Type 2 Diabetes Flashcards Preview

Endocrinology > Type 2 Diabetes > Flashcards

Flashcards in Type 2 Diabetes Deck (18):
1

Diabetes Diagnostic Criteria

Fasting glucose >126 on two occasions
Random or postprandial glucose >200
HgA1c>6.5%

2

Prediabetes Diagnostic Criteria

Fasting glucose between 100 and 126
Random/postprandial glucose: 140-200
A1c: 5.7-6.5%

3

What does HgA1c Reflect?

Glucose levels over past 2-3 months

4

Prevalence of diabetes

9.3% Americans: 28M with T2DM, 1.25 with T1DM, 8M undiagnosed

5

What are major pathophysiological defects in T2DM?
(Liver, Pancreas, Periphery)

Liver: Increased glucose output
Islet cell: Increased glucagon/Decreased insulin (beta cell mass)
Insulin resistance: reduced peripheral glucose uptake

6

Factors in B-cell Failure

First stage: Oversecretion of insulin Glucotoxicity/chronic hyperglycemia
Lipotoxicity (increased FFA release)

Second stage: metal cell dysfunction/exhaustion

7

What is 1st phase insulin secretion?
What happens during T2DM

Spike in insulin secretion in response to glucose stimulus
During T2DM it's shut down

8

What happens to glucagon in T2DM?

Inappropriately high glucagon secretion by a-cells in islet increases hepatic glucose output

Contributes to hyperglycemia, disease progression

9

Incretins stimulate secretion of _____ in response to food ingestion

Insulin

10

Incretin effect is _____ in T2Dm

diminished

11

Risk factors for T2DM (9)

Obesity (visceral fat), age, race/ethnicity, metabolic factors (HTN, hyperlipidemia), meds, lifestyle, gestational diabetes, genetics, intrauterine effects

12

T2DM Screening: Who to Test

Overweight+risk factor
Normal at age 45 every 3 years

13

Classic Symptoms (4)

Polyuria, polydipsia, polyphagia, unexplained weight loss

14

Nonspecific Signs (5)

Fatigue, blurry vision, dry mouth, dry/itchy skin, poor wound healing

15

Physical Exam Findings (5)

Hypertension
Obesity
Fundoscopic changes (retinopathy)
Foot: decreased sensation, ulceration, pulse
Skin findings: acanthosis nigricans, abscess, tags

16

Treatment Principles

Treating aggressively (A1c

17

Surgical Intervention in T2DM

Gastric bypass results in weight loss and lower A1c (diabetes remission)

18

Best way to prevent diabetes?

Lifestyle modifications > metformin