Clinical S/Sx
o T1DM- abrupt, although insulin secretion decline begins long before the symptoms
develop.
Classic manifestations (new onset):
Polydipsia
Polyuria
Wt loss
Hyperglycemia
Ketonemia or ketonuria
DKA = classic s/sx + fruity-smelling breath + drowsiness/lethargy + vomiting
Silent (asymptomatic) incidental discovery
o T2DM
Polydipsia
Polyuria
Hyperglycemia
Risk Fx and Associated complications
o T1DM
Genetic
abnormalities at six genetic loci
mutation of the hepatic transcription factor (HNFP-1 alpha) on
chromosome 12
defective glucokinase molecule on chromosome 7p
Autoimmune- destruction of islet cells -> beta cells destruction
Environmental- toxins, food antigen, viral infection
Race- idiopathic T1DM is common among African American or Asian American.
o T2DM
Obesity
Race- native americans, Asian americans, latinos, pacific islanders, african
americans
Sedentary lifestyle
Hypertension
Dyslipidemia
Family hx- 15% if both parents have T2DM
Gestational hx
Age
Genetics- have strong influence- chromosome arm 7q – insulin resistance
o COMPLICATIONS (all types):
Microvascular
Eyes, heart, kidneys, nervous system
Retinopathy with potential loss of vision
Nephropathy leading to renal failure
, Peripheral neuropathy with risk of:
o Foot ulcers
o Amputation
o Charcot’s joint
Autonomic neuropathy with:
o GI, GU, CV s/sx
o sexual dysfunction may occur.
Macrovascular
Atherosclerotic conditions which increases the risk of HTN,
abnormalities in lipid metabolism, abnormalities of platelet function,
and periodontal disease:
o Cardiovascular
o Peripheral vascular
o Cerebrovascular
Diagnostic Criteria
o Pre-diabetes
BG too high to be considered normal BUT does not meet criteria for DM
Impaired glucose tolerance (IGT) or Impaired fasting glucose (IFG)
IFG 100-125 mg/dL
IGT 140-199 mg/dL
HbA1c 5.7% - 6.4%
At risk for diabetes and CVDs and may have insulin-resistance syndrome
o T1DM and T2DM
4 tests used:
Acute symptoms of DM + casual plasma glucose ≥ 200mg/dL
Fasting plasma glucose (FPG) >126 mg/dL- most reliable
2-h post-load plasma glucose in an oral glucose tolerance test ≥
200mg/dL
HbA1c ≥ 6.5%
Tests should be:
confirmed on a subsequent day, unless (+) overt clinical s/sx
preferrable to confirm with the same test OR one that is considered
more predictive
If a repeated test is below the diagnostic criteria -> REPEAT TEST in 3-
6months.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Welch1. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.49. You're not tied to anything after your purchase.
