Type I and Type II diabetes Flashcards
two main ways that diabetes mellitus is brought about?
insufficient production of insulin or inadequate activity of insulin receptors.
what are the three classifications of diabetes?
Type I, Type II, and gestational diabetes
what is the plasma glucose for an essential diagnosis of diabetes?
126 after an overnight fast, documented on more than one occasion.
what are the essential of diagnosis of diabetes?
polyuria/polydipsia
weight loss
ketonemia/ketonuria
fasting blood glucose of 126
why do you have ketonuria/ketonemia with diabetes?
inadequate insulin leads to inadequate glucose within muscle cells which promotes fat metabolism.
Type 1 diabetes primarily occurs in what age group?
children to 30 years old.
Cause of type 1 diabetes
born with auto immune antibodies (anti-pancreatic islet cells, anti insulin, anti GAD65)
what are SOME clinical findings of diabetes:
polyuria, polydipsia, fatigue, polyphagia, weight loss, poor wound healing, blurred vision, infection (candidal vaginitis, balantis) UTIs, otitis externa.
what are the labs you should run for diabetes?
Urine dipstick
Plasma glucose (possible a GTT if suspected)
hbAIc
Findings with Urine screening for diabetes?
Glucosuria (detectable when above 150/180 mg/dl
Ketones
findings with blood testing for diabetes?
glucose @ 126 mg/dl or >
presence of autoantibodies (e.g. anti insulin, anti islet cells, anti GAD65)
HbA1c of 6.5%
what test is commonly used to test for gestational diabetes?
Glucose Tolerance Test (GTT)
what are some DDX for Diabetes Type I
Kidney disease (renal glycosuria)
Pre diabetes
Hormone disorder (from meds, Cushing, glucagonoma, acromegaly, pheochromocytoma)
Treatment for Type 1 diabetes (acute therapy)
insulin (10ml bottles containing 100 un/ml in AMAL)
Consult MO
short term therapy goal when treating diabetes type 1
control hyperglycemia, maintain electrolytes, hydration. avoid DKA.
what are the long term therapies for type 1 DM?
plasma glucose monitoring
diet and exercise
what increases the risk for late complications of type 1 DM and require special attention and tx?
hypercholesterolemia and hypertension
what is the drug of choice for treating diabetics with hypertension?
ACE inhibitors because of their renal protection action
Disposition of Type 1 DB
med board. (not worldwide deployable)
referred to internal medicine, endocrinology
what is the cause of type 2 DM “esentially”?
insulin resistance due to inadequate activity of insulin receptors
a random glucose of what value is diagnosable diabetes type 2?
200 mg/dl or higher
what are some conditions that are associated with type 2 DM?
hypertension, dyslipidemia, and atherosclerosis.
urine dipstick is sensitive to as little as _____ % glucose?
1%
an overnight fast is how many hours of fasting?
8
What are the stages for type II DM treatment?
Stage 1 diet modification and weight loss
Stage 2 various oral anti diabetic meds
Stage 3 insulin requirements
what is the first line medicinal treatment for DM?
Biguanides (metformin/glucophage)
what is the most important modifiable risk factor for DM?
obesity
what is the leading cause of death in diabetes related deaths?
heart disease
