Endocrine Systems Flashcards
What are the three types of DM?
Type 1, type 2, & gestational DM
When does gestational diabetes develop?
during pregnancy
What is the general age of onset of type 1 DM?
Childhood or adolescence
What is the general age of onset of type 2 DM?
> 40 years of age
What is the rapidity of onset of type 1 DM?
abrupt
What is the rapidity of onset of type 2 DM?
gradual
What is the typical body weight of an individual with type 1 DM?
usually thin and undernourished
What is the typical body weight of an individual with type 2 DM?
obesity is common
Which type of DM is autoimmune?
Type 1
Which type of DM has the presence of islet cell antibodies & pancreatic cell-mediated immunity?
Type 1
Which type of DM is ketosis most common in?
Type 1
If ketosis is present in type 2 DM, what is it normally associated with?
Severe stress or infection
Describe the insulin levels in type 1 DM
The insulin levels are markedly diminished early in disease or totally absent
Describe the insulin levels in type 2 DM
The insulin levels may be low, normal, or high (indicating insulin resistance)- KEY HALLMARK
Which type of DM may actually be asymptomatic?
Type 2
What are the 2 lab tests that are used to differentiate between type 1 and type 2 DM?
C-peptide and diabetes related antibody testing
What does the C-peptide test evaluate?
residual beta-cell function
The C-peptide test is performed to:
- Distinguish between type 1 and type 2 DM
- identify the cause of hypoglycemia
- check for complete removal of insulinoma
Where is proinsulin synthesized?
in the beta cells of the islets of Langerhans
Proinsulin is cleaved to form ________ and ________.
C-peptide and insulin
What do high levels of C-peptide indicate?
high levels of endogenous insulin production (type 2 DM)
What do low levels of C-peptide indicate?
low levels of endogenous insulin production (type 1 DM)
What are the four most common autoantibody tests?
ICA, GADA, IA-2A, and IAA
If autoantibodies are present in a person with symptoms of DM, which type of DM is confirmed?
type 1
What is the best indicator of glucose homeostasis?
fasting plasma glucose
What are the lab testings that are used for diagnosis?
FPG, OGTT, A1C, fructosamine, urine glucose
How is an OGTT performed?
it is performed by giving a 75 gram dose of an oral glucose solution over 5 minutes following an overnight fast
What is the OGTT used to screen and diagnose?
gestational diabetes
What does the OGTT measure?
both the ability of the pancreas to secrete insulin following a glucose load and the body’s response to insulin
what is the general term that is applied to any glycosylated protein?
fructosamine
In non-diabetics, what does fructosamine dissociate into?
glucose and protein; only small amounts of fructosamine circulate
In patients with DM, _________ glucose concentrations favor the generation of more stable glycation.
higher
Fructosamine correlates with glucose control over what period of time?
2-3 weeks
What are some complications of DM?
DKA, HHS, hypoglycemia
In DKA, the liver converts free fatty acids into what?
ketone bodies
Which type of DM is DKA most common in?
type 1
What are the common signs and symptoms of DKA?
dehydration, lethargy, acetone-smelling breath, abdominal pain, tachycardia, orthostatic hypotension, tachypnea
In patients with DKA, what should you expect their glucose concentration to be?
> 300 mg/dL
In patients with DKA, what do you expect the venous bicarbonate and arterial pH to be?
low venous bicarb and decreased arterial pH
In DKA, which electrolytes are expected to be abnormal?
Na, K, Phos
In DKA, how do the SCr and BUN present?
elevated
In DKA, how does the serum osmolality present?
it is elevated
In which patients will you most often see HHS?
elderly patients with type 2 DM
What are the common signs and symptoms of HHS?
decreased mentation (lethargy, confusion, dehydration), neurologic manifestations (seizures), GI symptoms
What are the findings in HHS?
severe hyperglycemia, absence of ketosis, electrolyte abnormalities, elevated SCr and BUN, elevated serum osmolality
what are the common causes of hypoglycemia?
excess of blood glucose lowering meds, physical activity, inadequate carbohydrate intake
What are the symptoms of MILD hypoglycemia?
sweating, trembling, shaking, rapid heart beat, heavy breathing, or difficulty concentrating
Which rule goes along with hypoglycemia?
rule of 15s
