Lecture 1: Approach to Endocrine Disorders I Flashcards
What defines Diabetes Mellitus Type II?
- Insulin resistance leading to ineffective glucose out of blood vessels
- Hyperglycemia
About what percent of the US population is estimated to have diabetes?
8% of population
What are some risk factors for diabetes?
Age > 45 BMI > 25 Close relatives with diabetes History of gestational diabetes Dyslipidemia HbA1c > 5.7 or fasting glucose > 100 Polycystic ovary syndrome History of vascular disease
What are some clinical presentations of diabetes?
Polyuria: frequent urination
Polydipsia: frequent thirst
Polyphagia: excessive hunger
Rapid weight loss Fatigue Blurry vision Fruity breath Tingling pain in extremities
What is acanthosis nigricans?
Brown to black, poorly defined, hyperpigmentation of the skin normally found around neck, armpits, navel, and other body folds
Sign for diabetes
What criteria has to be met to diagnose diabetes?
- HbA1c > 6.5%
- Fasting glucose > 126 mg/dL
- 2 hour glucose > 200 mg/dL on oral glucose tolerance test
- Random glucose > 200 mg/dL
What specific tests and exams would you perform, if you suspect a patient having diabetes?
- Fasting lipids
- Liver enzymes
- Renal function
- Microalbuminuria
- Dilated eye exam
- Foot exam
What does a diabetic foot exam consist of?
- Checking for calluses, breaks in skin, erythema, and dryness
- Check pulses
- Check sensation
- Check if diabetic footwear is covered
What are some ways to manage diabetes?
- Lifestyle changes
- Oral metformin
- Insulin
- Checking HbA1c levels every 3 months
- Smoking cessation
- Blood pressure control
- Hyperlipidemia control
What is diabetic ketoacidosis?
The body breaks down fats at a fast rate, releasing ketones that can cause the blood to become acidic
What are symptoms of diabetic ketoacidosis?
- Mental changes
- Nausea, vomiting
- Abdominal pain
- Dehydration
- Kussmaul respirations (deep breathes)
- Fruity smelly breath
What does the blood glucose level have to be in order to be considered hyperglycemic?
> 200 mg/dL
What does the blood pH level have to be in order to be considered in metabolic acidosis?
venous pH <7.3
What does the blood glucose level have to be in order to be considered marked hyperglycemic?
> 600 mg/dL
How do you treat a patient who is admitted for DKA?
Manage as inpatient!!
-IV fluids, IV insulin, and potassium replacement
