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11 Cards in this Set

  • Front
  • Back
When does loss of insulin secretion become clinically significant in type 1 DM?
after 90% of Beta-cell function has been destroyed
-catabolic state develops
-decreases peripheral glucose utilization & increases hepatic glucose production by gluconeogenesis & glycogenolysis
-hyperglycemia results
What causes Diabetic Ketoacidosis?
when insulin deficiency is severe & ketones are produced in significant quantities & the bloods native buffering capacity is overwhelmed
-hyperglycemia, dehydration, metabolic ketoacidosis, & lethargy
What is the most severe complication of DKA management?
Cerebral edema
What is the main risk factor for developing type 1 DM?
family history

presence of HLA-DR3 & DR4
What are the symptoms of DKA?
Moderate to profound Dehydration

Polydipsia = excessive thirst
Confusion or Comatose

Physical Exam
-Hyperpnea = Deep, rapid respiration
-Fruity odor on breath
What physical exam signs point to Cerebral Edema in DKA?
1. changing mental status
2. unequal pupils
3. decorticate or decerebrate posturing = Stiff, rigid posture
4. Seizures
What is the differential diagnosis in DKA?
Secondary Diabetes from:
1. excess Glucocorticoids (Cushing syndrome or Iatrogenic)
2. Hyperthyroidism
3. Pheochromocytoma
4. GH excess
5. Medications such as thiazide diuretics
What is the pathogenesis of type 2 DM?
Insulin resistance that initially causes a compensatory increase in insulin secretion; however, with time there is a progressive decline in the glucose-stimulated insulin secretion
What is usually seen on physical examination in children with type 2 DM?
BMI > 30 kg/m2
What skin condition is often associated with type 2 DM?
Acanthosis nigricans = hyperpigmentation & thickening of the skin folds, found primarily on the back of the neck & flexor areas
What patient history is consistent with type 1 DM?
1. Weight loss
2. Polydipsia = excessive thirst
3. Polyphagia = excessive hunger/eating
4. Polyuria