Diabeatus part one

Question 1

Condition in which greater amounts of insulin than normal are required to produce a normal response

Answer 1

Insulin resistance

-D/t obesity, aging, Cushing’s, genetics

Question 2

Retinal changes
Dry mucous membrane
Skin changes
foot changes

Answer 2

Signs of advanced DM

Question 3

Hypoglycemia, DKA, nonketotic hyperosmolar syndrome

Answer 3

Diabetic emergencies

Question 4

FBG 100-125

Answer 4

Impaired

Question 5

FBG <100

Answer 5

Normal

Question 6

Impaired glucose tolerance

Answer 6

2 hour postprandial gluc of 140-199 after 75 gm oral gluc

Question 7

How often to check HgBA1c

Answer 7

q 6 mo if stable, well controlled

q 3 mo if less well controlled or therapy has changed

Question 8

FBG =>126

Answer 8

DM

Question 9

Macrosomia

Answer 9

Big fat diabetes baby

-Can have congenital defrorm, hypoBG, hypoCa, polycthemia, jaundice

Question 10

Things to know about Gest DM

Answer 10

-Tight BG control VERY important
SMBG is crucial
Check HgbA1c
URINE gluc is NOT helpful

Question 11

Diagnosis GDM

Answer 11

Screen at 24-28 weeks
2 hour OGTT
Dx if ONE of these:
FBG =/>92
1 hour BG =/>180
2 hour BG =/> 153

Question 12

Renal threshold for glucose

Answer 12

150-180, if more than this spills into urine

Preggos have lower threshold and may have glucosuria w/o GDM

Question 13

HgbA1c for PREdiabetes

Answer 13

5.7-6.4

Question 14

Diabetes screening

Answer 14

All people older than 45
Younger if higher risk:
obese, first degree relatives w/ DM, blacks, hispnaics, native american, mom’s with giant babies, h/o GDM

Question 15

Goals for DM w/ dyslipidemia

Answer 15

LDL =/40

TG <150

Question 16

Signs of microvascular disease

Answer 16

Retino/nephro/neuropathy

Question 17

Important clue in DKA

Answer 17

Low serum CO2

-do serum ketone analysis, if present admitfor aggressive tx

Question 18

Classic DKA lab findings

Answer 18

High BG
Low CO2
+ketones in urine and serum

Question 19

Adrenergic: sweat, tremor, tachy, weak, hungry

Neuroglycopenic: d/t low CNS gluc
Dizzy, HA, clouded vision stupidness, confused, acting weird, seizing, coma

Features of true hypoglycemia

Answer 19

Features of true hypoglycemia

Question 20

Not conscious but super hypoglycemic

Answer 20

Glucagon 1 mg subq
or
IV dex, bolus 20-50 ml 50% dex then continuous drip of D10W or D5W

Question 21

Vague sx 1-2 hours after a meal

Too rapid gluc absorption followed by ROBUST insulin repsonse

Answer 21

Alimentary hypoglycemia

• can happen with GI resection
• low CHO, high prot diet

Question 22

Post prandial adrenergic S&S of hypoglycemia relieved by glucose
BUT w/ normal BG

Answer 22

Functional Hypoglycemia

Question 23

How to spot factitious self induced hypoBG

Answer 23

High insulin
LOW c-peptide
Low FBG