Diabetes Type I and Gestational Diabetes Flashcards Preview

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Flashcards in Diabetes Type I and Gestational Diabetes Deck (20):

What is the pathophysiology of gestational diabetes?

Hormonal changes make cells less responsive to insulin. Placenta produces larger quantities hormones. Babies have increased risk of being large for gestational age, low blood sugar and jaundice


Describe gestational diabetes that occurs during first half of pregnancy?

Anabolic. Pancreatic beta cell hyperplasia causes hyperinsulinemia. Increased uptake and storage of glucose


Describe gestational diabetes that occurs during the second half of pregnancy?

Catabolic. Placental hormones block glucose receptors and cause insulin resistance: Increased lipolysis, Increased gluconeogenesis, Decreased glycogenesis. Increased glucose and amino acids for the fetus


What are risk factors for gestational DM?

family history, previous child >9, glycosuria, previous stillbirth, maternal age >30, obesity


What are adverse pregnancy outcomes of gestational DM?

excess amniotic fluid (polyhydraminos), birth trauma/operative delivery, increased risk of developing type II DM


What is the classic triad of diabetes presentation?

polyuria, polydipsia, polyphagia


What causes polyphagia associated with diabetes?

Mitochondria can’t get the glucose so metabolizes fat and protein in the body. The amount of glucagon stays the same. Liver convert the fat and protein into ketones for energy


What causes lack of energy associated with diabetes?

High levels of glucose in the blood but the cells are lacking because insulin isn't there to allow entry into the cells--->can't make energy


What are the stages of type I diabetes?

I Genetic Susceptibility,II Triggering, III Active autoimmunity, IV Progressive metabolic abnormalities, V Overt Diabetes, VI Insulin Dependence


What causes blurred vision associated with untreated diabetes?

glucose enters the fluid and distorts the light. goes away with controlled glucose levels


What lab results diagnose diabetes?

Fasting blood sugar (FBS) >126 on two separate occasions. Random plasma glucose >200. Oral glucose tolerance test >200. Glycosylated hemoglobin (HgA1C) >6.5%. Loss of C-peptide <0.8ng/dl. Urine dipstick testing- glucose/ketones in urine


What are the microvascular complications of diabetes?

Diabetic Retinopathy (most common cause of blindness in the United States). Diabetic Nephropathy (most common cause of renal failure). Neuropathy (usually legs/feet but can be autonomic e.g. erectile dysfunction)


What are the macrovascular complications of diabetes?

Cardiovascular Disease (CAD, MI,). Cerebrovascular Disease (TIA and Stroke), and Peripheral Arterial Disease


When should insulin dependent diabetics check their blood glucose?

fasting AM, before and after meals, before/during/after excercise, before bedtime


When are insulin pumps recommended?

recurrent severe hypoglycemia, wide fluctuations in blood glucose levels, suboptimal diabetes control, microvascular/macrovascular complications, or insulin regimen that compromises lifestyle


What is the glycemic index?

describes what happens after eating carbs. different types of carbs affect plasma glucose in variable ways. Ex: glucose drink results in rapid rise of levels whereas an apples results in a slower rise


How can a UA miss diabetic ketoacidosis?

urine may be negative for ketones if severe renal insufficiency exists. the test reacts strongly to acetoacetic acid, but not with beta hydroxybutyrate. In DKA, most of the ketones present are in the form of beta hyroxybutyrate


What should be included in the comprehensive annual exam of diabetics?

BP, fundoscopic exam, thyroid palpation, skin examination, neurological, foot examination


What labs should be included in the comprehensive annual exam of diabetics?

HbgA1C, lipid profile, LFTs, TSH, CMP


Who do diabetics need to be referred to?

opthamology, dietician, diabetes educator, pharm D, family planning if woman of reproductive age