Type 1 Vs. Type 2

Question 0

Ketoacidosis symptoms

Answer 0

Dehydration, tachycardia, orthostatic hypotension, and abdominal pain
Also may have fruity breath (acetone)

Question 1

Presents with abrupt onset of illness and symptoms of hyperglycemia:
Polyuria 
Polydipsia
Hunger
Weakness
Unexplained weight loss

Answer 1

Type 1

Question 2

Typical Type 1 presentation

Answer 2

<30 and lean

Question 3

Type 2 presentation

Answer 3

Over age 40

Often incidental finding

Question 4

Common characteristics with Type 2 diagnosis

Answer 4

Family history of diabetes
Excess body weight
Sedentary

Question 5

Ethnic groups with higher incidence of Type 2

Answer 5

American Indians
Alaska natives
Hispanics
African Americans

Question 6

Type 1 or 2: which results from autoimmune destruction of the beta cells in pancreas?

Answer 6

1

Question 7

In Type 1, the destruction of beta cells in children is _____ and adults is ______.

Answer 7

Rapid in children and slower in adults

Question 8

Type 1 are also prone to:

Answer 8

Hashimoto’s thyroiditis, Addison’s, vitiligo, celiac sprue, autoimmune hepatitis, pernicious anemia, and myasthenia gravis.

Question 9

The first sign of Type 1 is often ________.

Answer 9

Ketoacidosis

Question 10

Absence of endogenous insulin in Type 1 is manifested by low _____________.

Answer 10

C peptide levels

Question 11

Type 1 or 2: characterized by insulin resistance and relative insulin deficiency

Answer 11

2

Question 12

True or false: there is no autoimmune destruction of the pancreatic beta cells with Type 2

Answer 12

True

Question 13

True or false: ketoacidosis is rare with Type 2

Answer 13

True

Question 14

Risk factors for type 2

Answer 14

Increased age, obesity, sedentary, positive family history, personal gestational diabetes. Also, genetic predisposition.

Question 15

What is MODY?

Answer 15

Maturity Onset Diabetes of Young, which is hyperglycemia in people under 25. Genetic defects of insulin action results in abnormal insulin receptors, leading to insulin resistance and hyperglycemia.

Question 16

Why do Type 1 diabetics have a “honeymoon period?”

Answer 16

There is a temporary increase in endogenous insulin production due to decreased inflammation of the Islets of Langerhans (which was caused by initial autoimmune assault). Exogenous insulin is given and the inflammation goes down with beta cells resuming function. Autoimmune disease progresses, and eventually the revived cells lose function and the honeymoon is over

Question 17

What is the length of the honeymoon period?

Answer 17

3 to 12 months.

More common in young adults than young children

Question 18

What is the dawn phenomenon?

Answer 18

Normal hormonal fluctuations that trigger liver to release excessive glucose in the latter part of the nightly sleep cycle. (Causes elevated fasting glucose levels)

Question 19

What medication is often used to treat dawn phenomenon?

Answer 19

Metformin, because it decreases glucose production by the liver.

Question 20

What insulin is helpful for dawn phenomenon?

Answer 20

Long acting or a pump

Question 21

What situations require careful adjustment of insulin related to the dawn phenomenon?

Answer 21

Those who work rotating shifts or suffer from jet lag

Question 22

What is Somogyi Phenomenon?

Answer 22

Theoretical rebound effect of nocturnal hypoglycemia, where counter-regulatory hormones cause excess release of glucose from the liver to compensate.

Question 23

How can Somogyi phenomenon be detected?

Answer 23

CGM (continuous glucose monitoring), or awaken at night to test blood sugar

Question 24

What insulin adjustment typically helps the Somogyi phenomenon?

Answer 24

NPH or glargine, as those typically affect the morning glucose.