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31 Cards in this Set
- Front
- Back
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What is the laboratory criteria for Diagnosing diabetes mellitus in adults
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FBS >125 on 2 occations or random BS >200 with characteristic sxs
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Define type 1 DM
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insulin deficient. typically abrupt onset, mostly chinldren and teens, possibly autoimmune, islet autoantibodies frequent
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Define type 2 DM
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insulin resistant. Abn B-cell response. Typically adult onset, fam hx, obese
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What other diseases are often associated with type 2 DM
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HTN, dyslipidemia, atherosclerosis
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What DM is associated with polyuria and thirst
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both
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What DM is associated with weakness or fatigue
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both
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What DM is associated with polyphagia and weight loss?
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Type 1
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What DM is associated with recurrent blurred vision
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both
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What Dm is associated with vulvovaginitis or pruritus
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both
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What DM is associated with peripheral neuropathy
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both
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What DM is associated with nocturnal enuresis
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Type 1
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What DM is often asymptomatic
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Type 2
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Briefly describe the role that autoimmunity plays in the causation of DM
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Most have antibodies to islets measureable with serum testing, vigorous response against altered pancreatic B cell
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Briefly describe the genetic inheritance in the roll of causation of DM
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certain HLAs are strongly associated w/type 1. Tissue insensitivity to insulin noted in DM2, including genetic factor aggrevated by diet, weight, etc.
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Briefly describe the role of insulin resistance in the causation of DM
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insulin antibodies bind to insulin and contribute to resistance.
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What are 2 major consequences of uncontrolled DM
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diabetic ketoacidosis DKA, and nonketotic hyperglycemic-hyperosmolar coma
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When might you see diabetic ketoacidosis (DKA)
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type 1, or resulting from increased insulin requirement during infection, trauma, MI, or surgery.
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What might cause nonketotic hyperglycemic-hyperosmolar coma
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severe hyperglycemia in absence of significant ketosis w/hyperosmolarity and dehydration. Occurs in mild or occult DM, pt's at lease middle-age to elderly
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What are the symptoms of DKA
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polyuria, polydipsia, fatigue, NV, mental stupor, rapid deep breathing, fruity breath, phyotension, tachycardia, abd px
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What are symptoms of hyperglycemic-hyperosmolar state / coma
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over days or weeks, weakness, polyuria, polydipsia, dehydration, inappropriate lack of thirst, nausea, lethargy, confusion, conculsions and deep coma without Kussmaul respirations
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Describe symptoms of hypoglycemia
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mental confusion, bizarre behavior, tachycardia, palpitations, sweating, tremulousness, coma
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What are some of the most common causes of hypoglycemia
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insulin without meals or excess exercise, hypopituitarism, Addison's disease, myxedema
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What are major chronic complications of DM
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HTN, renal failure, blindness, neuropathy, amputations, MI, CVA
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What DM characteristic findings may occur in the eyes
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diabetic cataracts, retinopathy, glaucoma
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What DM characteristic findings may occur in the kidneys
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diabetic nephropathy, micro9albuminuria
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What DM characteristic findings may occur in nerve tissue
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neuropathy, distal symmetric polyneuropathy, isolated peripheral neuropathy, autonomic neuropathy, erectile dysfunction
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What DM characteristic findings may occur in the heart
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heart disease, peripheral vascular disease
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What DM characteristic findings may occur in the skin and mucous memberane complications
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gangrene of the feet, necrobiosis lipoidica diabeticorum
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What should be included in the treatment plan for DM pt's
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diet, weight reduction, exercise, medications (insulin / oral agents), self-monitoring of BS, glycosylated hemoglobin assay (HBA1c)
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How should gestational DM be managed
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Insulin (oral agents contraindicated), weight reduction not advised, self monitoring, diet, exercise
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DIABETES: ADULT MED
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DIABETES: ADULT MED
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