complications of DM

Question 1

What is hyperosmolar hyperglycemic nonketotic syndrome?

Answer 1

extremely high glucose with profound dehydration. seen in pts with type II DM. it never occurs in type I DM because patients need to have sufficient insulin production to prevent DKA, which is what would happen first if they had no insulin production.

Question 2

What are causes of hyperosmolar hyperglycemic nonketotic syndrome?

Answer 2

DM2 + lengthy infection, stress, illness

Question 3

How can you distinguish between hyperosmolar hyperglycemic nonketotic syndrome and DKA?

Answer 3

HHNS usually has glucose levels >800 (and often >1000) and no acidosis or ketosis
DKA can have very high glucose levels, but usually levels are 300-800

Question 4

What are complications of HHNS

Answer 4

seizure, stroke

Question 5

What are potential complications of diabetic retinopathy?

Answer 5

vision loss, early catarcts, glaucoma, retinal detachment

Question 6

What are charcot joints?

Answer 6

foot deformity and joint destruction that occus due to repetitive foot trauma in the setting of impaired pain sensation

Question 7

What is motor neuropathy like in DM?

Answer 7

may be distally or proximally distributed

may show up as weakness or loss of coordination

Question 8

What are manifestations of autonomic neuropathy in DM?

Answer 8

postural hypotension, impotence, incontinence, gastroparesis

Question 9

How can alcoholism lead to hypoglycemia

Answer 9

glycogen depletion and gluconeogenesis ihibition by very high alcohol concentrations (serum ethanol levels greater than 45 mg/dL)

Question 10

How does adrenal insufficency lead to hypoglycemia?

Answer 10

decr. cortisol leads to insufficient hepatic gluconeogenesis in response to hypoglycemia