Diabetes Mellitus
Terms
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- What is the diagnosis for Diabetes Mellitus?
-
-More than one fasting glucose level greater or equal to 126.
-Plasma glucose level in the 2nd hr of the standard oral glucose tolerance test (OGTT) is greater or equal to 200, confirmed on subsequent day
-random plasma glucose level greater than 200, confirmed with classic symptoms of polyuria, polydipsia, and polyphagia - Normal fasting glucose level is _________ in the morning
- less than 110
- Impaired fasting glucose (IFG) is ________
- 110-126
- Impaired glucose tolerance (IGT) is _________
- 140-200
- What is the oral glucose tolerance test?
- administration of a 75g oral glucose load after a 10hr fast followed by measurement of plasma glucose 2hrs later
- What is glycosylated hemoglobin?
- how much glucose a blood cell will be exposed to in 120 days
- What % is normal glycosylated hemoglobin?
- 6% or less
- What % is a diabetic glycosylated hemoglobin?
- 7% or more
- What was type 1 diabetes called?
- insulin dependent diabetes
- What is the % of type I in the western world?
- 10%
- What are the causes of type I?
- genetic and environmental
- How many % have a first degree relative with type I?
- 10-13%
- Type I is immune related which means...
- auto-antibodies against inulin have been noted in many cases
- Type I is characterized by a lack of _______ and a relative excess of _______
- lack of insulin and excess of glucose
- Who is most commonly diagnosed with type I?
- whites younger than 30yrs
- What is the classic symptom of type I?
- weight loss
- What are the symptoms associated with type I?
-
hyperglycemia
loss of glucose in urine
polyuria
polydipsia - Is ketoacidosis in type I or type II?
- type I
- what is ketoacidosis?
- increased glucose and ketones and makes breath smell fruity and sweet
- What does insulin do in type I?
- reduces the blood glucose level
- What are the types of insulin?
-
rapid (regular) insulin- fast acting
NPH-intermediate active insulin- takes longer
long acting insulin- day long (ex: glargene) - Is type I or type II more common?
- type II
- What is the % of obese in type II?
- 60-80%
- The most powerful risk factor for type II is...
- obesity
- Type II has _____ resistance with ____________ secretion
- Type II has insulin resistance with inadequate insulin secretion
- Who does type II generally affect?
- those older than 30yrs
- Those with type II are often...
- overweight, dyslipidemic (high cholesterol), and hypertensive
- What is the cause of type II?
- genetic susceptibility triggered by environmental factors
- What does sulfonylureas do?
- stimulates insulin release from pancreatic beta cells
- What does thiazolidinedrones do?
- increases insulin sensitivity, particularly in adipose tissue
- What are the acute complications of DM?
-
hypoglycemia
diabetic ketoacidosis - What is hypoglycemia?
- low blood sugar
- What are the numbers for hypoglycemia in infants and adults?
-
infants- below 35
adults- below 45-60 - When does diabetic ketoacidosis develop?
- when there is an absolute or relative deficiency of insulin and an increase in insulin counteregulatory hormones: catecholamines, cortisol, glucagon, and growth hormone
- Which type does diabetic ketoacidosis usually occur with?
- type I
- What are the four chronic complications of DM?
-
diabetic neuropathies
micro-vascular disease
macro-vascular disease
infection - What is micro-vascular diasease?
- thickening of capillaries in extremities, retna of eye and kidneys
- What accompanies micro-vascular disease?
-
retinopathy- retna ascempia
diabetic nephropathy- destruction of kidneys due to damage of glumaria - What accompanies macro-vascular disease?
-
coronary arterty disease
stroke
peripheral vascular disease - what is macro-vascular disease?
- athrosclerosis, thickening of arteries
- Macro-vascular disease is most common with which type?
- type II
- what is peripheral vascular disease?
- increase incidence of ganglian