Endocrinology - Diabetes Mellitus

A serious complication of diabetes where high levels of ketones in the blood lower pH, causing dehydration and potentially life-threatening complications.

A serious diabetes complication where very high blood sugar levels lead to water loss from cells, dehydration and potentially coma. It's different from DKA.

Measurement of the amount of glucose (sugar) in the blood. High or low levels can be dangerous.

Abnormally low blood glucose levels (typically below 70 mg/dL), triggering potentially dangerous symptoms and requiring treatment.

A hormone that regulates blood sugar levels. Improper insulin levels can cause blood sugar issues.

Chemical substances produced when the body breaks down fat for energy, becoming elevated and dangerous when blood sugar levels are very high.

A small device used to prick the skin to collect a blood sample for testing.

A sudden and serious problem related to a medical condition. (e.g. DKA, Coma).

Requires insulin injections combined with careful blood glucose monitoring using blood testing devices. The goal is to keep blood glucose levels within a safe range.

The average glucose level for a type 1 diabetic should be as close to normal (80–120 mg/dl) as possible. Some physicians might suggest up to 140–150 mg/dl for those experiencing frequent low blood sugar.

Starts with lifestyle changes: increased physical activity, decreased carbohydrate intake, and weight loss. These can improve insulin sensitivity, even with modest weight loss.

Used to treat type 2 diabetes when lifestyle changes aren't enough. They help improve insulin production.

Used when oral medications fail to manage blood sugar levels due to further impairment of insulin production.

Requires a combination of approaches: diet, exercise, weight loss, oral medications (for type 2), and insulin (for type 1 or type 2 not responding to oral medications).

Diabetics have a higher risk of cardiovascular disease, highlighting the need for lifestyle changes to control blood pressure and cholesterol.

Include: combined use of regular and NPH insulin, synthetic insulin analogs (Humalog, Novolog), long-acting insulins (Lantus/Levemir), and insulin pumps (e.g., FLEXIBLE - PUMP).

Diabetes Mellitus is categorized into Type 1 (IDDM) and Type 2 (NIDDM), differing in incidence, age of onset, sex predilection, body weight, severity, stability, and insulin/oral hypoglycemic response.

Characterized by a relatively lower incidence, earlier age of onset (typically before 30, often in the teens), and a tendency to be more prevalent in males. Requires insulin for treatment.

More common, with a later age of onset (typically after 40), and a greater prevalence in females. Often associated with overweight or obesity, and frequently manageable with oral hypoglycemics.

Diagnosing diabetes involves assessing fasting plasma glucose, 2-hour post-prandial plasma glucose, and/or oral glucose tolerance test (OGTT) results to determine normal, impaired glucose tolerance, or overt diabetes.

Diabetes presentation encompasses asymptomatic cases and those with classic symptoms like polyuria (frequent urination), polydipsia (excessive thirst), polyphagia (increased hunger), weight loss, itching, numbness, repeated infections, and potential complications.

Monitoring diabetes includes both home blood glucose monitoring (HBGM) and urine testing for glucose, while glycosylated hemoglobin (HbA1c) provides a longer-term assessment of blood sugar control.

Diagnosis requires plasma glucose testing (fasting, postprandial, OGTT), urine analysis for glucose/ketones (strips/solutions), and potentially glycosylated hemoglobin (HbA1c) measurement to evaluate glucose control.

HbA1c measurement reflects average blood glucose levels over several weeks and is used to assess long-term diabetic control. Normal levels vary and often indicate 6% of total Hb during normal levels.