Diabetes Mellitus

Question 1

when did the dx criteria for DM change?

Answer 1

1997

Question 2

what is the fasting BG level for diagnosing DM?

Answer 2

126 mg/dl

Question 3

which ethnicity is most affected by DM?

Answer 3

african american

Question 4

what is type 3 DM?

Answer 4

maturity onset diabetes of youth

genetic insulin receptor syndromes

Question 5

what are secondary DM problems?

Answer 5

pancreatitis
pancreatic CA
Cushings
hemochromatosis
acromegaly

Question 6

which cells secrete glucagon?

Answer 6

alpha cells in the islets of langerhan

Question 7

what can the brain use in fasting state for energy?

Answer 7

ketones

Question 8

when plasma insulin declines dramatically (insulin deficient), what will happen in the liver?

Answer 8

liver generates tons of ketones

Question 9

what antibodies may affect DM type 1?

Answer 9

islet cell antibodies (ICA)
glutamic acid decarboxylase antibodies (GAD)
insulin autoantibodies (IAA)
tyrosine phosphatase antibodies (IA-2)

Question 10

when might you want to order antibodies studies?

Answer 10

younger, overweight pts (esp. with ketones)

older, thin pts

Question 11

which test would you order to see if there is any endogenous insulin?

Answer 11

C-peptide

Question 12

what are the MAJOR risk factors for type 2 DM?

Answer 12

obesity

family hx

Question 13

what is the metabolic syndrome?

Answer 13

list of systemic changes that often goes along with DM and goes along with weight gain

Question 14

what is the classic presentation of the lipid panel for a person with metabolic syndrome?

Answer 14

High triglycerides
Low HDL
small, dense LDL

Question 15

what are particularly concerning patterns of metabolic syndrome?

Answer 15

prothrombotic state
proinflammatory state
(causes ischemia in heart and brain)

Question 16

what is a common pediatric DM type 1 complaint?

Answer 16

irritability

Question 17

what is the renal threshold of glucose?

Answer 17

180, a blood glucose of higher than that will be urinated

Question 18

why do late DM type 2 pts lose weight?

Answer 18

their cells use lipids and proteins, since they can’t access the glucose

Question 19

why do type 2 diabetics get visual blurring?

Answer 19

dehydration of the lens

glucose deposits in the lens

Question 20

in the diabetes prevention study, which process worked best to prevent diabetes?

Answer 20

lifestyle modification 71% reduction

metformin, only 31% reduction

Question 21

according to the UKPDS, what is responsible for reducing cardio events in diabetic pts?

Answer 21

controlling blood pressure (144/82 avg)

Question 22

where do you get the biggest benefit from controlling blood sugar?

Answer 22

eye
kidney
peripheral neuropathy

Question 23

where else do you need to focus your efforts when managing your type 2 diabetic pts?

Answer 23

cardiovascular profile (lipids, healthy eating, exercise)

Question 24

when is metformin contraindicated?

Answer 24

creatinine of >1.4 for female, 1.5 for male

Question 25

what is the 2nd leading cause of death in pts who have DM?

Answer 25

infections of any kind