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24 Cards in this Set
- Front
- Back
How do you dx DM? |
1. Fasting blood glucose-- >126 mg/dL 2. Random blood glucose-- >200 mg/dL- 2 time points during OGTT 3. HbA1c-- >6.5 |
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What causes DM? |
1. Beta cells destroyed by autoimmune attack 2. Genetic predisposition of MHC gene |
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What is diabetes insipid us? |
1. Result of an ADH deficiency 2. Ssx-- inability of kidneys to resorb water |
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What are the ssx of DM? |
1. Blurry vision 2 Hunger/excessive eating 3. Excessive urination 4. Excessive thirst 5. Fatigue |
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What characterizes DM II? |
1. Peripheral insulin resistance 2. Impaired insulin secretion |
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What can lead to an increased risk to develop type II DM? |
1. IGT |
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What organ systems are primarily affected by DM? |
1. Blood vessels in eyes, kidneys, heart, and nervous system |
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What are the macrovascular complications of DM? |
1. Heart attack 2. Stroke |
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What are the microvascular complications of DM? |
1. Retinopathy 2. Nephropathy 3. Neuropathy-- amputations, impotence |
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What is the hallmark feature of DM? |
1. Hyperglycemia-- 2. Insulin dependent tissues do not remove glucose |
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What hormone predominates in type I DM? |
1. Glucagon |
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What happens in the liver in type I DM? |
1. Liver remains glycogenolytic and gluconeogenic 2. Uptake of lipids by muscle and fat is decreased 3. Uncontrolled lipolysis-- FFAs and other lipids in blood
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What leads to ketoacidosis in DM? |
1. Increased FFAs in the blood due to uncontrolled lipolysis--- |
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What occurs in the liver during DM II? |
1. Decreased uptake of lipids by muscle and fat 2. Hyperlipidemia due to decreased fat uptake and increased synthesis by liver |
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In what type of DM is ketoacidosis rare? |
1. DM II |
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What are the 4 major chronic complications of DM? |
1. Atherosclerosis 2. Retinopathy 3. Nephropathy 4. Peripheral neuropathy |
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What is responsible for retinopathy and nephropathy in DM? Where does this accumulate? |
1. AGE 2. Accumulates in ECM and within cells |
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What causes HbA1 to become glycosylated to HbA1c? |
1. 1-amino-1-deoxyketose bound to N-terminus of B-globin |
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What leads to cataracts in DM? |
1. Accumulation of sorbitol due to polyol accumulation 2. Leads to osmotic swelling 3. Leads to cataracts |
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What is the major organ through which glucose is disseminated throughout the body? |
1. Muscle |
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What is the consequence of polyol accumulation on neural tissue? |
1. Leads to defect in myo-inositol metabolism 2. Leads to neuropathy |
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How do you tx type I DM? |
1. Insulin 2. Tight insulin control decreases long-term complications |
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How do you tx type II DM? |
1. Diet, exercise 2. Oral hypoglycemic drugs 3. Insulin |
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How do you tx IGT? |
1. Diet and exercise |