Diabetes-Pino Flashcards

1
Q

Diabetes

Define

A

Chronic disorder. Of metabolism (carbs, fat)

Absolute/relative deficiency of insulin secretion

Ineffective response to insulin

Hyperglycemia

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2
Q

T1DM

Gene ass

A

HLA

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3
Q

DM

Risk factors

A

Viruses

Diet

Higher SES

Obesity

Vit D deficiency

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4
Q

Insulin

A

Get carbs into cell

Opens receptors for glucose

conversion of glucose to glycogen

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5
Q

T1DM

Pathogenesis

A

Genetic (HLA DR3/4) + environmental trigger

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6
Q

DM

Presentation

A

Polyuria

Polydipsia

Polyphagia (w weight loss)

Can be DKA

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7
Q

DM

Why do you get polyuria, polydipsia, polyphagia

A

Glucose goes above renal threshold. Goes into urine so draws water with it. Causes you to drink more.

Cells starve due to no glucose (no uptake). Cells shift to fat (polyphagia w weight loss)

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8
Q

Criteria for dx of DM

A

A1C: >6.5

FPG>126

2 hr PG > 200

Random PG>200

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9
Q

DM

DDx

A

Critical illness

Meds (steroids)

Neonatal

Gestational

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10
Q

DM

As

A

Thyroiditis (anti GAD)

Celiac (tTG)

Addsons

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11
Q

DM

Complications

A

Hypoglycemia

Hyperglycemia

DKA

Long list

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12
Q

Hypoglycemia

A

<70

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13
Q

Hypoglycemia

Sx

A

Cranky, light headed, diaphoretic

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14
Q

Hypoglycemia

Risk factors

A

Insulin

Diet

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15
Q

Other causes of hypoglycemia

A

Inborn errors of metabolism (fat, carbohydrate, amino acid, give dextrose solution)

Insulinoma

Ketotic hypoglycemia

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16
Q

DM

Management

A

Education

Glycemic control

Insulin

Diet

Activity

17
Q

Insulin

A

Rapid acting: lispro and as part

Short acting

Intermediate: humulin

Long acting: glargine and detemir

18
Q

Pump indications

A

Recurrent severe hypoglycemia

Wide fluctuations

Poor control

Microvascular complications

Kids

Athletes

19
Q

Follow up

A

Growth

Sugar

A1C every 3 months

Thyroid

20
Q

Type 2 DM

A

Insulin resistance

Obesity biggest risk factor

21
Q

DM2

Presentation

A

Asymptomatic

DKA

22
Q

DM2

Family

A

Strong family history!!!

23
Q

Metformin

MOA

A

Dec hepatic glucose production

Improves insulin sensitivity