Type I and Type II diabetes

Question 1

two main ways that diabetes mellitus is brought about?

Answer 1

insufficient production of insulin or inadequate activity of insulin receptors.

Question 2

what are the three classifications of diabetes?

Answer 2

Type I, Type II, and gestational diabetes

Question 3

what is the plasma glucose for an essential diagnosis of diabetes?

Answer 3

126 after an overnight fast, documented on more than one occasion.

Question 4

what are the essential of diagnosis of diabetes?

Answer 4

polyuria/polydipsia
weight loss
ketonemia/ketonuria
fasting blood glucose of 126

Question 5

why do you have ketonuria/ketonemia with diabetes?

Answer 5

inadequate insulin leads to inadequate glucose within muscle cells which promotes fat metabolism.

Question 6

Type 1 diabetes primarily occurs in what age group?

Answer 6

children to 30 years old.

Question 7

Cause of type 1 diabetes

Answer 7

born with auto immune antibodies (anti-pancreatic islet cells, anti insulin, anti GAD65)

Question 8

what are SOME clinical findings of diabetes:

Answer 8

polyuria, polydipsia, fatigue, polyphagia, weight loss, poor wound healing, blurred vision, infection (candidal vaginitis, balantis) UTIs, otitis externa.

Question 9

what are the labs you should run for diabetes?

Answer 9

Urine dipstick
Plasma glucose (possible a GTT if suspected)
hbAIc

Question 10

Findings with Urine screening for diabetes?

Answer 10

Glucosuria (detectable when above 150/180 mg/dl

Ketones

Question 11

findings with blood testing for diabetes?

Answer 11

glucose @ 126 mg/dl or >
presence of autoantibodies (e.g. anti insulin, anti islet cells, anti GAD65)
HbA1c of 6.5%

Question 12

what test is commonly used to test for gestational diabetes?

Answer 12

Glucose Tolerance Test (GTT)

Question 13

what are some DDX for Diabetes Type I

Answer 13

Kidney disease (renal glycosuria)
Pre diabetes
Hormone disorder (from meds, Cushing, glucagonoma, acromegaly, pheochromocytoma)

Question 14

Treatment for Type 1 diabetes (acute therapy)

Answer 14

insulin (10ml bottles containing 100 un/ml in AMAL)

Consult MO

Question 15

short term therapy goal when treating diabetes type 1

Answer 15

control hyperglycemia, maintain electrolytes, hydration. avoid DKA.

Question 16

what are the long term therapies for type 1 DM?

Answer 16

plasma glucose monitoring
diet and exercise

Question 17

what increases the risk for late complications of type 1 DM and require special attention and tx?

Answer 17

hypercholesterolemia and hypertension

Question 18

what is the drug of choice for treating diabetics with hypertension?

Answer 18

ACE inhibitors because of their renal protection action

Question 19

Disposition of Type 1 DB

Answer 19

med board. (not worldwide deployable)

referred to internal medicine, endocrinology

Question 20

what is the cause of type 2 DM “esentially”?

Answer 20

insulin resistance due to inadequate activity of insulin receptors

Question 21

a random glucose of what value is diagnosable diabetes type 2?

Answer 21

200 mg/dl or higher

Question 22

what are some conditions that are associated with type 2 DM?

Answer 22

hypertension, dyslipidemia, and atherosclerosis.

Question 23

urine dipstick is sensitive to as little as _____ % glucose?

Answer 23

1%

Question 24

an overnight fast is how many hours of fasting?

Answer 24

8

Question 25

What are the stages for type II DM treatment?

Answer 25

Stage 1 diet modification and weight loss
Stage 2 various oral anti diabetic meds
Stage 3 insulin requirements

Question 26

what is the first line medicinal treatment for DM?

Answer 26

Biguanides (metformin/glucophage)

Question 27

what is the most important modifiable risk factor for DM?

Answer 27

obesity

Question 28

what is the leading cause of death in diabetes related deaths?

Answer 28

heart disease