Diabetes Flashcards
Insulin is a hormone produced by ___ in the ___. It is responsible for moving glucose out from the blood and into body ___ to be used as ___.
Fill in the blanks
- Beta-cells
- Pancreas
- Cells
- Energy
The glucose is either moved to muscle cells for immediate use, or stored for later use by ___ cells as ___ or adipose (fat) cells.
Fill in the blanks
- Liver
- Glycogen
Glucagon is produced by ___ in the pancreas and works when ___ is ___. Glucagon pulls glucose back into the circulation by releasing ___ from ___. If ___ is depleted, glucagon will signal fat cells to make ___ as an alternative energy source.
Fill in the blanks
- Alpha-cells
- BG
- Low
- Glucose
- Glycogen
- Glycogen
- Ketones
What are the characteristics of T1D? How is it diagnosed and treated?
- T1D caused by an autoimmune destruction of beta-cells in the pancreas.
- Once beta-cells are destroyed, insulin cannot be produced
- The body starts to metabolize fat into ketones to use it as an alternative energy source
- Ketones are acidic and very high ketone levels can cause diabetic ketoacidosis (DKA)
- T1D usually diagnosed in children, but it can develop at any age
- The C-peptide test is used to determine if the patient is still producing insulin. If c-peptide level is very low or absent, the T1D is diagnosed
- Patients with T1D must be treated with insulin and should be screened for other autoimmune disorders (e.g., thyroid disorders, celiac disease)
What are the characteristics of T2D?
- T2D is due to both insulin resistance (decreased insulin sensitivity) and insulin deficiency
- T2D is strongly associated with obesity, physical inactivity, family hx and other comorbid conditions
- T2D can be managed with lifestyle modifications alone or in combination with oral and/or injectable medications
T2D (%95 of all cases) is more common than T1D (%5 of all cases)
What are the characteristics of prediabetes?
- Prediabetes means there is an increased risk of developing diabetes
- In prediabetes, BG is higher than normal, but not high enougy for a diabetes diagnosis
- Following exercise and dietary recommendations reduces the risk of progression from prediabetes to diabetes
- Annual monitoring for development of diabetes and tx of modifiable CVD risk factors are recommended
When can you initiate metformin in prediabates?
- Patients with a BMI >= 35 kg/m2
- Patients <60 years of age
- Women with a hx of gestational diabetes mellitus (GDM)
What are two types of diabetes in pregnancy?
- Diabetes that was present prior to becoming pregnant
- Diabetes that developed during pregnancy (GDM)
Note: In both types the BG goals during pregnancy are more stringent than the non-pregnant population with diabetes
What are the characteristics of babies born to mothers with hyperglycemia during pregnancy?
- Babies are larger than normal (macrosomia)
- Babies are at high risk of developing obesity and diabetes later in life
How do you test pregnant women for diabetes during pregnancy?
- Pregnant women are tested for GDM at 24-28 weeks gestation using the oral glucose tolerance test (OGTT)
- If hyperglycemia present, patients should be treated first with lifestyle modifications (diet and exercise)
- If medication is needed, insulin is preferred
What are the risk factors of developing prediabetes an T2D?
- Physical inactivity
- Overweight (BMI >=25 kg/m2 or >=23 in Asian-Americans)
- High-risk race or ethnicity: African-American, Asian-American, Latino/Hispanic-American, Native Americans or Pacific Islander)
- Hx of GDM
- A1C >= 5.7%
- First-degree relative with diabetes
- CVD hx or smoking hx
- HTN (>=140/90 mmHg or taking BP medication)
- HDL <35 mg/dL or TG >250 mg/dL
- Conditions that cause insulin resistance (e.g., acanthosis nigricans, POS)
What are the classic symptoms of diabetes?
- Polyuria
- Polyphagia
- Polydipsia
- Other: fatigue
Note: In T1D, DKA ia commonly the initial presentation due to total deficiency in insulin
Risk for diabetes increases with age. Everyone, even those with no other risk factors, should be tested beginning at ___ years old.
Fill in the blank
- 45
All asymptomatic children, adolescents and adults who are ___ with at least ___ other risk factor should be tested. If the results are normal, repeat testing every ___ years.
Fill in the blanks
- Overweight
- One
- 3
What tests are used to diagnose prediabetes or diabetes?Give details about the tests
- Hemoglobin A1C - indicates the average BG over approximately the past 3 months
- Fasting plasma glucose (FPG) - gives the BG at that moment, and is taken after fasting for >=8 hours
- The OGTT - determines how well glucose is tolerated by measuring the BG level 2 hours after drinking a liquid that in high in sugar (glucose)
Note: No single test is preferred. A positive test should be confirmed with a second abnormal test result from either the same sample or a new sample, unless there is clear clinical diagnosis (e.g., classic sxs of hyperglycemia + a random BG >=200 mg/dL)
