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Diabetes Mellitus
Patho
| Question | Answer |
|---|---|
| genetic predisposition, immunological factors, environmental factors, African American and Native America, HTN, high chol | TYPE I |
| obesity, genetic predisposition | TYPE II |
| increased insulin requirements, insufficient exogenous insulin | diabetic ketoacidosis |
| stressors (infarct, trauma, etc) + underlying hyperglycemia | hypersmolar hyperglycemic non-ketotic coma |
| impaired glucose tolerance and impaired fasting blood glucose | DM |
| DX of DM includes a plasma glucose value of ____ | 200 mg/dl or more |
| DX of DM includes a fasting plasma glucose value of ____ | 126 mg/dl or more |
| DX of DM includes a 2-hr postprandial plasma glucose value of ____ during an oral glucose tolerance test | 200 mg/dl or more |
| the DX of impaired glucose tolerance includes: 2-hr post-glucose ingestion value of ____ | > or = 140 <200 mg/dl |
| the DX of impaired fasting glucose tolerance includes: fasting plasma glucose value of ___ | >100 <126 mg/dl |
| damage to the pancreatic beta cells leading to uncontrolled glucose production by the liver abd subsequent hyperglycemia | TYPE I DM |
| the renal threshold for glucose in TYPE I DM is ____ and glucose ____ | exceeded and glucose spills into the urine |
| what is the reason for polyuria in TYPE I DM? | b/c glucose pulls fluid with it |
| what is the 3rd classic s/s of TYPE I DM? | polyphagia |
| failure to receive adequate amounts of insulin results in continued fat metabolism reaulting in > ketones and leading to ketoacidosis | TYPE I DM |
| results in severe metabolic, F and E disturbances | diabetic ketoacidosis (DKA) |
| ___ s/s: adb pain, n/v, FRUITY BREATH, Kussmaul resp, altered LOC, coma, death | diabetic ketoacidosis (DKA) |
| results from < in beta cells wt and number of from insulin resistance | TYPE II DM |
| see wt loss with __ | TYPE I DM |
| inadequate secretion of insulin or resistance to insulin leading to hyperglycemia | TYPE II DM |
| ____ early s/s: polyuria, polydipsia | both TYPE I and TYPE II DM |
| ___ early s/s: polyphagia, wt loss, glycosuria, fatigue | TYPE I DM |
| ___ early s/s: blurred vision, over wt | TYPE II DM |
| complications of DM | HYPERGLYCEMIA: diabetic ketoacidosis, hyperglycemic hypersomolar nonketotic coma...HYPOGLYCEMIA |
| what are some renal px that occur with DM? | hypertension, albuminuria, edema, chronic renal failure |
| what are some MS px that occur with DM? | jt contractures |
| what are some sensory px that occur with DM? | diabetic retinopathy, cataracts, glaucoma |
| what are some CV px that occur with DM? | CAD, atherosclerosis, hypotension, peripheral vascular disease, blood viscosity and platelet disorders |
| what are some somatic neuropathies px that occur LATE with DM? | parethesias, pain, loss of cutaneous sensation, and loss of fine motor control |
| what are some visceral neuropathies that occur LATE with DM? | sweating dysfunction, pupillary constriction, fixed heart rate, constipation, diarrhea, incomplete bladder emptying, and sexual dysfunction |
| what are some intergumentary px that occur with DM? | foot ulcers, gangrene of ft, and atrphic changes |
| what are some imune system px that occur with DM? | impaired healing, chronic skin infections, periodontal disease, UTI, lung infection, vaginitis |
| DM that develops during pregnancy | gestational DM |
| with hyperglycemic hyperosmolar nonketotic syndrome blood glucose = | > 600 |
| with hyperglycemic hyperosmolar nonketotic syndrome osmolarity = | > 310 which pulls water out of the cells |
| with hyperglycemic hyperosmolar nonketotic syndrome sensorium is __ | < |
| what are some causes of hyperglycemic hyperosmolar nonketotic syndrome? | TYPE II DM |
| insulin resistance + increased carb intake = | hyperglycemic hyperosmolar nonketotic syndrome |
| excess insulin causing low blood glucose levels | hypoglycemia |
| what are some causes of hypoglycemia? | too much insulin, not eating, > exercise |
| ___ s/s: clammy, HA, anxiety, diaphoresis, tachycardia, coma, altered thought process | hypoglycemia |
| cycle of insulin-induced posthypoglycemic episode | somogyi effect |
| hypoglycemia alternated with hyperglycemia | somogyi effect |
| increased levels of FBG or insulin requirements, or both b/t 5-9 AM | dawn phenomenon |
| What are 5 complications of DM? | neuropathies, nephropathies, retinopathies, macrovascular, infections |
Created by:
TayBay15
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