Diagnostic criteria

Question 1

ADA criteria

Answer 1

fasting glucose above 126
random plasma glucose above 200 with polyuria, polydipsia, polyphagia, unexplained weight loss or hyperglycemic crisis
hba1c above 6.5%
plasma glucose 2 hours post glucose load (75g anhydrous glucose in water) of 200 or greater

Question 2

HBA1C

Answer 2

long term measure of blood glucose level that is dependent on healthy RBC
thus, conditions that shorten RBC half life may lead to UNDERestimation
(weird RBC’s in general invalidate the results)

Question 3

spectrum of diabetes (low end risks)

Answer 3

there are major risk factors at the low end of the spectrum: macrovascular complications

Question 4

criteria for prediabetes

Answer 4

fasting glucose 100-125
impaired glucose tolerance 140-199 (2 hour 75g test)
(also HBA1C 5.7-6.4%)

Question 5

progression to diabetes from prediabetes depends on

Answer 5

functon the Pancrea, insulin secretion failure precedes hyperglycemia

Question 6

insulin resistance is manifest at what cells; how does that manifest

Answer 6

liver, muscle, adipose; hepatic production of glucose and reduced peripheral uptake of glucose

Question 7

glucose transporters in the beta cells

Answer 7

GLUT2 high Km

Question 8

once inside the beta cells the glucose gets trapped by an enzyme,

Answer 8

glucokinase turns it into G6P

Question 9

two phases of insulin secretion

Answer 9

early phase starts in 10 minutes

late phase over the course of hours

Question 10

functions of the first phase

Answer 10

inhibition of glucose production from the liver; repression of glucagon – lost early in DM

Question 11

functions of amylin; natural history and treatment

Answer 11

promotes satiety, suppresses glucagon, slows gastric emptying – lost in DM; synthetic version available