Endocrinology – Diabetes
1. How is Diabetes Mellitus defined as?: - a group of metabolic disorders of carbohydrate metabolism
in which glucose is both underutilized as an energy source and overproduced due to inappropriate gluconeogenesis
and glycogenolysis, resulting in hyperglycemia
2. What are causes of hyperglycemia?: - increased glucagon secretion by islet alpha cells
- increased hepatic glucose production in the liver
- increased glucose resorption by kidneys
- increased lipolysis of adipose tissue
- decreased insulin secretion by the pancreas
- decreased glucose uptake in the muscles
- neurotransmitter dysfunction
- decreased incretin effect (GLP-1 usually functions to suppress appetite) in the intestines
3. How does increased lipolysis cause hyperglycemia?: - causes FFA to be produced, which
produces ATP and ketones
- ketones affect the body's ability to utilize glucose
4. What are advantages of utilizing plasma or serum glucose to help diagnosis
,diabetes?: - values are independent of hematocrit and reflect glucose concentration to which body tissues are
exposed
5. Why is plasma glucose utilized, rather than whole blood glucose?: - plasma glucose
is 10-15% higher than whole blood glucose and often more accurate
6. What are the abnormal and impaired fasting plasma glucose levels?: Abnormal
fasting plasma glucose:
- greater than or equal to 126 mg/dL AFTER 8 or more hours of fasting
Impaired fasting plasma glucose:
- 100-125 mg/dL
7. What is an abnormal random plasma glucose level?: - greater than or equal to 200 mg/dL
8. What type of tests or values are used to make a diagnosis of diabetes?: 1. At least
one abnormal blood glucose value AND symptoms of diabetes
OR
, Endocrinology - Diabetes
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2. TWO abnormal blood glucose values
9. What is the indication for performing an Oral Glucose Tolerance Test (OGTT)?-
: - fasting plasma glucose <126 mg/dL with suspected diabetes
10. How is an OGTT performed?: 1. 150-200 g of carbohydrate per day for 3 days preceding test, no
food after midnight before test day
2. 75 g glucose in 300 mL water consumed within 5 minutes, test performed in morning, no smoking or activity during
test
3. Blood plasma glucose is measured before drinking the glucose water at 0 minutes and at 120 minutes after ingestion
11. What is the diagnostic criteria for an OGTT?: Normal
- Fasting plasma glucose <100 mg/dL
- 2 hour value <140 mg/dL
Diabetes
- fasting plasma glucose greater than or equal to 126 mg/dL
OR
- 2 hour value greater than or equal to 200 mg/dL
, Endocrinology - Diabetes
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Impaired glucose tolerance
- 2 hour value 140-199 mg/dL
12. When is it likely to get a false positive with an OGTT?: Possible with patients who are:
- malnourished
- bedridden
- infected
- severely stressed patients
13. When should you NOT order an OGTT?: - if you are HIGHLY suspicious of diabetes, as it may
cause the patient's blood glucose to increase severely
14. What is HbA1c actually testing for?: - glycated hemoglobin, which is a major form where glucose
is the carbohydrate and hemoglobin is attached to glucose
15. What is the clinical significance of HbA1c?: Diabetes indicator
- HbA1c is elevated in people with diabetes due to chronic hyperglycemia
1. How is Diabetes Mellitus defined as?: - a group of metabolic disorders of carbohydrate metabolism
in which glucose is both underutilized as an energy source and overproduced due to inappropriate gluconeogenesis
and glycogenolysis, resulting in hyperglycemia
2. What are causes of hyperglycemia?: - increased glucagon secretion by islet alpha cells
- increased hepatic glucose production in the liver
- increased glucose resorption by kidneys
- increased lipolysis of adipose tissue
- decreased insulin secretion by the pancreas
- decreased glucose uptake in the muscles
- neurotransmitter dysfunction
- decreased incretin effect (GLP-1 usually functions to suppress appetite) in the intestines
3. How does increased lipolysis cause hyperglycemia?: - causes FFA to be produced, which
produces ATP and ketones
- ketones affect the body's ability to utilize glucose
4. What are advantages of utilizing plasma or serum glucose to help diagnosis
,diabetes?: - values are independent of hematocrit and reflect glucose concentration to which body tissues are
exposed
5. Why is plasma glucose utilized, rather than whole blood glucose?: - plasma glucose
is 10-15% higher than whole blood glucose and often more accurate
6. What are the abnormal and impaired fasting plasma glucose levels?: Abnormal
fasting plasma glucose:
- greater than or equal to 126 mg/dL AFTER 8 or more hours of fasting
Impaired fasting plasma glucose:
- 100-125 mg/dL
7. What is an abnormal random plasma glucose level?: - greater than or equal to 200 mg/dL
8. What type of tests or values are used to make a diagnosis of diabetes?: 1. At least
one abnormal blood glucose value AND symptoms of diabetes
OR
, Endocrinology - Diabetes
Study online at https://quizlet.com/_h7z7vq
2. TWO abnormal blood glucose values
9. What is the indication for performing an Oral Glucose Tolerance Test (OGTT)?-
: - fasting plasma glucose <126 mg/dL with suspected diabetes
10. How is an OGTT performed?: 1. 150-200 g of carbohydrate per day for 3 days preceding test, no
food after midnight before test day
2. 75 g glucose in 300 mL water consumed within 5 minutes, test performed in morning, no smoking or activity during
test
3. Blood plasma glucose is measured before drinking the glucose water at 0 minutes and at 120 minutes after ingestion
11. What is the diagnostic criteria for an OGTT?: Normal
- Fasting plasma glucose <100 mg/dL
- 2 hour value <140 mg/dL
Diabetes
- fasting plasma glucose greater than or equal to 126 mg/dL
OR
- 2 hour value greater than or equal to 200 mg/dL
, Endocrinology - Diabetes
Study online at https://quizlet.com/_h7z7vq
Impaired glucose tolerance
- 2 hour value 140-199 mg/dL
12. When is it likely to get a false positive with an OGTT?: Possible with patients who are:
- malnourished
- bedridden
- infected
- severely stressed patients
13. When should you NOT order an OGTT?: - if you are HIGHLY suspicious of diabetes, as it may
cause the patient's blood glucose to increase severely
14. What is HbA1c actually testing for?: - glycated hemoglobin, which is a major form where glucose
is the carbohydrate and hemoglobin is attached to glucose
15. What is the clinical significance of HbA1c?: Diabetes indicator
- HbA1c is elevated in people with diabetes due to chronic hyperglycemia
