DM Type I and II Flashcards
Hormonal Abnormality
Type I DM
Type II DM
- **Hormonal Abnormality **
Deviciency of the Insulin Hormone
Insulin deficency maybe absolute or relative
**Type I DM **
Insulin Deficiency
Destruction of insulin -producing pancratic beta cells
**Type II DM
**Decreased sensitivity
Decreased of insulin produced by Beta cells **
Type I DM
- Insulin Deficiency **
**Destructio of insulin **-prodcing pancreatic **Beta Cells **
DM Type II
- Decrease Sensitivity
- Decrease of insulin produced by Beta cells
Insulin Function
- Released from Beta Cells
- Allows Cellular Glucose uptake
- Facilitates** lipids and protein** Metabolism
* - Promotes cell devision and growth
Insulin Aloud absorb glucose that in a blood stream; Glucose serves as energy to cells or can be converted to fat
Role of Insulin and Glucagon
* Low BG: Pancrease > Glucagon Released by Alpha Cells of Pancrease> Liver release **Glucose **into Blood = Achieve Normal Blood Glucose Level
* High Blood Glucose : > Pancrease > Insulin Released by** Beta Cells of Pancrease > Fat **Cells take in Glucose from Blood = Achieve Normal Blood Glucose Levels
Glycolysis : Break down of glucose
Type I DM
*** 5 to 10 % of all cases **
* **Autoimmune Predispostion **
* RElatively short onset weeks to months due to beta cells destruction
* Typical pateitn presentation is DKA
TYpe 2 DM
- 90 to 95 % of all cases
- Combination of insulin resistance and beta cell **dysfunciton **
- Progressive disease over time
Typ I DM symptoms
**Type II DM **
- **Hyperglycemia with DKA **
- Polyuria
- Polydipsia
- Blurry Vision
- Paresthesia ( sensation of tingling and numbness )
- **Acetone breath **
No acone breath
HHS ( profound hypeglycemia )
DM Work Up
A1C
* FG
* Urinalysis **(Proteuria ) **
* C-Peptide ( Type I no insulin production will be little to none C-Peptide ; )
( II : Makes isulin pancrease not use well ; C-Pap Highter
- Lipid Panel ( Hypelipedemia )
- EKG
- Foot Exam
- Eye Exam
- Weight loss when applicable
- Education
Type II DM
- Profound Hyperglycemia (HHS )
- Polyuria
- Polydipsia
- Blurry Vision
- Paresthesia
DM I lab and Dx
- Hgb A1C >= 6.5 or
- FBS >= 126 on 2 occasions or
- 2 Hr plasma glucose >= 200 during OGTT
- **Serum Ketones, eleveted BUN/CR , HYpokalemia, High Anion Gap
- Ketoacidosis **
Typ 2 DM
- Hgb A1C > = 6.5 or
- FBS >= 126 on two occasion or
- 2 hrs plasma glucose >= 200 durign OGTT
- Renal insult over years, chronic elevation in BUN /Cr
- Hyperosmolar non-ketosis
Prediabetes Dx
- **Definition **: Impaired Glucose Homeostatis
- Impaired Fasting Glucose (IFG)
- Fasting Plasma Glucose (FPG) 100 to 125
- Impaired Glucose Tolerance (IGT )
- Two hour plasma glucose elevated after OGTT of >= 140 to < 200 and FPG <125
After oGTT >/= 140 to <200
FPG <125
Typ I Management
Insulin SQ
Long
Itermidiate
Short
Insulin Pump ( with insurance )
Lifestyle Modifications
Type II Managemenet
- Metormin is mainstay treatment
* Maximize oral agents
* 2 or more RX
* Insulin
* Consider Insulin
* Lifestyle modification
* Victoza avoid with cardiac problems