Diabetes Overview Flashcards
Metabolic syndrome characterized by
Assc w ____ in females
important to dx bc of LT risks
PE
Labs
Tx
Potential meds
insulin resistance/obesity
polycystic ovary syndrome
diabetes/CV risk
obesity, inc weight circum, HTN, acanthosis nigricans
hypergly, dec HDL, elevated TG
lifestyle mod/wl (improve insulin sensitivity, further dz)
metformin, antiHTN, statins
Impaired glucose tolerance aka
identified by
glucose levels
glucose challenge range
HbA1c
any can be used for
Tx
pre-diabetes- indiv at risk of DM
insulin resistance
100-126
140-199
6-6.5
Lifestyle mod/metformin
Dx diabetes
HgA1c >
blood glucose >
2 separate fasting glucose >
2hr post prandial glucose >
6.5%
200
126
200
T1DM caused by
classically seen in indiv, less than
occurs as a result of
Sx
Tx
immune-mediated destruction of beta cells/loss of pancreatic insulin production
thin, less than 30
polyuria, polydipsia, polyphagia, fatigue, wl, DKA
insulin
DKA
serious complication of
T2DM do not get it bc
these indiv can produce enough ____ to prevent ketoacidosis
w/out insulin, glcose cannot be ____
gluocse levels in blood ___
this glucose spills into __, resulting in
Body cannot utilize gluocse, must use ___ for energy
FA breakdown results in
T1DM
resistant, not lacking, insulin
can produce enough insulin to utlize glucose
taken into cells
inc (hyperglycemia)
urine, diuresis/severe dehydration
FA
ketone prod (KA)
DKA can be presentation of new ___ or precipitated by ___, _____
Sx include
PE
Lab- glucose >
arterial pH <
____ AGAP due to
T1DM, infection, noncompliance
ab pain, vomiting
Kussmaul respiration (inc tidal volume), fruity/acetone smell, severe hypovolemia, coma
250
7.3
KA, LA, low bicarb (attempt to buffer acid)
HypoNa in DKA results from
total body K may be low due to
inc Lipolysis can result in
Tx is ___ as DKA has
First
next
Close monitoring/replacement of K is necessary bc
dilution
HyperK, cellular shift/urine loss
ketonuria/ketonemia
urgent, high MR
rehydrate w IV saline
insulin
transcell shift can result in hypoK
T2DM caused by
classically occurs in
strongly
sx are more
include
Severe cases can lead to
Tx
insuff insulin production from beta cells due to insulin resistance of peripheral tissues
older, obese indiv
genetic
gradual
wl, blurry vision, candida (esp vaginitis), poor wound healing
hyperosmolar nonketotic coma
monitor and treat complications
HHNK
severe comp of
pt may present w
this because of conc of ____ to prevent KA is much less than that necessary to adequately control ___ levels
common pt
sx include
tx
T2DM
glucsoe >600
insulin, glucose
older, comorbids
AMS, dehydration,hypovol/shock
hydration, lower glucose levels w insulin
Complications
Can have ____ vasc comps
Uncontrolled glucose inc risk for
micro/macro
CAD, PVD, stroke, neuropathy, nephropahty
DN screen w
evaluate for
much more sensitive than
w proteinuria, tx w
yearly urine microalbumin test
early spillage of protein in kidneys
check blood creatinine
ACE inhib/ARB
Diabetic retinopathy
can suffer from ___ comps due to neovascularization of the ____ as well as nonproliferative changes of
can get
Evaluate w yearly
occular comps, retina, microanueyrsms
cataracts, glaucoma, blindness
dilated eye exams
Diabetic neuropathy
occurs in ____, __ nerves
starts in ___ and spreads
causing
Tx
smaller, distant
feet, proximal
numb, paresthesias, burning sensation, dec DTR
meds for neuro pain
Gabapentin, pregabalin, amitriptyline
Diabetic foot
should perform regular
evalute for
bc of a lack of ___ due to neuropathy
sore on foot goes untreated, goes into deepr tissues, leading to
Findings
foot exams
areas of infection/skin breakdown
adeq senstation
cellulitis, osteomyelitis
infection/ PWH/ amputation
Autonomic dysfxn
potential conditions
G
E
N
w glucosuria can lead to
Gastroparesis
ED
Neurogenic bladder/incontinence
UTI
