Diabetes classification and complications

Question 1

what is DM

Answer 1

group of metabolic disorders char by hyperglycemia resulting from defects in insulin secretion, action, or both

Question 2

how many canadians

Answer 2

> 7%

Question 3

what are diagnostic criteria for diabetes (4)

Answer 3

1. FBG >7
2. casual BG > 11 + Sx
3. 2hrBG > 11
4. A1C >6.5%

Question 4

how is threshold for diagnosis based on

Answer 4

future risk of retinopathy

Question 5

5 Sx of hyperglycemia

Answer 5

1. polyuria/nocturia
2. polydipisia
3. hyperphagia
4. weight loss
5. visual blur

Question 6

what is type 1

Answer 6

idiopathic B-cell destruction leading to absolute insulin deficiency

Question 7

3 results of poor glucose transport into cell

Answer 7

1. incr. fatty acid mobilization, because lipase is not inhibited by insulin
2. hyperglycemia
3. increased glucogenisis becuase don’t have any in the cell

Question 8

what are downstream effects of fatty acid mobilization

Answer 8

1. glycerol and FA transported to liver
2. turned into acetyl CoA
3. acetyl CoA turned into ketones

Question 9

how do ketones cause acidosis

Answer 9

consumption of bicarb

Question 10

5 consequences of ketoacidosis

Answer 10

1. weakness, fatigue,
2. kussmaul resp
3. fruity breath odor
4. nausea vomiting
5. high WBC count

Question 11

4 complications of ketoacidosis

Answer 11

1. hypotension
2. depressed sensorium
3. cerebral edema
4. electrolyte abnormalities

Question 12

5 principles of DKA managment

Answer 12

1. prevent hypokalemia
2. restore ECF volume
3. correct met acidosis with insulin
4. manage hyperosmolarity
5. ID precipitating cause an treat

Question 13

what is main problem in DM2

Answer 13

insulin resistance due to genes and lifestyle/diet

Question 14

what happens in normal B-cell with insulin resistance

Answer 14

make more insulin to control glucose

Question 15

what are 2 key and 1 minor cellular consequences of insulin binding

Answer 15

1. GLUT transporter bring in glucose
2. up glucose metabolism
   3 - minor - cell growth and differentiation - leads to small babies if not given insulin

Question 16

8 risk factors for insulin resitance

Answer 16

1. age
2. obesity
3. sedentary lifestyle
4. ethnicity
5. familiy Hx
6. metabolic syndrome
7. PCOS
8. gestational diabetes

Question 17

what are the other 2 types of diabetes

Answer 17

1. secondary - known cause , genes, panc disease

2. gestational - early sign of later type 2

Question 18

3 acute complications of DM

Answer 18

1. hyperglycemic syndromes (DKA or hyperosmolar)
2. infecitons
3. hypoglycemia, esp from treatment

Question 19

how do long term complications come about

Answer 19

too much glucose to be normally broken down, so goes into another pathway

Question 20

4 general types of complications

Answer 20

1. retinopathy
2. neuropathy
3. nephropathy
4. macrovascular

Question 21

6 complications of neuropathy

Answer 21

1. pain
2. sensory ataxia
3. ulceration
4. infection
5. amputation
6. charcot syndrome

Question 22

what are ocular complications (3)

Answer 22

1. retinal disease
   a. nonproliferative
   b. proliferative - new blood vessels form to make up
   c. macular edema
2. cataracts
3. glaucoma

Question 23

how does nephropathy occur

Answer 23

hyperalbumenuria causes glomelural damage

Question 24

3 macrovascular events

Answer 24

1. CAD
2. cerebrovascular
3. peripheral vascular