Master the board step 3

Endocrinology 4
Diabetes
Diabetes Type 1 Type 2
Onset Juvenile Adult
Body type Thin Obese
Diabetic ketoacidosis
(DKA)
Frequent
Rare
Treatment Insulin Lifestyle management,
oral agents, or insulin
Diagnosis is made with one of the following:
1. Two fasting glucose ≥ 126
2. One random glucose ≥ 200 with symptoms (polyuria, polydipsia, polyphagia)
3. Abnormal glucose tolerance test (2-hour glucose tolerance test with 75 g
glucose load)
4. Hemoglobin A1c > 6.5%
The strongest indication for screening for diabetes is hypertension.
HgA1c > 6.5% diagnoses
diabetes.
Basic Science Correlate
Mechanism of Type 2 Diabetes
Adipose tissue must have insulin to permit entry of glucose and free fatty
acids (FFAs). Excess fat creates a deficiency of insulin. Insulin receptors are a
tyrosine kinase, which is neither a peptide nor a steroid hormone receptor.
Tyrosine kinase is also a mechanism for many forms of protein production.
89