pre-IC11 Flashcards
(39 cards)
How many stages are there in T1DM? Which stage starts to become symptomatic?
3; Stage 3
Describe the pathophysiology of Type 1 DM
An absolute deficiency of pancreatic β-cell function
Describe the pathophysiology of Type 2 DM
Progressive loss of adequate β-cell insulin secretion on the background of insulin resistance
Signs and symptoms of hyperglycemia
- extreme thirst (polydipsia)
- hunger (polyphagia)
- decreased healing
- drowsiness
- dry skin
- frequent urination (polyuria)
- blurred vision
Signs and symptoms of hypoglycemia
- fast heartbeat
- shaking
- hunger
- irritable
- headache
- dizziness
- weakness fatigue
- sweating
- impaired vision
Diagnosis of DM
HbA1c 7% and above
Types of positive antibodies found in T1DM patients
- islet cell autoantibodies and autoantibodies to GAD (GAD65)
- insulin
- tyrosine phosphatases IA-2 and IA-2b
- zinc transporter 8 (ZnT8)
What substance is measured to prove absence of insulin in the body, and why is this measured instead of insulin?
C-peptide; insulin has a short half life
Explain insulin resistance
In the presence of insulin, glucose utilization is impaired and hepatic glucose output increased
Levels of glucose and insulin at an early stage of T2DM
Both elevated (hyperglycemia triggers insulin secretion)
Primary cause of Type 1 Vs Type 2 DM
T1: Autoimmune-mediated pancreatic beta-cell destruction; positive antibodies
T2: Insulin resistance, impaired insulin secretion, negative antibodies
Insulin production (C-peptide level) for Type 1 Vs Type 2 DM
T1: Absent
T2: Normal or abnormal
Age of onset for Type 1 Vs Type 2 DM
T1: Usually <30 years
T2: Often >40 years, although increasing prevalent in obese
children and younger adults
Onset of clinical presentation for Type 1 Vs Type 2 DM
T1: Abrupt
T2: Gradual
Physical appearance for Type 1 Vs Type 2 DM
T1: Often thin
T2: Often overweight
Proneness to ketosis for Type 1 Vs Type 2 DM
T1: Frequent
T2: Uncommon
Onset and progress of hyperglycemia VS hypoglycemia
Hyper: gradual, may progress to diabetic coma
Hypo: sudden, may progress to insulin shock
Measurement of fasting plasma glucose (FPG)
No calorie intake for ≥ 8hrs
Measurement of Postprandial plasma glucose (PPG)
Glucose level measured after meal; usually after 2 hours
Can also be measured using a standardized 75-g oral glucose tolerance test (OGTT)
Measurement of HbA1c
Measures the average amount of glucose in a person’s blood over the past 3 months.
HbA1c = Past 3 months Average of (FPG + PPG)
- Glucose stays attached to hemoglobin for the lifespan of a red blood cell (~120 days)
Contributor to high HbA1c
Greater extent contributed by fasting/ basal hyperglycemia
Contributor to lower HbA1c
Greater extent contributed by postprandial hyperglycemia
Frequency of glucometer use for T1DM, pregnant women, or insulin pump users
- ≥ 4 times daily
- Before meals/snacks, at bedtime, at 3 a.m.
Frequency of glucometer use for T2DM
- ≥ 3 times daily for patients on multiple injections of insulin
- For patients using less frequent insulin injections, noninsulin therapies, or medical nutrition therapy alone, self monitoring of blood glucose (SMBG) may be useful as a guide to the success of therapy
