Term
| When is screening recommended for individuals for DM? |
|
Definition
| 45 yo or older at 3-year intervals |
|
|
Term
| Retinopathy occurs in what type of diabetes? |
|
Definition
| occurs in almost all type 1 and type 2 diabetics |
|
|
Term
| What is the most common form of retinopathy? |
|
Definition
| noproliferative rentinopathy |
|
|
Term
| What complication is associated with the highest mortality? |
|
Definition
|
|
Term
| What is a marker of the incipient phase of nephropathy? |
|
Definition
| excretion of low abnormal levels of albumin |
|
|
Term
| What is the most common presentation of neuropathy? |
|
Definition
| peripheral symmetrical sensorimotor neuropathy |
|
|
Term
| What neuropathy is most commonly seen in elderly men with DM? |
|
Definition
|
|
Term
| What is the only means of decreasing risk of neuropathy? |
|
Definition
|
|
Term
| What were the key points of the Diabetes Control and Complications trial? |
|
Definition
1)retinopathy, microabluminuria, neuropathy development reduced significantly - neuropathy greatest reduction 60%
2) main adverse event-hypoglycemia coma |
|
|
Term
| What is type 1 DM characterized by? |
|
Definition
| absolute insulin deficiency |
|
|
Term
| DM occurs when what percentage of beta cells are destroyed? |
|
Definition
|
|
Term
| What is the only certain viral infection associated with DM type 1? |
|
Definition
|
|
Term
| How is the diagnosis of type 1 DM almost always made? |
|
Definition
| symptom history confirmed by blood/plasma glucose >200 mg/dl with presence of glucosuria and often ketonuria |
|
|
Term
| What is the American Diabetes Association revised standards of care for BS levels for Type 1 DM? |
|
Definition
1) whole blood glucose 80-120 mg/dl
2) bedtime BS 100-140 mg/dl
3) postprandial peak BS <180 mg/dl
4) HbA1C <7.0% |
|
|
Term
| Insulin therapy for type 1 DM? |
|
Definition
1) long acting continuous that mimics nighttime and interprandial basal secretion
2) rapid, short acting insulin before meals |
|
|
Term
| What two drugs are given to mimic basal insulin secretions? |
|
Definition
|
|
Term
| By a rule of thumb, basal and mealtime insulin pulses each approximate what percentage of total daily dose? |
|
Definition
|
|
Term
| What may be the first manifestation of type 1 DM? |
|
Definition
|
|
Term
| What is as important as insulin therapy in treatment of diabetic ketoacidosis? |
|
Definition
|
|
Term
| What should be given promptly after insulin is given in DKA patients?? |
|
Definition
|
|
Term
| Rhabdomyloysis, hemolysis, and CNS deterioration can occur due to what in DKA patients? |
|
Definition
|
|
Term
| What diabetic emergency is more common and potentially more dangerous than DKA? |
|
Definition
|
|
Term
| What are the most common causes of hypoglycemic emergencies? |
|
Definition
1) missed meals/snacks
2) insulin dosage errors
3) exercise
4) alcohol
5) beta blockers |
|
|
Term
| What are the most common early symptoms with hypoglycemia? |
|
Definition
adrenergic symptoms
1) tachy, tremors, sweating, anxiety |
|
|
Term
| What are the major counterregulatory hormones against hypoglycemia? |
|
Definition
|
|
Term
| How much carbohydrate is usually sufficient to restore BS levels? |
|
Definition
|
|
Term
| What is the preferred test for Type 2 DM? |
|
Definition
FBS > 126mg/dl - preferred
*also HgbA1 >6.0%
pre-diabetes defined as FBS 100-125 mg/dl, or 2hr pp blood glucose 140-199mg/dl |
|
|
Term
| If type 2 DM has existed for more that 5-10 yrs, peripheral nueropathy, microalbuminemia, dyslipidemia, or smoking hx what things are essential to do? |
|
Definition
1) EKG
2) ECG stress test
*done before the start of an exercise program |
|
|
Term
| Which type 2 DM drugs are most effective in early DM and non-obese? |
|
Definition
|
|
Term
| What is the MOA of sulfonyurea agents? |
|
Definition
| close ATP-senstive potasium channels-inlflux of calcium - exocytosis of insulin granules |
|
|
Term
| What are some sulfonylurea agents? |
|
Definition
1) glyburide
2) glipizide
3) glimepiride |
|
|
Term
| What is the primary action of metformin |
|
Definition
| decreases excessive hepatic gluconeogenesis |
|
|
Term
| What is the most common and most feared SE of metformin? |
|
Definition
1) most common - Diarrhea, abdominal cramps, gastric upset
2) most feared-lactic acidosis |
|
|
Term
| How do thiazolidinediones primarily work? |
|
Definition
| decrease insulin resistance in muscle and adipose tissue |
|
|
Term
| thiazoliinediones work most effectively in what patients? |
|
Definition
|
|
Term
| What is HHNC, a common feared complication of diabetes, characterized by? |
|
Definition
1) extreme hyperglycemia >600mg/dl
2) serum hyperosmolarity >200 mOsm/L
3) little/no ketosis |
|
|
Term
| What is the most critical treatment of HHNC? |
|
Definition
|
|
Term
| What is the most prominent cause of morbidity and the most frequent cause of mortality in type 2 DM? |
|
Definition
| cardiovascular complications |
|
|
Term
| What are first line meds for HTN in DM type 2 Patients? |
|
Definition
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