DM Flashcards
What is role of insulin
transport glucose across membrane of cells
inhibit release of substrates from stores
What is role of glucagon
raise blood glucose
maintain blood glucose levels during fasting
What is role of liver in non-fasting state
extract glucose from blood
glycogen synthesis
fatty acid and TG synthesis
What is role of liver in fasting state
glucogenolysis
gluconeogenesis
What are complications of diabetes acutely
diabetic ketoacidosis
hyperglycemic hyperosmolar state
hypoglycemia
What are complications of diabetes chronic
retinopathy neuropathy nephropathy coronary artery disease cerebrovascular disease peripheral artery disease
What are complications of acute and chronic diabetes
lower extremity complications
Impotence
What are goals for DM treatment
preprandial plasma glucose 70-130 peak postprandial plasma glucose < 140/80 LDL < 100 HDL > 40 (M) and 50 (F) aspirin txt with one CVD risk factor
What is difference between DKA and HHS
absolute insulin deficiency HHS higher dehydration HHS higher glucose HHS pH > 7.3 HHS BUN elevated
What should diabetes do when sick
continue insulin even if not eating
test ketones
rest
drink plenty fluids
what is rebound hyperglycemia
counter-regulatory hormones cause delayed hyperglycemia after hypoglycemia
SS:
morning headaches
nightmares
What is dawn phenomenon
early morning hyperglycemia without nocturnal hypoglycemia
Txt:
increase insulin dose
What are macrovascular complications of DM
Coronary Artery disease - leading cause death DM1 & 2 Cerebrovascular disease - DB2 high risk stroke Peripheral Arterial disease - claudication - gangrene - amputations
Txt: lifestyle mod ACE/ARB Statins baby aspirin glycemic control
What are microvascular complications of DM
retinopathy
nephropathy
neuropathy
DM retinopathy summary
Def: proliferative vs nonproliferative
SS:
- small hemorrhage
- hard exudates
- microaneurysms
- edema
- cotton wool spots
Eval:
dilated eye exam
Txt:
laser photocoagulation
anti-VEGF
