Dm Flashcards
Mention diabetes, the latest classic symptoms, and labs criteria
RBG more than 200 mg per dj
Fasting blood sugar, more than 126 mg per this litter
Two hours post prandial more than 200
HEP A1c >= 6.5
Mention the laps of pre diabetes
Causes of type one diabetes mellitus
Genetic environmental autoimmune, destroying beta cells
Islet cell antibody ICA
Antibodies against in IAA
Glutamic acid decarboxylase gad
Protein, tyrosine phosphate Se Ia2 ica512
Down ,turner
Indication of insulin and diabetes, Me
Type one
Patient who filled order therapy
DKAHNS
Pregnancy
Mention treatment of type 1 diabetes
Insulin
Healthy lifestyle
What are the classical symptoms of diabetes mellitus and what is the first presentation that may be for type 1 diabetes and type two?
Polyuria Polyphia Polyphia polydipsia polyphagia
Weight loss
Fatigue
Glucosuria
DKA if type 1
Hns if type 2
Complication of insulin
Hypoglycemia
Allergy
Fat atrophy more than animal insulin
Fat hypertrophy more in human insulin
Insulin resistance
Mention acute complications of diabetes abilities
Hypoglycemia
DKA
HHNS
Lactic acidosis
Mention chronic complications of the diabetes mellitus
Diabetic foot
Diabetic nephropathy neuropathy
Retinopathy
Hypertension
Atherosclerosis
Mention, hypoglycemic, symptoms, and treatment
Cold sweating, tremors, tachycardia
, Convulsions coma, cognitive impairment
If conscious sugary fluids
If not IV glucose 25 to 50 ml 50%
Picture of DKA
What is the management of DKA and the complication of the treatment?
How to detect hypokalemia by ECG
Flat wave t
Do we give sodium bicarbonate indicate?
No
Hhns criteria for diagnosis
Severe hyperglycemia more than 600
Severe dehydration more than 9 to 12 L loss
Severe plasma molarity
More than 320
No ketone bodies
Mention lactic acid causes and the treatment
Metmorfin
Sodium bicarbonate
Mention complications of HNSS
Hemoconcentration
Mi
Mention treatment of HHNS
Which is more dangerous HHNS or DKA and which group it happens more
Hhns in type 2
Difference in timing between hypoglycemia , dka
Hypo within minutes
Dka gradual
Mention microvasvular and macrovascular comp
Micro vascular retinopathy nephropathy neuropathy
Macro cvs cerbro pvd
Diabetic retinopathy more in , risk factors , ttt , proleferative changes characteristics
Major cause of death in dm
Atherosclerosis
Risk factors for dm to produce atherosclerosis
Dyslipdemia , htn
Densser ldl in type
2
Causes of charcot foot
Site for ischmeic lesion in charcot foot
Foot sides and toes
Ttt for charoct foot
Orthopedically fitted shoes
Difference between stages of diabetic nephropathy and ttt according to gfr albumin bpm histology
Generalized symmetric polyneuropathy
Acute sensory neuropathy
Chronic sensory motor
Autunomic
Focal and multifocal nueropatgies
Mono neuropayhty
Radiculopathy
Proximal motor neuropathy (diabetic amyotrophy)
Mention systems affected by autuonmiv neuropathy
Most common form of diabetic neuropathy
Distal sensiromotor
Mentiod distal sensrimotor neuropathy characters
Acute sensory
Femoral neuropathy
Whipple triad
Motor momo neuropathy
Foot drop
Cn 3 6 4
Mention diabetic skin comp
Diabetic dermatopathy , pigmented peritibial papules , acanthosis agricans
Difference between dawn and somogyi phenomenon
Causes of secondary diabetes
Cushing
Acromegaly
Chronic pancreatitis
Gluconoma
Risk factors for both types of diabetes
Hla 1
Both family
Mention acarbose side effects
Gaseous distension
Dpp4 inhibtor
Simaglutide
block degradation of glp 1 so inc insulin
Glp-1 inc insulin dec glucagon
Alpha glucosidase
Dec intestinal cho metabolism
Glinides repaglinid
Inc insulin
Thiazolidindiones
Pioglitzone
Inc insulin sensitivty in adipose tissue and muscle
Se ; weight gain , hepatotoxicity , fluid retention, chf , bone fracture
Sulfonylurea (zide , pride)
Inc insulin sec ,
Se ;hypoglycemia , weight gain
Metmorfin
Metmorfin
Other types of dm
Other specific types of diabetes
Monogenic Diabetes (MODY)
Endocrinopathies: Cushing’s syndrome, acromegaly
Disease of exocrine pancreas: panceatitis, cystic fibrosis,
Hemochromatosis
Drug induced: glucocorticoids
➢ Gestational diabetes mellitus (GDM): 24–28 weeks of gestation
Difff in onset between type 1 , 2
1 sudden
2 gradual
Relatio between insulin and lipids
insulin decrease, lipolysis and fatty acid release increase.
Relation between insulin and protein
insulin decrease, protein degradation occur to supply amino acids to the
liver for transformation into glucose
Relation between insulin and liver
as insulin decrease, gluconeogenesis and glycogenolysis increase
Tight control for dm is not for
Children
Eldrely
End stage kidney
Glycemic goals:
Recommended glycemic goal for many nonpregnant diabetic
adults without significant hypoglycaemia:
HbA1c < 7 % .
➢ Preprandial capillary plasma glucose : 80 - 130 mg/dL.
➢ Peak postprandial capillary plasma glucose < 180 mg/dL.
Testing should be done in overweight (BMI ≥25 kg/m2) adults
With one or more of the following risk factors
First-degree relative with diabetes
• High-risk race/ethnicity (e.g., African American, Latino)
• History of CVD
• Hypertension (≥140/90 mmHg or on therapy for hypertension)
• W omen with PCO
• Physical inactivity
• Patients with prediabetes (A1C ≥5.7% ,IGT, or IFG)tested yearly
• Women who were with GDM tested at least / 3 years
• For all others, testing should begin at age 45 years/3 yrs
75-g OGTT timig and values
Should be performed in the morning after an
overnight fast of at least 8 h.
International Association of Diabetes and Pregnancy Study Groups (IADPSG) and American Diabetes
Association
Fasting ≥92 mg/dL (5.1 mmol/L)
OR
One hour ≥180 mg/dL (10.0 mmol/L)
OR
Two hour ≥153 mg/dL (8.5 mmol/
Type 2 diabetes:
a) Is caused by a reduction of beta cells
b)Is associated with decreased fasting glucose levels
c) Involves an overabundance of insulin
d) May involve insulin resistance
D
