DM 16p Flashcards

3 tx 3 compli 2 objetivo 2 predm (43 cards)

1
Q

Células alfa

A

Glucagon
Proglucagon

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2
Q

Células B

A

Insulina
Peptido C
Proinsulina
IAPP

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3
Q

Células delta

A

Somatostatina

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4
Q

Células epsilon

A

grelina

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5
Q

Celulas PP

A

Peptido pencreatico

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6
Q

VM insulina

A

3-8min

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7
Q

Activan la liberación de insulina por acetilcolina

A

MCH, VIP, PACAP, GRP

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8
Q

VM glucagon

A

5-10min

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9
Q

Estimulan liberacion de glucagon

A

Hipoglicemia
Epinefrina
Estimulacion vagal

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10
Q

Inhiben liberación de glucagon

A

Hiperglicemia
Somatostatina

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11
Q

Teoría del fenotipo ahorrador

A

Peso bajo al nacer <2-3kg o >4kg

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12
Q

Características de DM1

A

Autoinmune vs cels beta
Idiopática
> riesgo CAD
Peso normal

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13
Q

Anticuerpos en DM1

A

Anti GAD… estable 15años
Anti Zn8t… estable 4 años y disminuye
Anti islotes… caen rapidamente
Anti insulina…primeros en aparecer
Anti IA2… insulinoma

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14
Q

DM LADA

A

> 30a
6 meses sin insulina

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15
Q

DM2

A

Resistencia a insulina
Sobrepeso
CAD en infecciones

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16
Q

DM monogénica

A

MODY
Neonatal (primeros 6 meses de vida)

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17
Q

Genes MODY

A

Glucocinasa MODY2
HNF1 MODY 3

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18
Q

Comorbilidades en DM1 y DM2

A

DM1: enf autoinmunes
DM2: sx metabólico

19
Q

Criterios tamizaje DX DM2

A

Sobrepeso
Antecedente
Etnia
HAS
HDL<35 o triglicéridos >250
SOP
Sedentarismo

20
Q

Criterios DX PREDM

A

Ayuno: 100-125
CG 75g (2h): 140-200mg/dl
HbA1c: 5.7%-6.4%

21
Q

Crietrios DX DM

A

Ayuno: ≥ 126mg/dl
CG75g (2h): >200mg/dl
HbA1c >6.5%
Glucosa al azar >200 + sintomas

22
Q

Criterios DMG

A

Tamizaje primeras 15SDG
DM 24-28SDG

1 paso
- Ayuno >92
- 1h >180mg
- 2h >153

2 pasos… 50g
- Valorar a la hora >130
Agregar 100g
- Ayuno >95
- 1h >180
- 2h >155
- 3h >140

23
Q

Metas crontrol glicémico

A

HbA1c <7%
Ayuno 80-130
Posprandial 2h <180

24
Q

Metas glicémicas ancianos

A

HbA1c <7% u 8%
Ayuno: 80-130 o 90-150
Antes de dormir: 80-180 o 100-180

25
Metas embarazadaaas
HbA1c: <6% Ayuno: 70-95 1h posprandial 110-140 2h posprandial 100-120
26
TX primera línea
Metformina + cambios estilo de vida
27
TX mono
Metformina
28
TX dual
Metformina + GLP1 o SLGT2 Metformina + ___tida + ___ozina
29
Metformina Dosis: EA: Contraindicaciones: TFG <30ml
Inicial: 500mg al dia Efectiva: 1500mg EA: GI, acidosis lactica, def VitB12
30
Sulfonilureas (___ida) - Glibenclamida 2.5mg - Glimepirida 2-8mg
Riesgo hipoglucemia Ganancia de peso
31
TZD -> pioglitazona
15-45mg Ganancia de peso
32
Acarbosa -> glucobay
MA: inhibidor de alfa glucosidasa intestinal Dosis: 25-100mg ea: GI
33
GLP1 (__tida)
- Liraglutida - Semaglutida
34
DPP4 (___tina)
Sitagliptina 50mg al día Linagliptina NO REQUIERE AJUSTE
35
Grupo farmacologico que se encarga del 90% de la reabsorcion de la glucosa en el TCP
SGLT2
36
SGLT2 (__flozina)
Empaglifozina Dapaglifozina ** Infecciones micoticas genitales
37
Insulina basal
10UI o 0.1-0.2UI/kg
38
Def CAD
Deficiencia absoluta de insulina + elevacion de hormonas contrarreguladorsa
39
Clínica CAD
Polidipsia Polifagia Poliuria
40
TX CAD
SS 0.9% 500-1L en 1h Sodio corregido normal/ato... SS 0.45% - Glucosa 200mg/dl agregar glucosada 5% Sodio corregido bajo... SS 0.9% 250-500ml7h
41
TX nutricional
Reduccion de HbAc1 del 2% Sobrepeso/obesidad perder el 5% de peso
42
Recomendación de ingesta de cada grupo nutricional
Carbs: 14g Prot: 1-1.5g/kg Grasas: coleterol total <300mg/24h y grasas saturadas <10% Sodio: <2.3 g/día
43
Cantidad de ejercicio a la semana
150min