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Flashcards in Guide to Diabetes - Ch1 Deck (33):

How many people in US have Diabetes? How many have Prediabetes?

29 million in US have diabetes. 86 million have Prediabetes.


What is prediabetes?

1. Increased glucose levels
2. Impaired gluocose tolerance
3. Doesn't meet Dx criteria for Diabetes

There is a higher risk of progressing to full Diabetes


What is the Diagnostic criteria for Diabetes?

Fasting blood glucose of 100- 125 mg/dL
2 Hr Oral Blood glucose test of 140 - 199 mg/dL
A1C blood test of 5.7 - 6.4%


What is the A1C blood test?

It is a test to measure Blood glucose level from the last 2- 3 months


What do Education classes for Pre Diabetes focus on?

1. Pathophysiology of Pre DM and progression to full Diabetes
2. Healthy eatings
3. Regular physical activity and exercise
4. Stress management

Thee factors can affect and reduce conversion rate to full Diabetes.

See also National Diabetes Prevention Program


What are the 4 types of Diabetes?

1. T!DM
2. T1DM
3. GDM
4. Other


What is Type 1 Diabetes?

T1DM aka Juvenile onset, or Insulin dependent.
Results from B Cell destruction.
Creates an absolute Insulin deficiency.


What is Type 2 Diabetes?

T2DM aka MAture/ adult onset
Results from progressive insulin secretory deficit, reduced insulin function, increased insulin resistance.
Non insulin dependent form of Diabetes.


What is GDM?

Stands for Gestational Diabetes, usually diagnosed during pregnancy.


What other forms of DM are there?

Medication induced (ie steroids)
Chemically induced
Genetic defects in B Cell function
Dz in exocrine Pancrease
<5% , monogenic DM syndromes (neonatal or maturity onset)


How does the ADA Dx Diabetes?

The American Diabetes Association has multiple ways to Dz.
1. Fasting PLasma glucose >= 126 mg/dL
2. Casual plasma glucose >= 200 mg/dL
3. OGTT w 2He plasma glucose >= 200 mg/dL using glucose load of 75g.


What is the basic function of Insulin?

It activates transport of glucose form bloodstream to the cells.


What could happen without Insulin?

hyperglycemia, ketoacidosis, coma and death


What percentage of Diabetics have Type 1?

about 5- 10%.


What is the cause of Type 1 DM?

A lack of insulin due to autoimmune destruction of insulin producing B cells in the pancreas.


What is the Tx for T1DM?

insulin, meal planning and exercise


What percentage of Diabetics have Type 2?

about 90 - 95%


Who has T1DM?

Children, adolescents or adults. May be acute onset, but can also develop over years.


Who has T2DM?

Historically, pts over 40 yo. But over the last decade, seeing an increase in adolescent Dx r/t Obesity.


What is the condition for T2DM?

Insulin resistance and impaired insulin production can cause hyperglycemia.
Pts often have Hypertension, hyperlipidemia, and central or truncal obesity.


What is the Tx for T2DM?

Meal planning, exercise, and if Blood sugar is not controlled, Oral DM medication or Insulin.


Whats the key difference between T1DM and T2DM?

T1DM is insulin dependent. T2DM is Insulin requiring (body still makes insulin, it just doesn't work as well)


What happens in GDM?

Gestational DM is associated with pregnancy induced insulin resistance.
Continued hyperglycemia during pregnancy can lead to
- Macrosomia (big baby)
- hypoglycemia of newborn.


How do you Tx GDM?

Strict blood glucose control during pregnancy can lead to health newborn being born.
Tx includes meal planning, blood glucose monitoring, moderate exercise, and sometims insulin or Oral hypoglecemic agents.


What goes into Diabetes Managment?

In a nutshell, Management of blood glucose level to treat hyperglycemia.
Each pt has personalized Blood glucose range, the Tx helps keep the blood in that range.
ADA recommends minimal of Biannual A1C test. (goal <= %7.
If comorbidities or limited life expectancy, less stringent range is ok, like <= %8.


What kind of complications can Blood Glucose management prevent?

Long term complications of Cardiovascular, kidney, eye disease, neuropathy


Summarize the DCCT - Diabetes Control and Complications Trial.

1993, National Inst of Health did the largest most comprehensive study on DM tx.
Comparing Intensive vs Conventional DM tx, Intensive Tx had greater success in preventing complications vs Conventional Tx.


What goes into Intensive Tx for T1DM according to the DCCT Study?

3-4 Insulin injxn / day or an Insulin pump
3-4 Blood glucose monitoring / day
Healthy meal and exercise plan
Monthly evaluation by Diabetes Tx team


What goes into Conventional Tx for T1DM according to DCCT study?

1-2 Injection/ day
1/day Blood glucose monitoring
Standard meal planning and exercise.


What were the results of the DCCT?

In the Intensive vs Conventional Tx group:
Blood Glucose:
155 mg/dL vs 231 mg/dL

Dev Retinopathy:
23 pts vs 91 pts

Dev Neuropathy:
3% pts vs 10% pts

Shows strong correlation of Blood Glucose Control and Prevention of Complications


Summarize the UK Prospective Diabetes Study

Showed similar results as DCCT, but for T2DM and A1C test.


What are the Key risk factors for DM?

Age > 40
Family Hx of DM
S/S of hyperglycemia


What are the S/S of Hyperglycemia

Fatigue, thirst, hunger, frequent urination, blurry vision, reduced wound healing, numb or reduced sensation in extremities.