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Duke PA Diabetes Mellitus

polydipsia excessive thirst
polyuria excessive urination
early sign of type II DM nocturia
Type II DM has a strong __ genetic predisposition
two things to check each time a diabetic visits the office blood pressure and feet
least common type of diabetes type 1
__% of diabetics are type I 5-10
__% of diabetics are type II 90-95
type I diabetes is caused by __ destruction beta cell
__ can destroy beta cells pancreatitis or autoimmunity
most common type of diabetes type II
patients with __ diabetics have insulin resistance type II
formerly called juvenile onset diabetes type I
formerly called adult onset diabetes type II
women with gestational diabetes can have big babies
women with gestational diabetes have a __% chance of developing type II diabetes 50
Habitual physical inactivity lazy
diabetes risk factors age greater than __ 45
women with polycystic ovary syndrome have increased __ androgen levels
HDL < or = __mg/dl is a diabetes risk factor 35
triglycerides > or = __ is a diabetes risk factor 250
__ ovary syndrome is a diabetes risk factor polycystic
FPG > or = 126 mg/dl diabetes
FPG <126 mg/dl but > or = 110mg/dl pre-diabetes
FPG < 110 mg/dl normal
complications of diabetes stroke, retinopathy, end stage renal disease, heart disease, foot/leg amputation
screen for end stage renal disease with microalbumin
Measures Glucose Levels over 2-3 Month Period HbA1c
Cannont be used to diagnose diabetes HbA1c
don't order an HbA1c after a cardiac bypass
HbA1c will not be accurate in patients with sickle cell disease, hemolytic anemia, certain drugs, recent trasnfusion
suggested glucose range for diabetics before meals __mg/dL 80-120
suggested glucose range for diabetics after meals __mg/dL 100-180
suggested glucose range for diabetics at bedtime __mg/dL 100-140
suggested A1c for people with diabetes __% 7
the only current drug used to treat type I diabetes insulin
2 problems of type II diabetes lack of correct glucose secretion, insulin resistance
best treatment for type II diabetes lifestyle modification
ADA target A1c <__% 7
target bp for diabetics 130/80
target LDL for diabetics < or = __mg/dL 100
target HDL for diabetics > __ mg/dL 35-45
regular insulin is clear
NPH insulin is cloudy
in diabetes get rid of the __ first low sugars
we don't use __ insulin treatment anymore sliding scale
if you use a sliding scale insulin treatment you will let the patient get __ sweet (hyperglycemic)
diabetic ketoacidosis occurs in type __ predominantly I
diabetic ketoacidosis can occur in poorly controlled type __ diabetes II
diabetic ketoacidosis breathing Kussmaul breathing
reasons for DKA infection, cardiac event, skipped medication
what can happen if you overreplace fluid in a child with DKA cerebral edema
in euglycemia DKA treat the acid not the sugar
when shutting off the insulin pump first give a __ bolus of long acting insulin
enteral hypoglycemia treatment 15 gm of carbohydrates
15 grams of carbohydrates = 3 glucotabs, 1/2 cup OJ, 5 lifesavers, 1/2 cup regular soda
parenteral hypoglycemia treatment D50 IV, glucagon 1 mg IM
complications of diabetes atherosclerotic vascular disease, renal disease, neuropathy, retinopathy
FBS of 126 mg/dL is roughly equivalent to an A1c of __% 7
FBS of 126 mg/dL is roughly equivalent to a 2 hour GTT of __ mg/dL 200
created when proinsulin splits into insulin and C-peptide connecting peptide
c-peptide is decreased in __ diabetes type I
c-peptide is increased or normal in __ diabetes type II
Fasting blood glucose: no caloric intake for at least __ hours 8
Timed blood draw after oral load of a specific amount of glucose Oral glucose tolerance testing (OGTT or GTT)
medications that increase glucose diuretics, estrogens, beta blockers, corticosteroids
medications that decrease glucose acetaminophen, alcohol, propanolol, anabolic steroids
3 hour GTT Interpretation-normal fasting < __ mg/dL 95
3 hour GTT Interpretation-normal 1 hour < __ mg/dL 180
3 hour GTT Interpretation-normal 2 hour < __ mg/dL 155
3 hour GTT Interpretation-normal 3 hour < __ mg/dL 140
abnormal 3 hour GTT Interpretation is defined as 2 or more values above reference range
In normal people, 3-6% of hemoglobin is glycosylated in the form __ A1c
gives information about long term glycemic control(previous 8-12 weeks) HbA1c
patients with episodic or chronic hemolysis who have larger proportion of young RBCs might have spuriously low levels of HbA1c
glycated albumin or glycated serum protein fructosamine
Reflects hyperglycemic period within the last few weeks fructosamine
Gives information of short term glycemic control fructosamine
Useful for patients with chronic hemolytic anemias that cause shortened RBC life span fructosamine
urine microalbumin nephropathy
most common complication of DM neuropathy
these are painless due to peripheral neuropathy diabetic foot ulcer
1 out of __ Americans born in the United states in 2000 are at risk for DM 3
Caused by destruction of insulin producing cells Type I DM
Diabetes develops during pregnancy and resolves after pregnancy gestational diabetes
Created by: bwyche