Endocrine Disorders Part 1 Flashcards
What is Type 2 Diabetes?
What is a clinical feature of Type 2?
What can it lead to?
Insulin resistance leading to ineffective glucose transport out of blood vessels
Hyperglycemia
end organ damage
What risk factors are assoc. with Type 2 diabetes?
- Age >45
- BMI > 25 (overweight)
- Sedentary lifestyle
- first degree relative with Type 2
- high risk ethnicity
- past gestational diabetes
- hypertension ( BP > 140/90)
- dyslipidemia
- A1C > 6.5, fasting glucose >100
- polycysitic ovarian syndrome
- history of vascular disease
Clinical presentations (3 most important)?
1) Polyuria
2) Polydypsia
3) Polyphagia
3 clinical manifestations/issues with having type 2 diabetes?
1) Acanthosis nigricans
2) Foot ulcer
3) eye hemorrhage and aneurysm
American Diabetes Assoc. criteria for diagnosis of type 2 diabetes?
- A1C > 6.5%
- fasting glucose >126
- 2 hour glucose >200 on oral test
- random glucose >200 w/ Symptoms of hyperglycemia
Name other things you should be looking at after diagnosis of type 2 diabetes?
- Fasting Lipids
- Liver Enzymes
- Renal Funcation
- Microalbuminuria
- Dilated eye exam
- Foot exam
Management of type 2 Diabetes?
1) Lifestyle changes
2) oral metformin
3) insulin
*check HbA1C every 3 months, then every 6 when stable
- stop smoking
- control BP
- hyperlipidemia
Name the 3 major complication groups assoc with Type 2 Diabetes?
1) microvascular
2) macrovascular
3) increase in infections, including unusual infections
What are some microvascular diseases? (Type 2)
- retinopathy = blurred vision
- nephropathy = CKD
- neuropathy = numbness, tingling in extremities
What are some macrovascular diseases? (Type 2)
- Myocardial infarction
- stroke
- peripheral vascular disease
Describe symptoms of Diabetic Ketoacidosis?
- in type 1 and 2
- mental changes
- patient looks sick
- nausea, vomit, ab pain
- signs of dehydration
- labored breathing
- fruity breath
DKA vs Hyperosmolar hyperglycemic State?
DKA = hyperglycemia; acidosis, ketosis
HHS = marked hyperglycemia, minimal acidosis, absent/mild ketosis ; marked elevation in serum osmolality
DKA/ HHS management?
-admit to hospital for fluid and electrolyte correction (fluids, insulin, K+)
name some things in a working differential for type 2 diabetes?
- metabolic syndrome
- obstructive sleep apnea
- anemia
- hyperlipidemia
- SD
- impaired fasting glucose
What is so significant about Type one diabetes and children?
it’s one of the most common diseases of childhood
