Diabetes Mellitus Flashcards

1
Q

when did the dx criteria for DM change?

A

1997

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2
Q

what is the fasting BG level for diagnosing DM?

A

126 mg/dl

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3
Q

which ethnicity is most affected by DM?

A

african american

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4
Q

what is type 3 DM?

A

maturity onset diabetes of youth

genetic insulin receptor syndromes

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5
Q

what are secondary DM problems?

A
pancreatitis
pancreatic CA
Cushings
hemochromatosis
acromegaly
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6
Q

which cells secrete glucagon?

A

alpha cells in the islets of langerhan

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7
Q

what can the brain use in fasting state for energy?

A

ketones

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8
Q

when plasma insulin declines dramatically (insulin deficient), what will happen in the liver?

A

liver generates tons of ketones

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9
Q

what antibodies may affect DM type 1?

A

islet cell antibodies (ICA)
glutamic acid decarboxylase antibodies (GAD)
insulin autoantibodies (IAA)
tyrosine phosphatase antibodies (IA-2)

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10
Q

when might you want to order antibodies studies?

A

younger, overweight pts (esp. with ketones)

older, thin pts

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11
Q

which test would you order to see if there is any endogenous insulin?

A

C-peptide

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12
Q

what are the MAJOR risk factors for type 2 DM?

A

obesity

family hx

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13
Q

what is the metabolic syndrome?

A

list of systemic changes that often goes along with DM and goes along with weight gain

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14
Q

what is the classic presentation of the lipid panel for a person with metabolic syndrome?

A

High triglycerides
Low HDL
small, dense LDL

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15
Q

what are particularly concerning patterns of metabolic syndrome?

A

prothrombotic state
proinflammatory state
(causes ischemia in heart and brain)

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16
Q

what is a common pediatric DM type 1 complaint?

A

irritability

17
Q

what is the renal threshold of glucose?

A

180, a blood glucose of higher than that will be urinated

18
Q

why do late DM type 2 pts lose weight?

A

their cells use lipids and proteins, since they can’t access the glucose

19
Q

why do type 2 diabetics get visual blurring?

A

dehydration of the lens

glucose deposits in the lens

20
Q

in the diabetes prevention study, which process worked best to prevent diabetes?

A

lifestyle modification 71% reduction

metformin, only 31% reduction

21
Q

according to the UKPDS, what is responsible for reducing cardio events in diabetic pts?

A

controlling blood pressure (144/82 avg)

22
Q

where do you get the biggest benefit from controlling blood sugar?

A

eye
kidney
peripheral neuropathy

23
Q

where else do you need to focus your efforts when managing your type 2 diabetic pts?

A

cardiovascular profile (lipids, healthy eating, exercise)

24
Q

when is metformin contraindicated?

A

creatinine of >1.4 for female, 1.5 for male

25
Q

what is the 2nd leading cause of death in pts who have DM?

A

infections of any kind