Shared Flashcard Set

Details

DM Type 1 and 2
FM 2 EOC 2
51
Health Care
Graduate
08/22/2009

Additional Health Care Flashcards

 


 

Cards

Term
In this type of DM, the beta-islet cells DO NOT produce insulin
Definition
type 1
Term
fat used for metabolism causes a build-up of
Definition

ketones--> ketoacidosis

** mostly only found in type 1

Term
when more ketones are produced than can be cleared in the urine what results
Definition
ketoacidosis (metabolic acidosis)
Term
excess of glucose in the urine causes what sx of DM
Definition
polyuria
Term
clinical definition of DM
Definition

1. random plasma glucose >200 + sx

2. overnight fasting BGL > 126 on at least 2 occassions

Term

immune-mediated antibodies against B-cells

follows infx or toxic exposure

Definition

DM1 type 1A

norther europeans

Term
idiopathic type DM, w/o antibodies
Definition

DM1 type 1B

asian or africans

Term
peak incidence for DM1
Definition
preschool/adolescence
Term
tx of DM1
Definition
exogenous insulin
Term
OGTT requires what for dx of DM2
Definition

BGL > 200,

2 hrs after 75 g of oral glucose given

Term
Non-obese pt w/ blunted early phase insulin release is seen in what type of DM2
Definition
DM2 type 2A
Term
tx for DM2 type 2A
Definition
diet, insulin, and oral hypoglycemic agents
Term
what is not a factor in DM2 type 2A pts
Definition
peripheral insulin resistance
Term
insensitivity to endogenous insulin.  starts as hyperplasia of B-cells with exaggerated insulin response --> B-cells that can't produce enough insulin
Definition

DM2 type 2B

pts w/ visceral abdominal obesity!

Term
peak incidence of DM2
Definition
> 40 yoa but trend is showing in younger age groups d/t childhood obesity increase
Term
subgroup of NIDDM d/t autosomal dominate genetic expression; hyperglycemia d/t impaired insulin response of B-cells to glucose
Definition
MODY
Term
peak incidence of MODY
Definition
25 yoa or younger
Term
most common type of MODY
Definition

type 3 (total 6 types)

accounts for 2/3 of all cases

Term
tx of MODY
Definition
diet, insulin, oral hypoglycemics
Term
MELAS syndrome assoc w/ what type of DM
Definition
DM w/ mutation on mitochondrial DNA
Term
DM w/ Wolfram sx has what components
Definition

DIDMOAD:

diabetes insipidus

diabetes mellitus

optic atrophy

deafness

Term
when is the OGTT test done?
Definition

when the Fasting plasma glucose levels are < 126 but pt has other risk factors/sx

 

***NOT NEEDED IF FPG levels are > 126 on 2+ occasions!

Term
normal glucose levels
Definition
< 110
Term
impaired fastin glucose levels
Definition
110-125
Term
HbA1c should be done how often in diabetic pts
Definition
q 3 mos
Term
dyslipidemia in DM1 pts
Definition

slight incr in LDL

 

 

**corrected w/ insulin**

Term
dyslipidemia in DM 2 pts--> d/t insulin resistance
Definition

incr in LDL, low HDL, and high TG

 

--> incr in atherosclerosis!!!

Term
initial tx of DM1
Definition

insulin replacement w/ FPG levels of 90-130

1 hr postprandial 150

A1c w/i 1% upper normal limit

Term
initial tx of DM2 obese
Definition

weight reduction and oral hypoglycemics

METFORMIN 1st! --> add glitazone/sulfonylurea if needed

Term
initial tx of DM 2 non-obese
Definition

diet tx and oral hypoglycemics

SULFONYLUREA 1st!!!--> add metformin/glitazone if needed

Term
sx of hypoglycemia may be blunted in pts on what meds
Definition
B-blockers
Term
tx of hypoglycemia
Definition

glucose tabs, and glucagon

(orange juice works!)

Term
which type of DM has higher incidence of ESRD and retinopathy
Definition
type 1 d/t longer duration
Term
which type of DM has > macrovascular dz and incr risk of MI
Definition
DM2
Term
initial manifestation of diabetic nephropathy
Definition

proteinuria

--> incr levels of creatinine and urea

Term
when should you stop ACE-I in diabetic pts
Definition

with hyperkalemia, or incr serum CR!

 

needs kidney transplant!

Term
how often should an eye exam be performed on DM pt
Definition
annually!
Term
how often should a foot exam be performed on a DM pt
Definition
every visit!
Term
what meds are CI in pts w/ ischemic foot ulcers
Definition
B-blockers
Term
most common CHRONIC complication of DM
Definition
diabetic NEUROPATHY
Term
most common type of peripheral neuropathy
Definition
distal symmetrical polyneuropathy
Term
stocking glove pattern, bilateral and symmetrical, more in LE--> long term leads to silent fx or charcot's joint
Definition
distal symmetrical polyneuropathy
Term
vascular ischemia or trauma w/ sudden onset in 1 or more nn. usually motor and resolves in 6-12 wks
Definition
isolated peripheral neuropathy
Term
hypersensitivity to touch. often at night
Definition
painful diabetic neuropathy
Term
how is painful diabetic neuropathy tx
Definition

amitriptyline --> better in 72 hrs

also gabapentin and capsaician cream

Term
gastroparesis, urinary retention, constipation/diarrhea, decr CV response to valsalva maneuver
Definition
autonomic neuropathy
Term
what may be the first manifestation of DM type 1
Definition
ketoacidsis
Term
rapid acting insulin
Definition
lispro
Term
short acting insulin
Definition
novolin, humulin
Term
intermediate acting insulin
Definition
NPH
Term
long acting insulin
Definition
glargine
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