Disorders of Glucose Metabolism Flashcards
occurs AFTER 10 HOURS without food intake
a. post-absorptive/fasting hypoglycemia (neurogylcopenic)
b. post-prandial/alimentary/reactive hypoglycemia (neurogenic)
a. post-absorptive/fasting hypoglycemia (neurogylcopenic)
secondary to hyperinsulinism, hormonal deficiencies, genetic disorders, autoimmunity or drug-induced
a. post-absorptive/fasting hypoglycemia (neurogylcopenic)
b. post-prandial/alimentary/reactive hypoglycemia (neurogenic)
a. post-absorptive/fasting hypoglycemia (neurogylcopenic)
occurs usually within 4 HOURS AFTER eating a meal
a. post-absorptive/fasting hypoglycemia (neurogylcopenic)
b. post-prandial/alimentary/reactive hypoglycemia (neurogenic)
b. post-prandial/alimentary/reactive hypoglycemia (neurogenic)
symptoms of hypoglycemia begin to appear at what plasma glucose level?
50-55mg/dL
tremulousness, palpitations, anxiety, diaphoresis, hunger, and paresthesias
a. neurogenic
b. neuroglycopenia
a. neurogenic
“TPAD”
patient’s with reactive hyperglycemia and it AFFECTS AUTONOMIC NERVOUS SYSTEM
a. neurogenic
b. neuroglycopenia
a. neurogenic
patient’s with FASTING HYPOGLYCEMIA
a. neurogenic
b. neuroglycopenia
b. neuroglycopenia
dizziness, tingling, blurred vision, behavioral changes, seizure, and coma
a. neurogenic
b. neuroglycopenia
b. neuroglycopenia
seizures and coma occur at what plasma glucose level?
≤40mg/dL
Diagnostic Criteria for Hypoglycemia: ____
Includes:
- symptoms of hypoglycemia
- low plasma glucose level
- relief of symptoms with correction of hypoglycemia
Whipple’s Triad of Hypoglycemia
pancreatic tumor that hyper-secretes insulin
insulinoma
change in glucose level ≥25mg/dL (under controlled fasting condition) coincident with:
↑ /↓
__ insulin (≥41.7 pmol/L)
__ proinsulin (≥5 pmol/L)
__ C-peptide (≥0.2 nmol/L)
__ B-hydroxybutyrate levels (≤2.7 mmol/L)
↑ insulin (≥41.7 pmol/L)
↑ proinsulin (≥5 pmol/L)
↑ C-peptide (≥0.2 nmol/L)
↓ B-hydroxybutyrate levels (≤2.7 mmol/L)
hyperglycemic disorder
diabetes mellitus
B-cell destruction leading to absolute insulin deficiency
Type 1
immune-mediated DM
Type 1a
idiopathic (unknown etiology) DM
Type 1b
insulin resistance with progressive insulin deficiency
Type 2
genetic defects of B-cell function DM
Type 3a
genetic defects in insulin action DM
Type 3b
disease of the exocrine pancreas DM
(pancreatitis, pancreatectomy, pancreatic cancer/neoplasia, cystic fibrosis, hemochromatosis, fibrocalculous pancreatopathy)
Type 3c
endocrinopathies DM
Type 3d
drug or chemical-induced DM
Type 3e
infections DM
Type 3f
uncommon forms of immune-mediated diabetes
Type 3g
other genetic syndrome DM
Type 3h
glucose intolerance during pregnancy
Gestational DM
disappears post-partum but may convert to type 2 DM in 30-40% of cases within 10 years
Gestational DM
due to metabolic and hormonal changes
Gestational DM
Frequency: <10%
a. Type 1 DM
b. Type 2 DM
a. Type 1 DM
Frequency: >90%
(Female>Male)
a. Type 1 DM
b. Type 2 DM
b. Type 2 DM
Autoimmunity
a. Type 1 DM
b. Type 2 DM
a. Type 1 DM
Genetic predisposition
HLA-DR3/DR4 -> develops
a. Type 1 DM
b. Type 2 DM
a. Type 1 DM
genetic, race, ethnicity
a. Type 1 DM
b. Type 2 DM
b. Type 2 DM
obesity, sedentary lifestyle
a. Type 1 DM
b. Type 2 DM
b. Type 2 DM
dyslipidemia, hypertension
a. Type 1 DM
b. Type 2 DM
b. Type 2 DM
PCOS
a. Type 1 DM
b. Type 2 DM
b. Type 2 DM
Therapy for Type 1 DM
insulin injection
Therapy for Type 2 DM
lifestyle change, oral agents (metformin)
Acute complication of Type 1 DM
diabetic ketoacidosis
Acute complication of Type 2 DM
hyperglycemic hyperosmolar non-ketotic coma
Plasma glucose level of hyperglycemic hyperosmolar non-ketotic coma
> 1,000 mg/dL
Panic value of hyperglycemic hyperosmolar non-ketotic coma
≥500 mg/dL
glucosuria renal threshold
160-180 mg/dL
in diabetic ketoacidosis what decreases?
blood
urine pH
what increases in DM?
plasma and urine glucose
serum osmolality
urine SG
symptoms of DM
3P’s (polydipsia, polyuria, polyphagia)
pruritis
poor wound healing
what causes electrolyte imbalance in DM
low sodium (hyponatremia)
low calcium (hypokalemia)
long-term complications of DM: nephropathy, retinopathy, neuropathy
a. microvascular complications
b. macrovascular complications
a. microvascular complications
long-term complications of DM:
- cerebrovascular accident (stroke)
- coronary artery disease (heart attack)
a. microvascular complications
b. macrovascular complications
b. macrovascular complications
