DM-1 Flashcards
Defn of Diabetes
hyperglycemia resulting from defects in insulin secretion, insulin action, or both that leads to the failure of various organs
Morbidity of DM
blindless
end-stage renal disease
non-traumatic amputations
Type 1:
percent
cause
age
clinical presentation
body type
treatment
other
percent: 5%
cause: auto-immune
age: children
clinical presentation: acute, life-threatening polydipsia, polyphagia, weight loss, DKA
body type: thin
treatment: insulin
other: predisposed to other types of auto-immune disorders
Type 2:
percent
cause
age
clinical presentation
body type
treatment
other
percent: 95%
cause: lifestyle, insulin resistance, genetic
age: adult >40
clinical presentation: gradual, subtle sx., fatigue, polydipsia, polyuria
body type: overweight/obese
treatment: lifestyle, non-insulin injections, orals, insulin
other: have metabolic syndrome
If a patient has C-peptide what type of DM does it indicate
Type 2
(type 1 has zero)
If a patient has islet cell antibodies what type of DM does it indicate
Type 1
If a patient has antibodies to insulin what type of DM does it indicate
Type 1
Risk factors for T2DM
lifestyle
FH
HTN
Dyslipidemia
gestational DM or giving birth >9 lb baby
Race (Hispanic, Native, AA, Pacific)
Genetic defects in B-Cell function
can resent like type 1 or type 2 (more type 1)
usually insulin dependent
MODY (maturity-onset diabetes of youth)
LADA (latent autoimmune diabetes in adults)
Secondary causes of DM
Pancreatic disease (pancreatitis, cystic fibrosis)
Endocrinopathies (acromegaly, cushings, hyperthyroidism)
Most prevalent drug induced diabetes
steroids
atypical antipsychotics
protease inhibitors
statins
Imparied fasting glucose
> 100 mg/dl but <126 mg/dl
Imparied glucose tolerance
2 hour OGTT >140 mg/dl but <200 mg/dl
HgbA1C between what is pre-diabetes
5.7% and 6.4%
Oral Glucose Tolerance Test (OGTT)
75 gm glucose load
BS check q30 min x 2 hours
level peak at 1 hr, remain below 200 throughout return to fasting at 2 hrs
Diagnosis of DM
symptoms of DM + any glucose >200
Fasting plasma glucose >126
Plasma glucose >200 after 2 hrs of OGTT
HgbA1C >6.5%
Fasting BG range: normal, pre DM, DM
normal: <100
pre DM: 100-126
DM: >126
2hr PP BG range: normal, pre DM, DM
normal: <140
Pre DM: 140-200
DM: >200
A1C range: normal, pre DM, DM
normal: <5.7
Pre DM: <5.7-6.4
DM: >6.4
What stores glucose
adipose tissue
glycogen
triglycerides
How much insulin is secreted a day and how much can your body store
secreted: 25-50 units
store: 200 units
Epi stimulates what
glycogenolysis
Glucocorticosteriods stimulate what
gluconeogenesis
GLP-1 secreted from the small intestine after a meal, increases _________ secretion, inhibits _________ secretion, signals satiety in CNS, and delays gastric emptying
insulin
glucagon