Week 9 Flashcards
(45 cards)
What is it called when you frequently urinate at night?
nocturia
What is the darkening of the skin on the back of the neck called?
acanthosis nigricans
**indicative of insulin resistance
What were Hector Sandoval’s chief complaints?
fatigue & frequent urination
What are some reasons why Hector might have fatigue?
hyperthyroidism or hypothyroidism, depression, anemia, sleep apnea, sleep deprivation, interruption of REM sleep w/ nocturia
What are some possible explanations for Hector’s polyuria?
Prostate cancer (benign prostatic hyperplasia) Type II Diabetes Diuretics use psychogenic polydipsia hypercalcemia Diabetes insipidus
Up until this point, Hector had been gaining 3 lbs/year. Now, his weight has plateaued even tho his lifestyle hasn’t changed. Why might that be?
Cancer
Type II Diabetes–decreased fat storage
Dehydrated from Type IIDM
Peeing out calories of carbs w/ Type II DM
How many calories are in glucose/gram?
Glucose: 4cal/gram
Why do patients with T2DM have polyuria?
b/c the extra glucose in their blood exceeds the amount that can be reabsorbed in the kidneys. Therefore, you get excretion of glucose & with that: osmotic diuresis.
What are some of the complaints that patients with Diabetes have when you put them on insulin?
Insulin is an anabolic hormone. When you don’t have it you sometimes lose weight. Then when you give it, you can sometimes gain weight.
If you suspected that a patient had T2DM what would you check?
Fasting glucose levels
A1c
Glucose Tolerance Test
What level of fasting glucose is considered normal? What level is considered Pre-Diabetes? What level is considered Diabetic?
Normal: 125
What does the a1c tell you? What level is considered normal? Pre-diabetes? Diabetes?
**tells you about your average sugar levels over the past 3 months…measures glycated hemoglobin
Normal: 6.5
We’re talking Glucose Tolerance Test here. What level is considered normal for a 2 hour plasma glucose level? Pre-Diabetes? Diabetes?
2 hour plasma glucose of Glucose Tolerance Test
Normal: <200
Diabetes: 200 or greater
T/F A 10 year old kid showing symptoms of diabetes most certainly has Type I Diabetes.
Sadly, false. If the child is obese, possible that they have Type II Diabetes.
Diabetic Ketoacidosis is more associated with which form of diabetes?
Type I Diabetes
Type I/II Diabetes is considered a relative/absolute insulin deficiency. Why?
Type I: absolute deficiency
**autoimmune attack of pancreatic beta cells. Really, don’t make enough insulin.
**shows antibodies
**completely insulin dependent
Type II: relative deficiency
**lots of insulin available, but exhibiting insulin resistance
Does it make sense to give a patient with Type II Diabetes insulin?
Not really, but sometimes you need to do that at first in their treatment.
What does the presence of C-peptide indicate? Which type of diabetes do you see zero C-peptide?
preproinsulin–>proinsulin–>cleaved into insulin + C-peptide
Type I Diabetes has zero C-peptide b/c they have zero insulin!
What is Hector’s diagnosis?
Type II Diabetes. This is consistent with his a1c & fasting glucose levels.
When evaluating a patient that you suspect of having Type II Diabetes…why do you order a urine albumin/creatinine level?
to check for kidney damage from uncontrolled diabetes
What is a typical a1c goal for patients with Type II Diabetes?
a1c=7.
What are some of the current dietary guidelines of diet for patients with T2DM?
monitoring carb intake less calories foods w/ low glycemic index saturated fat intake of less than 7% of diet An aside: make sure to exercise!
What are the ABCs of Diabetes?
A1c
Blood pressure
Cholesterol
**important to control these things…
What are some important things to do for cardiac risk reduction in patients with T2DM?
smoking cessation
BP control
Lipid control
Diet & exercise
