LECT Approach to Endocrine Disorders Flashcards
Diabetes Mellitus Type 2
Insulin resistance leading to ineffective transport of glucose out of blood vessels and leads to hyperglycemia and end organ damage.
Clinical Presentation of Diabetes Type 2
Polyuria, polydypsia, polyphagia, rapid weight loss, increased hunger, weight gain, dehydration, fatigue, blurry vision,impaired healing, acanthosis nigricans, fruity breath, recurrent UTIs
Diabetes Type 2 diagnosis criteria
HbA1c over 6.5%, fasting glucose over 126, 2 hour glucose over 200
Diabetic Foot Exam
Look for callus/corn formation, breaks in skin, erythema, dryness, check for pulses, sensation
Management of Diabetes Type 2
lifestyle changes, metformin, insulin, check HbA1c every three months. Stop smoking, control blood pressure, hyperlipidemia
What is the Ominous Octet?
- Increased lipolysis and reduced glucose uptake
- Increased glucose reabsorption
- Decreased glucose uptake
- Decreased incretin effect
- Increased hepatic glucose production
- Increased glucagon secretion
- Impaired insulin secretion
- Neurotransmitter dysfunction
Complications of Diabetes Type 2
Microvascular diseases: retinopathy, nephropathy, neuropathy
Macrovascular diseases: Myocardial infarction, Stroke, peripheral vascular disease
Increase in infections
Diabetic Ketoacidosis (DKA)
Usually associated with Type 1, but can present with Type 2
Symptoms: mental changes, nausea, vomiting, abdominal pain, dehydration, kussmaul respirations, fruity smelling breath
Hyperglycemia (over 200), acidosis (pH < 7.3 or bicarb < 15), ketosis (in blood and urine)
Hyperosmolar Hyperglycemic State (HHS)
Hyperglycemia (over 600), minimal acidosis (venous pH > 7.25, arterial pH > 7.3, or serum bicarb > 15), absent or mild ketosis, marked elevation in serum osmolality (>320)
Type 1 Diabetes Clinical Presentation
Polydipsia, polyuria, weight loss with hyperglycemia, ketonemia, or ketonuria, also DKA
Type 1 Diabetes associated conditions
autoimmune Thyroiditis, celiac disease, Addison’s Disease
