Clinical Approach to Diabetes and Hypoglycemia Flashcards Preview

Endocrinology > Clinical Approach to Diabetes and Hypoglycemia > Flashcards

Flashcards in Clinical Approach to Diabetes and Hypoglycemia Deck (48)
Loading flashcards...
1

In what area of the U.S. is DM most prevalent?

- deep southeast

2

What is Latent Autoimmune Adult Diabetes (LADA)?

- diabetics who do not fit type 1 or 2 categories

3

Is the onset of T1DM abrupt?

YES

4

Is the onset of T2DM abrupt?

NO

5

What is double diabetes?

- pt has T1DM with a family hx of T2DM

6

What is impaired glucose tolerance (pre-diabetes)?

- risk of developing DM.

7

How many adults in the U.S. have pre-diabetes (risk of developing T2DM)?

- 78 million

8

How many adults in the U.S. have T2DM?

- 29 million and growing

9

Do whites or black have a higher risk of developing T2DM?

- blacks

10

What is the fastest growing minority group in the U.S. for T2DM?

- hispanic americans

11

What are some environmental (acquired factors) that can lead to T1DM?

- viral infections
- nutrition
- chemical agents

12

How is insulin secreted in non-diabetics?

- in 2 phases

13

- how is insulin secreted in pts with T2DM?

- loss of phase 1 secretion
*so we want to try to promote phase 1 secretion when treating.

14

What is Hgb A1c?

- 3 month average of plasma glucose attached to valine on B-chain of hemoglobin A; benchmark for assessment of glycemic control (we want it to be less than 7% in T2DM).

15

To what does a reduction in HbA1c correlate in T2DM?

- reduction in risk for microvascular complications: retinopathy, nephropathy, and neuropathy.

16

How do steroids impact diabetics?

- increase hepatic gluconeogenesis, glycogenolysis, and antagonist peripheral insulin response, decreasing glucose uptake.

17

What is the first line treatment for T2DM?

- metformin

18

What is the most common ADR of metformin?

- lactic acidosis

19

What agents can we use when we need supplementation with metformin?

- sulfonylureas (glipizide..)= cheapest.
- incretins (GLP agonists or DPP-4 inhibitors)= well tolerated and oral.
- SGLT-2 inhibitors= increase glycosuria.
- amylin
- insulin

20

What are the 3 rapid-acting mealtime insulins?

1. aspart
2. lispro
3. glulisine

21

What are the long-acting (24 hour) peakless insulins?

- glargine
- detimir

22

What are insulin pumps?

- senses sugar and injects insulin as needed

23

What are the complications of T2DM?

- MICROvascular= retinopathy, neuropathy, nephropathy
- MACROvascular= MI, stroke, peripheral vascular disease

24

If we reduce HbA1c by just 1%, by what percent will microvascular complications be reduced?

- 35%

25

What may you see in the rare case of autonomic neuropathy associated with T2DM?

- GI dysfunciton
- orthostatic hypotension
- cardiorespiratory arrest
- bladder dysfunciton
- impotence

26

What is the number one cause of end-stage renal disease?

- T2DM

27

Does diabetic neuropathy tend to affect the lower or upper extremities first?

- lower (symmetrical)

28

Can diabetics present with atypical symptoms of MI?

- YES. They may not present with chest pain.

29

Can pts with DM have postgustotory sweating?

- YES

30

What are the nonparmacologic therapies for T2DM?

- diet (restricting refined carbs)
- exercise
- vitamins