Pancreatic Diseases

Question 1

Greatest risk factor for DM2

Answer 1

Obesity

Question 2

What is the Somogyi effect?

Answer 2

Rebound response to nocturnal hypoglycemia, leads to morning hyperglycemia. Treat by decreasing insulin in the patient in the evening to avoid the hypoglycemia during the night.

Question 3

What is the Dawn Phenomenon?

Answer 3

Nocturnal secretion of growth hormone leading to morning hyperglycemia. Treat by increasing insulin in the evening to cover higher blood sugar overnight.

Question 4

What are the 4 ways DM can be diagnosed?

Answer 4

1. Two fasting glucose measurements greater than 125mg/dL
2. One Random glucose of 200 or greater with symptoms
3. Increased glucose level on oral glucose tolerance test
4. HbA1c greater than 6.5%

Question 5

What medication should be given to all diabetics over age 30?

Answer 5

ASA

Question 6

How often should HbA1c be measured in diabetics and what should the goal be?

Answer 6

Every 3 months and goal is less than 7%

Question 7

How is diabetes screened?

Answer 7

Tested in all patients over 45 at least every 3 years

Question 8

Best initial therapy for DM 2

Answer 8

Diet and Exercise

Question 9

Best initial therapy for DM 2 when diet and exercise fail.

Answer 9

Oral Hypoglycemic Drug like metformin

-acts on the liver to stop production of glucose and stop glycogenolysis

Question 10

With Metformin:

1. Major side effect
2. Contraindication

Answer 10

1. Lactic Acidosis

2. Renal Failure

Question 11

How is insulin dosed?

Answer 11

By units

usually dosing in 0.5U to 1U per day

Question 12

What information does an HbA1c measurement give?

Answer 12

Degree of glucose control over the past 2-3 months