Diabetes Mellitus

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1. Distinguish the historical, physical and laboratory findings which are classically associated with the clinical presentation of Type 1 and Type 2 Diabetes Mellitus.

2. Identify the risk factors associated with the development of Type 1 and Type 2 Diabetes.

3. Define the therapeutic goals in the management of Type 1 and Type 2 Diabetes.

4. Identify non-pharmacologic measures useful in the management of Type 1 and Type 2 Diabetes.

5. Explain how the different pathophysiology of Type 1 and Type 2 Diabetes affects management.

6. Recall the pharmacologic therapeutics used in Type 1 and Type 2 Diabetes.

A. Explain their mechanisms of action.
B. Identify those factors that influence therapeutic selection.

7. Define:

A. Insulin allergy.
B. Insulin resistance.
C. Somogyi effect.
D. Dawn phenomena.
E. Honeymoon period.

8. Identify the common long-term complications of diabetes and describe how they should be monitored.

9. Determine interventions useful in preventing or delaying these complications.

10. List therapeutic complications associated with diabetes management.

11. Explain how and why the psycho social impact of a diagnosis of diabetes mellitus differs for the Type 1 and Type 2 diabetic.

12. Discuss ways in which the following commonly concurrent conditions may impact on the patient with Type 2 Diabetes.

A. Hypertension.
B. Acute infection.
C. Alcoholism.
D. Obesity.
E. Renal failure.
F. Steroid dependent COPD or asthma.

13. Define the screening criteria for gestational diabetes.

14. List the patient and family educational objectives important for proper management of diabetes mellitus.

15. Discuss the management differences between hyper osmolar states and diabetic ketoacidosis.

Sources:

Family Medicine:  Ambulatory Care and Prevention, Chapter 74, Pages 476-484

Essentials of Family Medicine, Chapter 15, Pages 227-246

"Diabetic Foot Ulcers: Pathogenesis and Management" Robert G. Frykberg, D.P.M., M.P.H., Des Moines University, Des Moines, IA, American Family Physicians, November 1, 2002.

"Diabetic Nephropathy: Common Questions" Micah L. Thorp, D.O., M.P.H., Lake Road Nephrology Clinic, Milwaukie, Oregon, , American Family Physicians, July  1, 2005.

"Insulin Therapy for Type 2 Diabetes: Rescue, Augmentation, and Replacement of Beta-Cell Function" Jennifer A. Mayfield, M.D., M.P.H., Seattle, Washington and Russell D. White, M.D., University of South Florida College of Medicine, Tampa, FL, American Family Physicians, August 1, 2004.

“Management of Type 2 Diabetes in Youth:  An Update”

Kevin Peter, M.D., MPH, University of Minnesota Medical School, Minneapolis, Minnesota; Janet Silverstein, M.D., University of Florida College of Medicine, Gainesville, Florida; Francine Kaufman, M.D., Childrens Hospital Los Angeles and Keck School of Medicine of the University of Southern California, Los Angeles, California; Elizabeth Warren-Boulton, RN, MSN, Hager Sharp, Washington, DC, American Family Physician, September 1, 2007.

 

"Tight Control of Type 1 Diabetes:  Recommendations for Patients" Stephen Havas, M.D., M.P.H., M.S., American Medical Association, Chicago, IL and Thomas Donner, M.D., University of Maryland, School of Medicine, Baltimore, MD, American Family Physicians, September 15, 2006.