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Unformatted text preview: esponsiveness to insulin.
Decrease in the number of insulin receptors.
Hyperglycemia due to a relative deficiency of insulin related
to insulin resistance and beta cell dysfunction.
Inadequate secretion of insulin or an insensitivity which
leads to hyperglycemia.
leads Diagnostic Criteria
– random glucose > 200 mg% plus symptoms
– OR: fasting glucose > 126 mg%, twice
– OR: fasting glucose < 126 mg%, but OGTT is
> 200 mg% at 2 hours
200 Impaired Glucose Tolerance:
– fasting glucose < 126 mg%, 2 hr OGTT is
between 126-200, 0-2 hr is > 200 mg%
between Clinical Manifestations
Onset of Type I diabetes may be associated with
Polyuria---due to osmotic diuresis from glucose
Polydipsia---response to fluid loss.
Polyphagia---due to gluconeogenesis
Weight loss---impaired metabolism
Glycosuria--inability of kidney to reabsorb
glucose. Clinical Manifestations
weight gain Compare Type 1 and Type 2
Type 1 Onset
Beta cell function
HLA-linkage Any age
Yes Type 2 Adults
No Gestational Diabetes
A disorder of glucose tolerance that is diagnosed
Gestational diabetes mellitus occurs in 4% of
pregnant women, may recur with subsequent
pregnancies, and tends to resolve at delivery. It is
associated with a markedly increased risk—up to
50% in obese.
Placental hormones and weight gain are contributing
Resembles Type II DM.
Onset 24-28 week gestation.
Risk factors---obesity, 40 years, family history of
Type II DM and previous Gestational DM.
High birth weight and neonatal hyperglycemia
Impaired glucose tolerance and impaired fasting
Intermediate stages between normal glucose
metabolism and diabetes
Represent risk factors for the development of
diabetes and onset of cardiovascular disease
Screening for Diabetes All adults older than age 45 at least every 3 years for
type 2 Individuals with risk factors should be screened
earlier or more frequently No screening requirements for type 1 Complications of Diabetes
inability to heal paresthesia
amputation Complications of Diabetes
Occurs primarily in Type I diabetes.
Failure to receive adequate amounts of
insulin results in continued fat metabolism,
which produces ketones bodies leading to
DKA results in severe metabolic, fluid, and
May be life threatening. Ketoacidosis
thyroid storm Diabetic Ketoacidosis
fruity breath odor Kussmaul’s respirations
death if untreated Chronic Hyperglycemia
-Macrovascular---damage to large vessels
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- Spring '14