Term
| What are the common symptoms of Diabetes |
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Definition
Polydipsia
Polyuria
Polyphagia
Blurred Vision |
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Term
| What is the diagnostic criterea of Diabetes and Pre-diabetes |
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Definition
Diabetes
Fasting Glucose >126 with second confirmation
Random Glucose >200 with symptoms
Glucose >200 Glucose Tolerance Test
Pre-Diabetes
Fasting Glucose 100-125
Glucose 140-199 Glucose Tolerance Test |
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Term
| What are some common characteristics of the two major types of Diabetes |
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Definition
Type 1: HLA Association, DKA, Younger
Type II: High Concordance, HHNK, Older/Intraabdominal Obesity, Family History |
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Term
| What is the most likely cause of diabetes type 1 |
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Definition
| Autoimmune disease set off by an environmental factor in an immunosuseptible individual |
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Term
| What is the pathogenesis of Type II diabetes |
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Definition
Intraabdominal Fat Secretes factors that may impair insulin sensitivity
ROS's, AGE's, Incretin Deficiency-> Beta loss/dysfunction
Glucagon increase and Incretin deficiency-> increased liver glucose production
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Term
| How do you screen a pregnant woman for gestational diabetes? |
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Definition
Glucose >140 Post-50 gm Oral Glucose
Then 3 Hr OGTT (2 Positive=Diagnosis)
Fasting>95
1 hr >180
2 hr >155
3 hr >140 |
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Term
| What is a common complication in Post-partem Gestational diabetic patients |
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Definition
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Term
| What are some unusual causes of Diabetes |
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Definition
Pancreatic
LADA
MODY
Autosomal Dominant (signaling disruption) |
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Term
| What are the acute and chronic complications of diabetes |
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Definition
Acute: Ketoacidosis, HHNK caused by infections or non-compliance
Chronic: Macrovascular: Stoke, Heart Disease
Microvascular: Blindness(Proliferative and Non-proliferative), Kidney disease, Nerve damage/Amputation(Typically start distally) |
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Term
| What is the most effective treatment in Pre-diabetes |
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Definition
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Term
| What are the goals for glucose control in a diabetic |
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Definition
fasting 90-130
Postprandial <180
A1C <7% |
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Term
| what are the potential problems with using A1C as a dianosis for diabetes |
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Definition
Flase(+) Anemias/Thalassemias
False(-) Hemolysis, Blood Loss, Anemia Rx
Doesn't show acute rises |
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Term
| What does the evidence suggest about the effectiveness of diabetes treatment in reducing complications |
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Definition
| Reduces Microvascular complications, but macrovascular complications are inconclusive |
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Term
| When is insulin used to treat diabetes? |
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Definition
Type 1
Symptomatic
Oral Med failure
Hospitalized for high glucose
Pregnant women
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Term
| What is the mechanism of action of Metformin and when is it contraindicated |
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Definition
Reduces the genesis of glucose by the liver
Risk of Lactic Acidosis, CHF or Renal Failure |
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Term
| What is the mechanism of Sulfonylureas and Meglitinides |
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Definition
| Stimulate insulin secretion from beta cells |
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Term
| What is the mechanism of action of Alpha Glucosidase Inhibitors and their side effects |
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Definition
Decrease intestinal absorption of Glucose
Sides: (GI Signs)Flatulence, diarrhea, Ab Pain |
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Term
| What is the mechanism of action of Thiazolidenediones and when is it contraindicated |
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Definition
Insulin Sensitizers for peripheral tissues
Contra: CHF and Liver Disease bc of Fluid retention |
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Term
| What are the GLP analogs, when are they used and what are their problems, what is their mechanism of action? |
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Definition
Exenatide, Liraglutide
Oral med failure
GI problems with overeating
Mechanisms: Decrease High Glucagon, Slow Emptying, Sensitize Beta cells |
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Term
| What is the main difference between the GLP 1 analog(Exenatide) and Amylin(pramlinitide) analogs |
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Definition
| Amylin analogs do not sensitize beta cells |
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Term
| What are the DPP 4 Inhibitors, what is their mechanism |
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Definition
Saxagliptin, Sitagliptin
Increase levels of GLP 1 and GIP by inhibiting their degradation |
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Term
| What glucose level is considered hypoglycemia and how is it treated |
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Definition
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