Small Group: Type I and II Diabetes Flashcards

1
Q

What are diagnostic tests for diabetes?

A
  • Random glucose above 200 with symptoms
  • HbA1c above 6.5%
  • Fasting blood glucose over 126 mg/dL
  • Two hours post 75 grams of glucose intake with a blood glucose over 200
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2
Q

What tests might you order in a newly diagnosed diabetic?

A
BMP (to assess creatinine) 
Urine albumin to creatinine ratio
A1c
Lipids 
Fasting glucose
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3
Q

Many people argue that type-2 diabetics with A1cs above _____ should be started on insulin.

A

9.0%

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4
Q

Guidelines now state that those with GFRs down to ______ can still be started on metformin.

A

30 ml/min

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5
Q

How many excess calories need to be eaten to gain one pound?

A

3,500

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6
Q

For every 100 mg/dL increase in glucose, sodium needs to be correct by ________.

A

an increase in 1.6 mEq/L

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7
Q

Anion gap uses ___________ sodium.

A

uncorrected

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8
Q

HLA _______ are associated with type 1 diabetes.

A

DR3 and DR4 (DR2 is protective)

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9
Q

What test is used to monitor diabetic nephropathy?

A

Urine albumin:creatinine ratio

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10
Q

What is a good rule of thumb for total amount of insulin needed per day?

A

0.5 units per kg

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11
Q

Of the total insulin given per day, how much should be basal and how much prandial?

A

Half and half. So if a person weighs 88 kg, then they need 44 units per day, of which 22 U should be basal and 22 U should be prandial.

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12
Q

How do you calculate correction factor?

A

1650/(total daily dose of insulin) = amount of mg/dL that one unit will change

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13
Q

True or false: patients with type 2 diabetes that need to be NPO should cease all insulin.

A

False. They should cease prandial insulin but not basal, because the liver is always producing glucose.

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14
Q

What causes the pseudo-hyponatremia found in extreme hyperglycemia?

A

The sugar can pull water into the serum, thus diluting the sodium.

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15
Q

Why does serum phosphate fall after administering insulin?

A

Because many molecules will be phosphorylated (glucose and ADP), so phosphate will fall

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16
Q

Which should be given first to a patient with DKA, fluid or insulin?

A

Fluid, because insulin moves water into cells (pulled by glucose osmosis), and if they’re already hypovolemic then that could precipitate shock.

17
Q

Those with type 1 diabetes are at risk for two main categories of complications: ______________.

A

microvascular and macrovascular disorders