Lecture 25: DM screening and management 1 Flashcards
what is the initial cause of weight loss in T1DM? what about later?
intial - water depletion
later - muscle mass loss
why does blurred vision occur in DM
exposure of lenses to hyperosmolar fluids
what are the manifestations of peripheral in DM
ED and gastric dysmotility
how often should those at risk for DM be screened
if screening is normal thy should be retested every 3 years
how does hematocrit affect BG
low hematocrit (<40%) causes INCREASED glucose
high hematocrit (>50%) causes INCREASED glucose
how does acetominophen affect BG
decreases it
how does Alcohol affect BG reading
decreases it
how do elevated uric acid levels affect BG
decreases it
how does renal failure affect BG
inceases it
how does pheochromocytomas affect BG
increases it
how does pancreatitis affect BG
increases it
how does hypopituitarism affect BG
decreaes
how does liver disease affect BG
deceases it
what are the 4 A’s that decrease glucose
acetominophen
alcohol
high uric AAAcid levels
Hct ABOVE 50%
what would cause an elevation in “young” RBCs
- shortened erythrocyte survival (hemolytic anemia)
- decreased mean erythrocyte age (recent blood loss)
- IV iron or erythropoietic drugs
splenectomy and chronic or recurrent acute stress response causes…
false elevations in HbA1c
young RBCs
Sickle cell
abnormally low protein levels
all can cause…
false lows of HbA1c
indicated to assess hypoglycemia and/or to assist with dx of DM
OGTT
indicated for:
* identifying causes of hypoglycemia
* eval of beta cell function
* eval of insulinomas
C-peptide or C-peptide insulin ratio test
C your FATE acronym is used when?
C-peptide is useful with:
Factitious hypoglycemia
Anti-insulin antibodies
T1 v T2 DM dx
Exogenous insulin use
renal failure
pancreas transplant
sulfonylureas
all have what effect?
increases C-Peptide levels
what would decrease C-peptide levels
destruction of all or part of the pancreas
low C-peptide and low insulin is suggestive of
DM
high C-peptide and high insulin is suggestive of
sulfonylurea use or CKD
