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Types of Diabetes Mellitus Compared
  Type 1 Type 2

Pathophysiology

Insulin deficient, β-cell destruction

Insulin resistant, β-cell dysfunction

Autoantibody presence

(+) islet cell (ICA), glutamic acid decarboxylase, islet protein tyrosine phosphatase-like molecule IA2 antibodies

(–) antibody

Age of onset

Most common in children and adolescents, though can occur at any age

Most common in adults, though increasing prevalence in younger population

Body habitus

Obesity is uncommon

Abdominal obesity common

Onset

Sudden

Gradual

Adapted from Triplitt CL, Repas T, Alvarez C. Diabetes mellitus. In: Pharmacotherapy A Pathophysiologic Approach. 10th ed.

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Normal Blood Glucose Values in Adults Diagnosed with Diabetes
  ADA** AACE/ACE***

Preprandial (“fasting”)

80–130 mg/dL

<110 mg/dL

Postprandial

<180 mg/dL

<140 mg/dL

Adapted from: Riddle MC, Bakris G, Blonde L, et al. American Diabetes Association standards of medical care in diabetes—2020. Diabetes Care. 2020;43(Supplement 1):S1-211. doi:10.2337/dc20-Sint; Garber AJ, Handelsman Y, Grunberger G, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology of the Comprehensive type 2 diabetes management algorithm—2020 executive summary. Endocr Prac. 2020;26(1):107-139.

**ADA= American Diabetes Association, Standards of Medical Care in Diabetes, 2019 guidelines.

***AACE/ACE = American Association of Clinical Endocrinologists and American College of Endocrinology, Comprehensive Type 2 Diabetes Management, 2019 executive summary.

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Hyperglycemia and Hypoglycemia Presentation
Hyperglycemia (Elevated Blood Glucose) Hypoglycemia (Low Blood Glucose)*

Increased thirst (polydipsia)

Increased heart rate (tachycardia)

Increased hunger (polyphagia)

Shakiness

Increased urination (polyuria)

Dizziness

Headache

Lightheaded

Decreased concentration

Fatigue/weakness

Blurred vision

Sweating

 

Difficulty speaking

Adapted from: Riddle MC, Bakris G, Blonde L, et al. American Diabetes Association standards of medical care in diabetes—2020. Diabetes Care. 2020;43(Supplement 1):S1-211. doi:10.2337/dc20-Sint; Garber AJ, Handelsman Y, Grunberger G, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology of the Comprehensive type 2 diabetes management algorithm—2020 executive summary. Endocr Prac. 2020;26(1):107-139.

*Clinical hypoglycemia is usually defined as a blood glucose value < 70 mg/dL; ADA = American Diabetes Association, Standards of Medical Care in Diabetes, 2019 guidelines.

How to Check Blood Glucose

  • Select testing site

    • Primary: finger

    • Alternative: upper forearm, upper arm, thigh, calf, fleshy part of hands

      • Should not use alternate testing site when blood glucose is rapidly changing

  • Wash and dry hands

  • Insert test strip into meter (perform any coding if necessary)

  • Prick selected site with lancet

  • Squeeze finger gently near puncture site, wipe off first drop of blood, and continue squeezing until large drop of blood forms

  • Collect blood sample

  • Record results (include date, time, preprandial/postprandial, reasons for abnormal numbers, and if any symptoms occurred)

  • Dispose of supplies appropriately

References

1. +
American Diabetes Association. Complications. https://www.diabetes.org/diabetes/complications
2. +
American Diabetes Association. Understanding A1c, A1c does it all. https://www.diabetes.org/a1c
3. ...

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