Other Diabetes

Question 1

MODY (maturity onset diabetes of the young)

Answer 1

INHERITED DM (1-2% of DM in youth), AD
MUTATION OF GLUCOKINASE gene –> defect in “glucose sensor” –> defect of insulin secretion
Presents early in life with strong family hx and NEGATIVE Ab
Treat: sulfonylureas or insulins (& genetic counseling)

Question 2

Gestational Diabetes

Answer 2

Insulin resistance due to hormonal changes/weight gain
4% of pregnant women, usually in 2nd/3rd trimester
30-40% will develop T2DM in 10 years (child also at risk)
BIGGER BABIES (MACROSOMIA)
Fasting glucose >95
2-h OGTT >155

Question 3

Pancreatic Diabetes

Answer 3

DM resulting from injury or removal of pancreas (loss of beta cells –> insulin defic)
Alcoholics with liver dz (EtOH impairs gluconeogenesis –>hypoglycemia)
Also lacks glucagon (PRONE TO HYPOGLYCEMIA)
May have MALABSORPTION, may be underweight

Question 4

Pre-diabetes (LABS)

Answer 4

fasting glucose: 100-126
2-h OGTT: 140-200
HbA1c: 5.7-6.4%

Question 5

Pre-diabetes (info and treatment)

Answer 5

21% US 40-74 yo
Abnormal carb metabolism, assoc with metabolic syndrome, incr risk for T2DM and macrovascular dz
Pre-symptomatic
Treat: diet and exercise best (esp. if lose 5-10% weight)
Can add Metformin and screen for DM every year

Question 6

Metabolic syndrome (definition and diagnx)

Answer 6

Clustering of comorbid conditions that contribute to incr risk of macrovascular dz
3 or more of:
Waist: >40 (m) >35 (f)
Triglycerides: >150
HDL:  130/85
Fasting glucose: >100

Question 7

Normal values (fasting glu, 2-h PG, HbA1c)

Answer 7

Fasting glu: