Type 2 Diabetes Mellitus

Question 1

Describe type 2 diabetes mellitus

Answer 1

• Is the majority of cases
• Resistance to insulin w/ an insulin secretory defect
• Don’t usually require insulin therapy
• May go undiag’d for years
• Strong genetic predisposition
• Risk increases with age, obesity and lack of exercise

Question 2

Signs/symptoms of type 2

Answer 2

Obese/lots of abdominal fat, w/ greatly increased gluc: shaking, nausea, slurred speech, tachycardia, abdominal pain

Question 3

What are the clinical characteristics of type 2?

Answer 3

• Adult onset
• More mild symptoms than type I
• Ketosis uncommon (high gluc w/out ketones
• More likely to go into hyperosmolar coma (seen in untreated patients)
• Increased risk of macro and microvascular complications

Question 4

Explain hyperosmolar coma

Answer 4

• Body tries to get rid of excess gluc via urine
• Hyperosmolar hyperglycemic nonketotic syndrome happens when people w/ uncontrolled gluc levels affected by heart disease, stroke, pancreatitis, injury or meds cant take in enough water to balance polyuria, becoming severely dehydrated
• Can lead to seizures, coma or death

Question 5

Lab findings of type 2

Answer 5

Hyperglycemia, increased osmo, nonketotic, dyslipidemia (abnormal # of lipids in blood)

Question 6

Lab findings in non-ketotic hyperosmolar coma

Answer 6

• High mortality, plasma gluc >55mmol/L, norm or increased Na and K, slight decrease in HCO3, increased urea and creat (fr. dehydration), very increased serum osmo (>320)

Question 7

How do you distinguish non-ketotic hyperosmolar coma fr. diabetic ketoacidosis?

Answer 7

More severe elevations in gluc and osmo, increased urea and absence of ketones

Question 8

What are some other specific types of diabetes?

Answer 8

Secondary to these conditions:

• Genetic defects of β-cell func or insulin action
• Pancreatic disease
• Endocrine diseases
• Drug/chemically induced insulin receptor abnorms
• Some genetic syndromes

Note: Characteristics depend on primary disorder