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22 Cards in this Set
- Front
- Back
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diagnostic criteria - diabetes mellitus
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FBS >126
2h PG >200 random >200 w/ symptoms HbA1c >6.5% |
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diagnostic criteria - impaired glucose tolerance
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FBS >100 and <126
2h PG >140 and <200 HbA1c 5.7-6.4% |
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type 1 diabetes - pathogenesis
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absence of insulin secretion
autoimmune/idiopathic rapid onset of symptoms require insulin therapy HLA association young/thin patients |
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type 2 diabetes - pathogenesis
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reduced insulin secretion or raised insulin resistance
no antibody/HLA assoc insidious onset of symptoms insulin therapy not required older/obese pts |
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type 2 diabetes - frequent symptoms
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**polyuria, polydipsia, polyphagia
slow onset / asymptomatic weakness/fatigue glycosuria dry, itchy skin visual changes skin/mucous memb infxns |
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type 2 diabetes - risk factors
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>45 y/o
obese 1st degree relative w/ hx physically inactive ethnicity hx of gestational diabetes HTN HDL <35 or TG >250 IFG or IGT hx vascular disease |
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blood sugar < 50
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hypoglycemia -- type 1+2
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absolute insulin deficiency w/ production of large amount of ketones
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DKA -- type 1
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marked elevation of blood sugar (>600) with severe dehydration
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hyperglycemic hyperosmolar state (type 2)
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diabetes - macrovascular complications
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CAD - heart attack
cerebrovascular disease - stroke pvd - amputation |
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diabetes - microvascular complications
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retinopathy - blindness
nephropathy - crf neuropathy |
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HbA1c goal in DM
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<7.0%
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LDL goal in DM
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<100
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BP goal in DM
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<130/80
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HbA1c - glycosylated hemoglobin
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**normal <5.7%
irreversible binding of glucose w/aa on globulin accurate average for 8-12 wks monitor level of control |
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action of sulfonylureas
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increase insulin secretion by binding ro receptors on the surface of pancreatic beta cells, triggering a series of rxns leading to insulin secretion
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action of biguanides
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decrease hepatic glucose production, increase insulin-mediated peripheral glucose update
(metformin) |
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biguanides - contraindications
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**contraindicated in pts w/ impaired renal function
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action of thiazolidinediones
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decrease insulin resistance by making muscle and adipose cells more sensitive to insulin
also suppress hepatic glucose production |
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action of meglitinides
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stimulate insulin secretion in presence of glucose
**similar to sulfonylureas, but are shorter-acting, most effective when taken after meals |
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exenatide (byetta)
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glp-1 analog
indicated for pts w/ t2DM not controlled on sulfonylurea/metformin/tzd |
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liraglutide (victoza)
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glp-1 receptor agonist
t2DM w/ diet and exercise **weight loss |
