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24 Cards in this Set

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  • 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

What causes DM?

1. Beta cells destroyed by autoimmune attack


2. Genetic predisposition of MHC gene

What is diabetes insipid us?

1. Result of an ADH deficiency


2. Ssx-- inability of kidneys to resorb water

What are the ssx of DM?

1. Blurry vision


2 Hunger/excessive eating


3. Excessive urination


4. Excessive thirst


5. Fatigue

What characterizes DM II?

1. Peripheral insulin resistance


2. Impaired insulin secretion

What can lead to an increased risk to develop type II DM?

1. IGT

What organ systems are primarily affected by DM?

1. Blood vessels in eyes, kidneys, heart, and nervous system

What are the macrovascular complications of DM?

1. Heart attack


2. Stroke

What are the microvascular complications of DM?

1. Retinopathy


2. Nephropathy


3. Neuropathy-- amputations, impotence

What is the hallmark feature of DM?

1. Hyperglycemia--


2. Insulin dependent tissues do not remove glucose

What hormone predominates in type I DM?

1. Glucagon

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


What leads to ketoacidosis in DM?

1. Increased FFAs in the blood due to uncontrolled lipolysis---

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

In what type of DM is ketoacidosis rare?

1. DM II

What are the 4 major chronic complications of DM?

1. Atherosclerosis


2. Retinopathy


3. Nephropathy


4. Peripheral neuropathy

What is responsible for retinopathy and nephropathy in DM? Where does this accumulate?

1. AGE


2. Accumulates in ECM and within cells

What causes HbA1 to become glycosylated to HbA1c?

1. 1-amino-1-deoxyketose bound to N-terminus of B-globin

What leads to cataracts in DM?

1. Accumulation of sorbitol due to polyol accumulation


2. Leads to osmotic swelling


3. Leads to cataracts

What is the major organ through which glucose is disseminated throughout the body?

1. Muscle

What is the consequence of polyol accumulation on neural tissue?

1. Leads to defect in myo-inositol metabolism


2. Leads to neuropathy

How do you tx type I DM?

1. Insulin


2. Tight insulin control decreases long-term complications

How do you tx type II DM?

1. Diet, exercise


2. Oral hypoglycemic drugs


3. Insulin

How do you tx IGT?

1. Diet and exercise