Diabetes and Endocrinology Review (Key Concepts)

A set of practice Q&A flashcards covering diabetes type 1 and type 2, diagnostic criteria, management, complications, and related endocrine topics.

What type of diabetes is most common in adults?

Type 2 diabetes accounts for more than 90% of cases.

At what age is type 1 diabetes most often diagnosed?

Usually in childhood; can occur in young adults, but classically pediatric.

What is the classic presenting symptom set for type 1 diabetes at onset?

Polyuria, polydipsia, polyphagia, weight loss; may progress to diabetic ketoacidosis.

What are the core pathophysiologic components of type 2 diabetes?

Insulin resistance with relative insulin deficiency and glucagon dysregulation.

What is the diagnostic criterion for diabetes using A1C?

A1C ≥ 6.5%.

What fasting plasma glucose level defines diabetes?

Fasting plasma glucose ≥126 mg/dL.

What 2-hour plasma glucose value during an OGTT indicates diabetes?

2-hour plasma glucose ≥200 mg/dL.

What random plasma glucose value with symptoms indicates diabetes?

Random plasma glucose ≥200 mg/dL with classic hyperglycemia symptoms.

What is the first-line pharmacologic therapy for type 2 diabetes?

Metformin (unless contraindicated by eGFR <30 mL/min).

What is a major contraindication to metformin?

Creatinine clearance or eGFR <30 mL/min.

What are common adverse effects of metformin?

Gastrointestinal upset; B12 deficiency with long-term use; rare lactic acidosis.

What are SGLT2 inhibitors and their primary action?

Block renal glucose reabsorption in the proximal tubule; promote glucosuria; no hypoglycemia.

What are the advantages and disadvantages of SGLT2 inhibitors?

Advantages: weight loss, BP and CV benefits; Disadvantages: higher cost, genital infections, volume depletion, possible fractures with some agents, risk of DKA, increased LDL.

What are GLP-1 receptor agonists and their key effects?

Increase insulin secretion, decrease glucagon, slow gastric emptying, promote weight loss; no hypoglycemia; often injectable; CV benefits; GI side effects; possible pancreatitis risk and rare thyroid tumors in animals.

What are DPP-4 inhibitors and their characteristics?

Oral meds that increase incretin hormones, increase insulin secretion, decrease glucagon; low hypoglycemia risk; well tolerated; possible pancreatitis and joint pain.

What are sulfonylureas and their risks?

Increase insulin secretion; cheaper; risk of hypoglycemia and weight gain.

What is the role of insulin in diabetes management?

Powerful agent with universal efficacy; reduces microvascular risk; risks include hypoglycemia and weight gain.

What is a common initial basal insulin used in type 2 diabetes?

Glargine (Lantus) once daily (often adjustable to twice daily in some cases).

When should insulin be started at diagnosis of type 2 diabetes?

In patients with severe hyperglycemia: fasting >250 mg/dL, random >300 mg/dL, or A1C ≥9% at diagnosis; or long-standing disease not controlled with oral agents.

What are macrovascular complications of diabetes?

Coronary heart disease, cerebrovascular disease, and peripheral artery disease.

What are microvascular complications of diabetes?

Retinopathy, nephropathy (microalbuminuria), and neuropathy.

What is the recommended weekly amount of exercise for diabetes management?

At least 150 minutes of moderate-to-vigorous aerobic activity per week (can be broken into shorter sessions).

What is the target A1C for most adults with diabetes?

What annual eye exam is recommended for diabetics?

Dilated eye exam to screen for diabetic retinopathy.

What screening test detects early diabetic nephropathy and how is it detected?

Screen for microalbuminuria in urine (urine albumin-to-creatinine ratio); detects nephropathy before GFR decline.

What are key bone health recommendations for people with diabetes?

Calcium 1200 mg/day, vitamin D 800 IU/day; weight-bearing exercise; smoking cessation; fall prevention; consider bisphosphonates if indicated.

What constitutes weight-bearing exercise with respect to osteoporosis prevention?

At least 30 minutes of weight-bearing activity several times per week (non-weight-bearing activities like swimming do not count for bone health).

What are the classic signs of primary hyperparathyroidism and its treatment?

Bones, stones, abdominal groans, psychiatric moans; treatment is parathyroidectomy if symptomatic or with complications.

What are the two main forms of diabetes insipidus and their differences?

Central DI: insufficient ADH secretion; Nephrogenic DI: kidneys do not respond to ADH.

How does desmopressin (DDAVP) testing differentiate central from nephrogenic DI?

Central DI: urine concentrates and output decreases after DDAVP; nephrogenic DI: no change.

What is SIADH and its main treatment approach?

Syndrome of inappropriate ADH secretion; managed with fluid restriction and treating underlying cause.

What are the main types of thyroid cancer and which is most common?

Papillary (≈85%), Follicular (≈12%), Anaplastic (<3%); Papillary is the most common.