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Cards In This Set
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Diabetes is the leading cause of what 2 things?
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Adult blindness and end stage renal disease
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High risk population for DM2? Intermediate? Low
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High: Native Americans, Pima Indians. Intermediate:Blacks and Hispanics. Low: White.
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Peak age for presenting with DM1?
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14
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Wihtout insulin DM1 pts are prone to develop what?
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Ketoacidosis (lack of insulin and increased release of glucagon) --> increase gluconeogeneis, release of fatty acids, adn oxidation of fatty acids to form ketone bodies. glucagon acceleartes the oxidation of fatty acids by increasing their carnitine-mediated transport into teh mitochondira, where the oxidation occurs
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Earliest detectably abnormality in DM2?
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Hyperinsulinemia without frank hyperglycemia
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In DM2, what can improve sensitivity to insulin?
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Wt loss, exercise, decreased caloric intake
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Hyperglycemia leads to the long-term ___ complications of diabetes. What are the 3?
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Microvascular; retinopathy, nephrophaty, neuropathy
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DM pts are at increased risk for ___ complciations. Give 3
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Macrovascular; coronary artery diseaes, peripheral vascular disease, stroke
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Pts with DM1: how do they present?
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If presenet with diabetic keotacidosis, appear quite ill. complain of nausea, vomiting, adn polyuria.
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How do pts with DM2 present?
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Often asymtpomatic or minially symptomatic. if symptomatic: polyuria, polydipsia, polyphagia, fatigue, or blurred vision.
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A minority of pts present with microvasc or macrovasc complications, like what?
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Peripheral numbness/neuropathy, loss of vision (retinopathy), angina, claudication or impotence (peripheral vasc disease)
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Should also test which pts for DM?
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Pts with poor wound healing or recurrent candidal vaginitis
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Fundoscopic exam for retinopathy: see what in nonproliferative retinopathy?
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Microaneurysms, hard exudates (vascular leakage), soft exduates (ischemic injury), and macular edema
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See what on fundoscopy for proliferative retinopathy?
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Bc of overcompensation for an ischemic retina, get neovascularizatin of the retina or optic disc...can't see well on fundscopy...should dilate pupils and look with slit lamp at least 1x/yr with these pts
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Peripheral neuropathy:
*starts where? *foot ulcers appear where? *another complication is autonomic neuropathy, which presents how? |
*feet then hands
*where there's increased pressure (eg metatarsophalangeal joints) *orthostatic hypotension |
