Diabete type 2 Flashcards Preview

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Flashcards in Diabete type 2 Deck (32):
1

what is the definition of type II diabetes

metabolic order that is characterized by hyperglycemia in the context of insulin resistance and relative lack of insulin

2

who is at risk for DM type II

Women, South Asian, Pacific Islanders, Latinos, Native americans, Life style, genetics

3

what lifestyle factors contribute to Type II diabetes

obese, overweight, lack of physical activity, poor diet, stress

4

What gene has a strong correlation of succeptibility?

TCF7L2 gene

5

who is at risk for secondary diabetes

taking glucocorticoids
cushing syndrome
pheochromocytoma

6

What needs to be established for T2DM

peripheral insulin resistance, inadequate insulin secretion by pancreatic beta cell

7

what is insulin resistance

body produces insulin but cell receptors fail to respond effectively or at all to the normal actions of the insulin hormone and no glucose uptake into the cell

8

what is adiponectin

secreted by fat cell, a hormone that is sensitive to insulin. makes us less susceptible to diabetes

9

what is islet paracrinopathy

refers to how the reciprocal relationship between the glucagon secreting alpha cells and the insulin-secreting beta cells is lost, leading to hyperglucagonemia and further hyperhlycemia

10

what are the signs and sx of T2DM

polyuria, polydipsia, polyphagia, fatigue, blurred vision, neuropathy
yeast/fungal infection (increased pH), Cardio disease, dyslipidemia, poor would healing, Acanthosis nigricans

11

what lab values would you need to characterized a pt as a diabetic

fasting glucose>126mg/dl
2hour fast>200mg/dl
HA1c>6.5%

12

what does the urine dip stick measure

glucose, ketone, albumin

13

What are the goals for DM

maintaining blood glucose 90-130
HbA1c<7%

14

What are the treatment options?

1st line: diet&exercise
2nd line:oral anti-diabetic meds
3rd line: insulin therapy
low carb, low fat, carb counting (15-30gm)

15

what are the most common DM meds

biganides (metformin)
sulfonylureas
meglitinide dervi.
alpha-glucosidase inhibitors
thiazolodnediones

16

what is the first medication you would start a new T2DM on?

biguanides (metformin)
effective and safe
rarely causes hypoglycemia
facilitates modest weight loss
improve lipid profile, lowers basal and post prandial glucose
decreased intestinal absorption of glucose and improves insulin sensitivity

17

What is the second medication added to a T2DM

sulfonylureas
insulin scretagogues
stimulate insulin release from beta cells
enhance peripheral sensitivity to insulin by increasing insulin receptors and insulin receptor binding
hypoglycemia common side effect

18

What are meglitinide derivatives

short acting insulin secretagogues
used for PT with SULFONYLUREA allergy
causes weight gain

19

How do alpha-glucosidase inhibitors

delays sugar absorption, prevent postprandial spikes

20

What are risks with hyperosmolar hyperglycemic state

complications, coma, death

21

what is the treatment for hyperosmolar hyperglycemic state

IV fluids, insulin, manage underlying condition

22

What are class of drug does pioglitazone and rosiglitazone belong to which class of drugs how does it work

Thiazolidinediones (TZD)
insulin sensitizers so insulin needs to be present
takes 12-16weeks to work
used as monotherapy or in conjunction with other orals/insulin
decreases triglycerides and increases HDL and LDL
>2yrs of bladder CA
>1yr of fractures
increase risk of MI

23

What are some of the signs of hyperosmolar hyperglycemic state?

polyuria, decreased volume and hemoconcentration that causes further increase in blood glucose levels

24

what does diabetic retinopathy effect

lens, vitreous, and retina
causes macular edema
pts also develop cataracts sooner

25

how frequently should a diabetic visit the opthamologist

6-12 months

26

what causes the visual blurring that develops acutely in DM pts

the lens changes shape with changes in the blood glucose concentrations.
The osmotic fluxes of water into and out lens which usually occurs as hyperglyceimia increases but it also may be seen when high glucose levels are lowered rapidly.
can take upto a month for visual acuity for recover

27

what is diabetic neuropath

the most common complications
patients may have paresthesias, numbness, or pain
Better control of glucose may alleviate some symptoms
protect feet apply lubricating agents and wear proper foot wear
inspect feet after bathing
orthostatic hypotension

28

what is diabetic nephropathy
what is the 1st sign

microalbuminuria(protein in urine)
most common cause of ESRD

29

how would you treat a person with diabetic nephropathy

ACEI/ARB even in normo tensive patients

30

what is the systolic/diastolic goal for a DM pt

140/80 mmHg

31

how do you treat DM patients who are at risk of CAD/Cerebrovascular/PVD

control HTN
Apirin
Lower LDL/raise HDL

32

what are complications of peripheral vascular disease+neuropathy

diabetice foot ulcers, poor would healing
gangrene
digit/limb amputation