Diabetes-Pino Flashcards
(23 cards)
Diabetes
Define
Chronic disorder. Of metabolism (carbs, fat)
Absolute/relative deficiency of insulin secretion
Ineffective response to insulin
Hyperglycemia
T1DM
Gene ass
HLA
DM
Risk factors
Viruses
Diet
Higher SES
Obesity
Vit D deficiency
Insulin
Get carbs into cell
Opens receptors for glucose
conversion of glucose to glycogen
T1DM
Pathogenesis
Genetic (HLA DR3/4) + environmental trigger
DM
Presentation
Polyuria
Polydipsia
Polyphagia (w weight loss)
Can be DKA
DM
Why do you get polyuria, polydipsia, polyphagia
Glucose goes above renal threshold. Goes into urine so draws water with it. Causes you to drink more.
Cells starve due to no glucose (no uptake). Cells shift to fat (polyphagia w weight loss)
Criteria for dx of DM
A1C: >6.5
FPG>126
2 hr PG > 200
Random PG>200
DM
DDx
Critical illness
Meds (steroids)
Neonatal
Gestational
DM
As
Thyroiditis (anti GAD)
Celiac (tTG)
Addsons
DM
Complications
Hypoglycemia
Hyperglycemia
DKA
Long list
Hypoglycemia
<70
Hypoglycemia
Sx
Cranky, light headed, diaphoretic
Hypoglycemia
Risk factors
Insulin
Diet
Other causes of hypoglycemia
Inborn errors of metabolism (fat, carbohydrate, amino acid, give dextrose solution)
Insulinoma
Ketotic hypoglycemia
DM
Management
Education
Glycemic control
Insulin
Diet
Activity
Insulin
Rapid acting: lispro and as part
Short acting
Intermediate: humulin
Long acting: glargine and detemir
Pump indications
Recurrent severe hypoglycemia
Wide fluctuations
Poor control
Microvascular complications
Kids
Athletes
Follow up
Growth
Sugar
A1C every 3 months
Thyroid
Type 2 DM
Insulin resistance
Obesity biggest risk factor
DM2
Presentation
Asymptomatic
DKA
DM2
Family
Strong family history!!!
Metformin
MOA
Dec hepatic glucose production
Improves insulin sensitivity
