DM CIS Flashcards
What do you see in prediabetes
abnormal carbohydrate metabolism
what is gestational DM
diabetes during pregnancy
Which type of DM is prone to ketoacdosis
Type I DM
other causes of diabetes
pancreatectoy, acromegaly, hemochromatosis, hypercortisolism
drugs: glucocorticoids, antipsychotics
What diabetes has a younger age of onset
type I
what is the difference in patho between DM I and II
DM I is autoimmune
DM II is insulin resistance
What are the assoc conditions with DM I
autoimmune thyroid disease
celiac disease
addison’s disease
What are the assoc conditions with DM II
obesity
lipid abnormalities
PCOS
NAFLD
how do we calculate DMI
weigh in kg divided by square of height in meters
What are the criteria for Dx diabetes
fasting
oral glucose tolerance test
random glucose
Hb A1c
What level of fasting blood glucose is diabetes? pre diabetes?
diabetes is greater than 126
pre diabetes is between 100 and 126
What level of oral glucose tolerance test is diabetes? pre diabetes?
diabetes is greater than 200
prediabetes is between 140 and 200
What is the incretin effect
when oral glucose given, stimulate secretion of incretins
does not happen with IV glucose
What is the role of GLP-1,glucagon-like intestinal peptide
suppress apetite
suppress gastric emptying
suppress alpha cells secreting glucagon
stimulate beta cells to secrete insulin and amylin
how is glucagon similar to GLP 1 and GLP2
processed from same gene
What is the underlying patho for type II DM
insulin Resistance
at any level of the insulin dependent glucose transporters GLUT4
In chronic DM II what will c peptide look like
slight elevated since hyperplasia does take place in beta cells
Describe incretin effect in diabetics
a very decreased incretin effect. barely responds to oral glucose
GLP 1 is used to treat what type diabetes
II DM
Which type DM will sometimes present with rapid shallow breathing and why
DM I because in acidosis from ketones
How do you calculate anion gap
Na- (HCO3+Cl)
Describe patho of type I diabetes
increasing T cell mediated autoimmune disease
What do we look for to predict type I DM
islet autoAb and genes
What other category of disease does the type I diabetes cause secondarily
metabolic disease
Which gene has the strongest gene with type I DM
HLA
What are the markers for class II HLA
DP DQ DR
What are the marker for class I HLA
B C A
Which marker on HLA is most associated with DM
DQ, class II, 3 and 4
What is ICA
Islet cell antigen
What 4 Ab can be used to predict DM
ZnT8, IA-2, GAA, mIAA(insulin ab)
What hormone is given to Tx type I DM
glucagon ton increase blood glucose levels
What would c peptide look like in someone suffering from diabetic ketoacidosis
close to zero
What is the defining Dx to differentiate between I or II DM
autoimmune ab
can type II DM present with ketoacidosis
yes, illness
sometimes there is an increased cortisol which can increase ketones
alcoholic
