DM PART 1

Question 1

autoimmune destruction of the pancreatic beta-cells

associated with ketosis

exogenous insulin is required

peak incidence early teens, but may occur at any age

usually thin

sudden onset

polyuria

25% present with DKA

weight loss

blurred vision

paresthesias

Answer 1

type 1 DM

Question 2

non immune pancreatic beta cell loss

sufficient insulin to prevent ketosis

multiple medication options

typically >25 yr but now younger adolescents

> 90% are overweight

visceral obesity correlates with insulin resistance

HTN, DLD, atherosclerosis often associated

gradual onset of hyperglycemia

metabolic signs often realized in retrospect

GU signs: balanitis, candidal vulvovaginitis

Answer 2

type II DM

Question 3

what are the lab tests done?

Answer 3

urine glucose

plasma or serum glucose

glycated hemoglobin

DKA: tests for ketone bodies

Question 4

what are the causes of hyperglycemia?

Answer 4

cystic fibrosis related DM

chronic pancreatitis

pancreatic carcinoma

pancreatectomy

Question 5

name the metabolite with associated endocrinopathies?

pheochromocytoma

acromegaly

cushings disease

glucagon

somatostatin

Answer 5

epinephrine
growth hormone
cortisol
secreting tumors
secreting tumors

Question 6

increased glucose production + insulin resistance

Answer 6

exogenous glucocorticoids

Question 7

altered hepatic glucose metabolism + increased insulin resistance

Answer 7

oral contraceptives

Question 8

decreased insulin synthesis and release

Answer 8

immunosuppresants

Question 9

weight gain + insulin resistance

Answer 9

atypical antipsychotics

Question 10

normal values/prediabetic/asymptomatic hyperglycemia values for fasting blood glucose and Hgb A1C?

Answer 10

70-100 mg/dL, 100-125 mg/dL, >126 mg/dL

4-5.6%, 5.7-6.4%, >6.5%

Question 11

mainstay tx for T1DM?

Answer 11

insulin

Question 12

fastest route for insulin absorption is where?

Answer 12

abdomen, intermediate from arm, slowest from leg and buttock