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2013-02-24 19:08:25

Show Answers:

  1. What is the different between Type 1 and type 2
    type 1 is no insulin production, younger age of development, DKA (hypergly, <PH, >anion gap). 

    Type 2 insulin resistence, obesity, behavioral, Hyperosmolar hypergycem, older development, more complication
  2. What are the way to DX
    >126 fasting venous plasma 2 different occassions

    >200 OGTT (75) 2-hour

    HGBa1c >6.5

    Random glucose >200 with symptoms of hyperglycemia
  3. What is impaired fasting glucose
    fasting venous value 100-125
  4. What polyuria, polydipsia, polyphagia
    Classic triad of hyperglycemia
  5. What is the ADA recommendation for BS
    90-130 and less than 180 postprandial
  6. How often for HGBa1c
    • Every 6months if BS controlled
    • Every 3 months if uncontrolled or change in therapy
  7. What is IGT
    • Impaired glucose tolerance is
    • 140-199 after 2 hour OGTT
  8. Blood pressure goal of DM
  9. DKA
    • BS 400-800
    • High anion gap (higher=severity)
    • >serum ketone bodies
  10. Treatment DKA
    • Fluid replacement (fluid loss 4-10L)=give NS the 1/2 NS
    • Electro
    • insulin for reversal of ketogensis (IV infusion bolus of 10-15 units) 0.1U/KG/HR=when BS reaches 250 <0.05u/kg/hr
    • Plasma glucose hrly
    • Normal decrease of 50/75 mg/hr is normal.  > is concerning.
  11. what causes DKA
    NO insulin so body breaks down fatty acid and increase ketone resulting in metabolic acidosis
  12. How is electrolyte effected
    • K due to acidosis = extracellular shift
    • Hyperkalemia

    Insulin will reverse this and cause hypokalemia

    hypophosphatemia is common during acidosis=phospate infusion not required
  13. Which antidiabetic does not cause weigt gain or hypoglycemia
    Biguannides (metformin)
  14. Which antidiabetic is FDA approved for dm2 prevent
  15. insulinomas
    Elevation of insulin an c-peptide during fast
  16. Whipple triad
    Symptoms of (adregenic or neuroglycopenia) + Hypogylcemia+rapid recovery of BS with replacement.
  17. Hyperosmolar hyperglycemia treatment
    Fluid only
  18. Fasting Hypoglycemia
    mostly common caused by iratrogenic cause.  Insulin and sulfonylureas most common medications
  19. Clinical manfestation of severve (45) hypoglycemia
    Catecholamine (tremor, sweating, palpations)

    neuroglycopenia (confusion, irritability, H/A, seizure)
  20. C-peptide is
    a inactive cleavage fragment of proinsulin in same amount as insulin.
  21. Facitious hypoglycemia
    • inappropriate insulin use causing hypoglycemia. 
    • dx by low c-peptid level and high lvl of circulating insulin. 

    Urune level of sulfonylurea