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42 Cards in this Set

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What is the diagnosis for Diabetes Mellitus?
-More than one fasting glucose level greater or equal to 126.
-Plasma glucose level in the 2nd hr of the standard oral glucose tolerance test (OGTT) is greater or equal to 200, confirmed on subsequent day
-random plasma glucose level greater than 200, confirmed with classic symptoms of polyuria, polydipsia, and polyphagia
Normal fasting glucose level is _________ in the morning
less than 110
Impaired fasting glucose (IFG) is ________
110-126
Impaired glucose tolerance (IGT) is _________
140-200
What is the oral glucose tolerance test?
administration of a 75g oral glucose load after a 10hr fast followed by measurement of plasma glucose 2hrs later
What is glycosylated hemoglobin?
how much glucose a blood cell will be exposed to in 120 days
What % is normal glycosylated hemoglobin?
6% or less
What % is a diabetic glycosylated hemoglobin?
7% or more
What was type 1 diabetes called?
insulin dependent diabetes
What is the % of type I in the western world?
10%
What are the causes of type I?
genetic and environmental
How many % have a first degree relative with type I?
10-13%
Type I is immune related which means...
auto-antibodies against inulin have been noted in many cases
Type I is characterized by a lack of _______ and a relative excess of _______
lack of insulin and excess of glucose
Who is most commonly diagnosed with type I?
whites younger than 30yrs
What is the classic symptom of type I?
weight loss
What are the symptoms associated with type I?
hyperglycemia
loss of glucose in urine
polyuria
polydipsia
Is ketoacidosis in type I or type II?
type I
what is ketoacidosis?
increased glucose and ketones and makes breath smell fruity and sweet
What does insulin do in type I?
reduces the blood glucose level
What are the types of insulin?
rapid (regular) insulin- fast acting
NPH-intermediate active insulin- takes longer
long acting insulin- day long (ex: glargene)
Is type I or type II more common?
type II
What is the % of obese in type II?
60-80%
The most powerful risk factor for type II is...
obesity
Type II has _____ resistance with ____________ secretion
Type II has insulin resistance with inadequate insulin secretion
Who does type II generally affect?
those older than 30yrs
Those with type II are often...
overweight, dyslipidemic (high cholesterol), and hypertensive
What is the cause of type II?
genetic susceptibility triggered by environmental factors
What does sulfonylureas do?
stimulates insulin release from pancreatic beta cells
What does thiazolidinedrones do?
increases insulin sensitivity, particularly in adipose tissue
What are the acute complications of DM?
hypoglycemia
diabetic ketoacidosis
What is hypoglycemia?
low blood sugar
What are the numbers for hypoglycemia in infants and adults?
infants- below 35
adults- below 45-60
When does diabetic ketoacidosis develop?
when there is an absolute or relative deficiency of insulin and an increase in insulin counteregulatory hormones: catecholamines, cortisol, glucagon, and growth hormone
Which type does diabetic ketoacidosis usually occur with?
type I
What are the four chronic complications of DM?
diabetic neuropathies
micro-vascular disease
macro-vascular disease
infection
What is micro-vascular diasease?
thickening of capillaries in extremities, retna of eye and kidneys
What accompanies micro-vascular disease?
retinopathy- retna ascempia
diabetic nephropathy- destruction of kidneys due to damage of glumaria
What accompanies macro-vascular disease?
coronary arterty disease
stroke
peripheral vascular disease
what is macro-vascular disease?
athrosclerosis, thickening of arteries
Macro-vascular disease is most common with which type?
type II
what is peripheral vascular disease?
increase incidence of ganglian