langerhan
what can the brain use in fasting state for energy?
ketones
when plasma insulin declines dramatically (insulin deficient), what will happen in the liver?
liver generates tons of ketones
what antibodies may affect DM type 1?
islet cell antibodies (ICA)
glutamic acid decarboxylase antibodies (GAD)
insulin autoantibodies (IAA)
tyrosine phosphatase antibodies (IA-2)
when might you want to order antibodies studies?
younger, overweight pts (esp. with ketones)
older, thin pts
which test would you order to see if there is any endogenous insulin?
C-peptide
what are the MAJOR risk factors for type 2 DM?
obesity
family hx
what is the metabolic syndrome?
list of systemic changes that often goes along with DM and goes along with weight gain
what is the classic presentation of the lipid panel for a person with metabolic syndrome?
High triglycerides
Low HDL
small, dense LDL
what are particularly concerning patterns of metabolic syndrome?
prothrombotic state
proinflammatory state
(causes ischemia in heart and brain)
what is a common pediatric DM type 1 complaint?
irritability
what is the renal threshold of glucose?
180, a blood glucose of higher than that will be urinated
why do late DM type 2 pts lose weight?
their cells use lipids and proteins, since they can’t access the glucose
why do type 2 diabetics get visual blurring?
dehydration of the lens
glucose deposits in the lens
in the diabetes prevention study, which process worked best to prevent diabetes?
lifestyle modification 71% reduction
metformin, only 31% reduction
according to the UKPDS, what is responsible for reducing cardio events in diabetic pts?
controlling blood pressure (144/82 avg)
where do you get the biggest benefit from controlling blood sugar?
eye
kidney
peripheral neuropathy
where else do you need to focus your efforts when managing your type 2 diabetic pts?
cardiovascular profile (lipids, healthy eating, exercise)
when is metformin contraindicated?
creatinine of >1.4 for female, 1.5 for male
what is the 2nd leading cause of death in pts who have DM?
infections of any kind
