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Gaznabi DM

Between meals insulin production is ________ minimal
Lack of insulin causes ______ of stored fat in the liver cells to form ________ and _________ inc. the tendency of developing ____________ lipolysis, phospholipids, cholesterol, atherosclerosis
In the mitochondria of the liver cells, fat molecules are further broken down to form ________ which turns into ________ bodies acetoacetic acid, ketone
Insulin promotes protein _____ and inhibits ________ of proteins formation, degredation
What are the gastrointestinal hormones that lead to insulin secretion? Gastrin, CCK, secretin
Which gastric hormone causes insulin release from the beta cells? GIP
What factors increase insulin secretion? Glucagon, Growth hormone, cortisol, parasympathetic stimulation, insulin resistance, obesity, sulfonylurea drugs
What are some factors that decrease insulin secretion Dec. blood glucose, fasting, somatostatin (GH inhibiting hormone)
Patients with _______/_______ have immune mediated type Type 1 Diabetes HLA-DR3/HLA-DR4
What is another gene for genetic risk of Type 1? 5' polymorphic region of insulin gene
Viruses as coxsackie, mumps, rubella, ECV and retrovirus have a strong link to DM-1 due to... Directly destroying beta cells
In type 2 DM why are there no ketones Endogenous insulin is enough to prevent ketoaciddosis
MODY is a ____ insulin dependant diabetes. It is autosomal _________. And the tx is __________ . non, dominant, insulin
In gestational diabetes, inc ______ leads to insulin ________ requirement, resistance
What are the endocrine tumors that can cause hyperglycemia due to tissue insensiticiy? Acromegaly, Cushing syndrome, Pheochromocytoma
What are some Agents that cause hyperglycemia due to tissue insensiticiy? Corticosteroids, sympathomimetic drugs, niacin
What dzs cause hyperglycemia due to tissue insensiticiy? Cirrohsis, hemachromatosis
What is an adipose tissue d/o that causes hyperglycemia due to tissue insensiticiy? lypodystrophy, truncal obesity
What hormonal tumors cause hyperglycemia due to reduced insulin secretion? Somastinomas, pheochromacytomas
What pancreatic disorder cause hyperglycemia due to reduced insulin secretion? Pancreatitis, hemachromatosis
WHich agents cause reduced insulin secretion? THiazide, phenytoin, pentamidine
What are the major signs and symptoms of Type 1 diabetes? Osmotic diuresis (2nd to hyperglycemia), thirst (due to hyperosmolar state), blurred vision, wt loss w/ loss of apetite, symptoms of postural hypotension, paresthesia and neuropathies (reversible), ketoacidosis
At what level does the serum osmolality rise to when mental status is noted above 330
In Type 2 diabetics, since the pt may be asymptomatic, what is detected in teh urine glucose
What are other signs of DM 2 polydipsia, polyuria, chronic skin infections, candida/vulvovaginits, big baies, milkd HTN,
What are the numbers for fasting BG >126 two times, diabetc
What are the nubers for oral GTT? >200 diabetes
Afasting level of 100-125 or 2 hr GTT of 140-199 means impaired glucose tolerance
What is normal HGB A1C <5.7%
If repeat A1C is > 6.5% we treat for biabetes bc retinopathy begins shortly after 6.5%
HGB A1c btw 5.7-6.4% are considered high risk
What is the secondary test after A1C Fructosamine (1-2 weeks preceding
In DM pts, cholesterol should be limited to ? 300
T/F Infection leads to insulin resistance? T
What are late clinical manis of DM? Involvement of small and large BC's, lens of eye, peripheral nerves and skin
What are some late clinical manis specifically HTN, nephropathy, diabetic retinopathy, glaucoma, Autonomic and peripheral neuropathy (gastroparesis), MI, CVS, amputation of lower extremities, DKA, HHS, Lactic Acidosis
When should pts with type 2 be referred to opthamologist? Type 1? 2: at time of diagnosis 1: 5 years after dx
DKA is noted to have _______ pain, HHS does not abdoimnal
Metabolic syndrome is 3 or more of the following: Central obesity, INsulin resistant diabetes, INc. TG's, Inc. BP, Low HDL, Fasting plasma glucose >100
Metformin helps reduce _______ hyperglycemia
TZD increases insulin ________, improves insulin mediated glucose uptake in muscle and adipose tissue sensitivity
Created by: naroby