DM2

Created by

Sara Fuad

Cards (13)

Classic symptoms of hyperglycemia
Polyuria
Polydipsia
Nocturia
Weight loss (weight loss is prominent in type 1, infrequent in type 2)
Polyuria
Due to osmotic diuresis that occurs when blood glucose levels exceed the renal tubular resorptive capacity (the renal threshold)
Fluid and electrolyte losses
Stimulate thirst
Weight loss
Caused by fluid depletion and breakdown of fat and muscle secondary to insulin deficiency
Other symptoms
Visual blurring
Genital thrush
Lethargy
Skin sepsis
Frequent candida infections
May present with complications, ex: retinopathy
Other causes of diabetes
Gestational diabetes
Drugs: steroids, anti-HIV drugs, antipsychotics, thiazides
Pancreatic: pancreatitis, surgery, trauma, cancer, hemochromatosis, CF
Endocrine disorders (Cushing, acromegaly, pheochromocytoma, hyperthyroidism)
Genetic/chromosomal syndromes, e.g. Down and Turner
Others: congenital lipodystrophy, glycogen storage diseases, iron overload in thalassemia
Types of diabetes
Type 1
Type 2
MODY
LADA
Type 1 diabetes
Age: Younger (usually <30 years)
Progression: Rapid (days/weeks)
Weight: Normal
Heredity: HLA DR3 or DR4 in >90%
Autoantibodies: Present
Clinical: Complete insulin deficiency
May develop ketoacidosis
Type 2 diabetes
Age: Older (>25 years)
Progression: Slow (years)
Weight: Overweight or obese
Heredity: No HLA links, 50% concordance in identical twins
Autoantibodies: Absent
Clinical: Partial insulin deficiency, insulin resistance
May develop hyperosmolar state
MODY
Age: < 25
Progression: Slow
Weight: Normal
Heredity: Autosomal dominant, Family history of DM in 2-3 generations
Autoantibodies: Absent
Clinical: Insulin secretion varies
Ketosis is rare
LADA
Age: >30
Progression: Months/years
Weight: Normal
Heredity: Low HLA links, 30-50% concordance in identical twins
Autoantibodies: Present
Clinical: Insulin secretion varies
May develop ketoacidosis
peptide
Eventual disappearance in Type 1
Persists in Type 2
Variable in MODY and LADA