DISORDERS OF GLUC METABOLISM Flashcards
Post-absorptive/Fasting hypoglycemia occurs after
10 hours without food; secondary to hyperinsulinism, hormonal deficiencies, genetic disorders, autoimmunity, or drug-induced
Post-prandial/Alimentary/Reactive hypoglycemia occurs
Usually within 4 hours after eating a meal
Symptoms of hypoglycemia appear after
10 hours post-prandial at 50-55 mg/dL
Neurogenic symptoms of hypoglycemia include
Tremulousness, palpitations, anxiety, diaphoresis, hunger, paresthesias
Neuroglycopenic symptoms of hypoglycemia include
Dizziness, tingling, blurred vision, behavioral changes, seizure, and coma
Whipple’s triad of hypoglycemia includes
Symptoms of hypoglycemia, low plasma glucose level, relief of symptoms with correction of hypoglycemia
Diagnostic criteria for insulinoma include a change in glucose level
≥25 mg/dL under controlled fasting conditions
Diagnostic criteria for insulinoma: Increased insulin levels
≥41.7 pmol/L
Diagnostic criteria for insulinoma: Increased proinsulin levels
≥5 pmol/L
Diagnostic criteria for insulinoma: Increased C-peptide levels
≥0.2 nmol/L
Diagnostic criteria for insulinoma: Decreased B-hydroxybutyrate
≤2.7 mmol/L
Insulin-to-C-peptide ratio in insulinoma
5:1 to 15:1
Type 1 diabetes is characterized by
β cell destruction leading to absolute insulin deficiency
Type 1 diabetes can be
Immune-mediated (autoimmune type I, juvenile) or idiopathic
Type 2 diabetes is characterized by
Insulin resistance with progressive insulin deficiency
Type 2 diabetes is more common in
Adults
Other types of diabetes include
Genetic defects of β cell function, genetic defects in insulin action, diseases of the exocrine pancreas, endocrinopathies, drug- or chemical-induced, infections, uncommon forms of immune-mediated diabetes, other genetic syndromes
Gestational diabetes is
Glucose intolerance during pregnancy that disappears post-partum but may convert to type 2 DM in 30-40% of cases within 10 years
Type 1 diabetes accounts for
<10% of diabetes cases
Type 1 diabetes usually has an onset in
Childhood (juvenile)
Risk factors for Type 1 diabetes include
Autoimmunity (+ auto-abs), Genetic predisposition (HLA DR3 and DR4)
Therapy for Type 1 diabetes involves
Insulin injection
Ketones in Type 1 diabetes are a product of
Lipolysis
Acute complication of Type 1 diabetes is
Diabetic ketoacidosis (Increased BHA)
Type 2 diabetes accounts for
> 90% of diabetes cases
Risk factors for Type 2 diabetes include
Family history of DM, high-risk minority population, PCOS, GDM, overweight tendencies, hypertension, dyslipidemia, history of CVD
Therapy for Type 2 diabetes involves
Lifestyle changes, oral hypoglycemic agents, may require insulin
Acute complication of Type 2 diabetes is
Hyperglycemic hyperosmolar non-ketotic coma
Type 2 diabetes panic value is
≥500 mg/dL
Lab findings in Type 2 diabetes include
Increased PG, serum osmolarity, urine glucose, urine specific gravity, decreased pH, sodium
Common symptoms of Type 2 diabetes include
Polyuria, Polydipsia, Polyphagia (3Ps), pruritus, poor wound healing
Long-term complications of Type 2 diabetes include
Microvascular complications (nephropathy, retinopathy, neuropathy), Macrovascular complications (CAD, CVA)
Nephropathy in Type 2 diabetes is characterized by
The earliest indicator of microalbuminuria
Retinopathy in Type 2 diabetes can lead to
Blindness
Neuropathy in Type 2 diabetes can lead to
Numbness, pain, and loss of sensation
Macrovascular complications of Type 2 diabetes include
CAD (Myocardial infarction), CVA (stroke)
Type 1 diabetes is typically diagnosed based on
Presence of auto-antibodies and increased C-peptide levels
Risk factors for gestational diabetes include
Obesity, age >25, family history, high-risk ethnicity (African American, Latino, Native American, etc.)
Gestational diabetes may convert to type 2 diabetes within
10 years in 30-40% of cases
