Term
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Definition
- Impaired fasting glucose – even just 101
- Impaired glucose tolerance
- Type I diabetes
- Type II diabetes
- LADA (latent autoimmune diabetes in adult |
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Term
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Definition
- Asymptomatic or nonspecific
- 3 P’s (polyuria, polydipsia, polyphagia), by then the sugar is terrible like 300s 400s
- Acute complications :DKA (type 1 uncontrolled)
- Chronic complications: Nephropathy, Retinopathy, Neuropathy
- CVS |
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Term
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Definition
1. Symptoms + random glucose >200
2. FBS > 126 or random glucose > 200 on two separate occasions
3. 2 hour plasma glucose >200 after 75g of glucose load (Oral glucose tolerance test)
4. HbA1C > 6 |
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Term
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Definition
| polyuria, polydypsia, polyphagia |
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Term
| Impaired glucose tolerance |
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Definition
| 2 hour plasma glucose = 140 to 199 during OGTT |
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Term
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Definition
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Term
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Definition
| - every 2 yrs starting at 10 or onset of puberty |
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Term
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Definition
- YEARLY for DM nephropathy
NOT UA |
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Term
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Definition
- start 5 yrs after diagnosis of type I, then every year
- initial diagnosis of type II |
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Term
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Definition
annually
- microfilament test |
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Term
| monitoring control of diabetes |
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Definition
- Intensive blood glucose monitoring
- Glycosylated hemoglobin (HbA1c) |
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Term
| Blood glucose control goals |
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Definition
Acceptable Ideal
Fasting 60-130 70-100
Preprandial 60-130 70-100
Postprandial <200 <160
3 A.M. > 65 >65 |
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Term
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Definition
- Estimate of mean BG over previous 2-3 months
- Recent 30 days responsible for 50% of observed HbA1c level |
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Term
| If suspect falsely low or high, what do? |
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Definition
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Term
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Definition
- weight loss and exercise
- control blood glucose
- avoid hypoglycemia
- HbA1c<7% or 6.5 (younger)
- HbA1c 8& if elderly or life expectancy < 5 yrs |
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Term
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Definition
- Mainly type I
- 3 Ps, N/V, abdominal pain, fatigue, blurring vision, obtundation, coma
- Glucose >250
- Low CO2 (<15mEq/L)
- PH < 7.3
- Complicated by cerebral edema, shock |
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Term
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Definition
- Mainly Type II
- Precipitated by infection, stroke, MI
- In setting where fluid intake is limited (elderly)
- 3Ps, blurred vision, obtundation, shock
- Hyperglycemia >600, serum osm >320, pH >7.3 |
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Term
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Definition
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Term
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Definition
| CVS, retinopathy, nephropathy, retinopathy, neuropathy |
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Term
| Late complications of DM: CVS |
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Definition
| CAD, Stroke, PAD, silent MI |
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Term
| Late complications of DM: Retinopathy |
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Definition
Simple (wool spots, exudate)
Vs
Proliferative (new vessels, scarring, hemorrhage, retinal detachment) - this means they have pretty severe end stage new vessels that can lead to blindness |
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Term
| Late complications of DM: Nephropathy |
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Definition
silent at onset, microalbuminuria (30-300mg/d), >550mg/d, macroproteinuria (dipstick positive)
Predict CVS mortality
GFR falls 1ml/min per month once macroproteinuria |
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Term
| Late complications of DM: Neuropathy |
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Definition
- peripheral polyneuropathy (numbness, paresthesias, pain)
- Charcot joints ( loss of proprioceptive fibers leads to abnormalities of gait)
- Mononeuropathy (wrist drop, foot drop, CN 3rd, 4th, 6th nerve paralysis)
- Autonomic neuropathy
- DM foot ulcers |
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Term
| ********Who is metformin contraindicated in? |
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Definition
| older than 80 or CR >1.5 in male and CR >1.4 in female |
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Term
| #1 choice for type II diabetes |
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Definition
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Term
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Definition
- DON’T GIVE IN older than 80 or CR >1.5 in male and CR >1.4 in female
- SE: GI, minimal risk of lactic acidosis
- No weight gain! |
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Term
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Definition
- SECOND LINE for type II
- Glipizide (Glucotrol), Glyburide (Diabeta, Micronase), Glimepiride (Amaryl)
- Stimulate insulin production from beta cells
- Cause hypoglycemia, weight gain |
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Term
| Disaccharidase inhibitors |
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Definition
(Acarbose – Precose, Miglitol – Glyset)
- slowing absorption of monosaccharides in intestine
- SE: FLATULENCE, abdominal discomfort, diarrhea
- Beneficial in elderly w/ constipation and postprandial hyperglycemia |
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