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Diabetes Management

Adult II EXAM III

QuestionAnswer
What type of disorder is Diabetes? metabolic disorder
Where is insulin produced (what cells, what organ, what location on organ)? Beta cells of Pancreas in the Islets of Langerhands
What is Insulin's function? gets glucose into cells
Definition: "Insulin" carrier/transport molecule to take glucose into cells
What is the main source of fuel for the body? Glucose
What is the "problem" in Type 1 DM (what is the root source of the issue)? Pancreas produces little or NO Insulin
What type of Diabetes used to be called "Juvenile-Onset Diabetes"? Type 1 DM
What are other names for Insulin Dependent Diabetes? Type 1 DM, Juvenile-Dependent Diabetes
What is the cause of Type 1 DM? UNKNOWN
What kind of disease is Type 1 DM believed to be? Autoimmune; believed that something causes the body's immune system to destroy Normal Insulin producing cells
To what may Type 1 DM onset be linked? Viral Infection and Impaired Immune System
What age group does Type 1 DM most commonly occur in? Children and Young Adults
What is REQUIRED for Type 1 DM patients? MUST have Insulin to SURVIVE, even if NOT EATING, to maintain basal requirements
Do Type 1 DM patients require Insulin when not eating? MUST have Insulin to SURVIVE, even if NOT EATING, to maintain basal (basic) requirements for body function
What type of disease is Type 2 DM? metabolic disorder
What is the "problem" in Type 2 DM (what is the root source of the issue)? EITHER (and/or) 1. Pancreas produces some Insulin, just not ENOUGH 2. Insulin Resistance in cells
In what age group does Type 2 DM occur? Any age
What is the most common type of Diabetes? Type 2 DM
What are two risk-factors for Type 2 DM? Genetic Pre-disposition and Obesity
What are the two most common types of Diabetes? Type 1 and Type 2
Definition: "Type 2 Diabetes" metabolic disorder in which the body does not properly use Insulin or produce Insulin in the right amounts or at the right times
What type of Diabetes occurs in women during pregnancy? Gestational Diabetes
What are women who have had Gestational Diabetes at increased risk for later in life? Type 2 DM
What are more rare causes of Diabetes? Surgery, some Medications, Various Illnesses
Definition: "Gestational Diabetes" impaired glucose tolerance during pregnancy
How does Insulin production change as we age? ability to produce Insulin DECREASES over time
What occurs when there is an Insulin shortage or Insulin resistance? Glucose does not go into cells = Glucose is not used = Glucose accumulates in blood for a long period of time = Hyperglycemia
What are Symptoms of Hyperglycemia? Poly's: -Dypsia (thirst); -Phagia (hunger); -Urea (urination) Dry skin Blurred Vision Drowsiness Nausea
Do all body Organs require Insulin to use Glucose? no
What body Organs do NOT require Insulin to use Glucose? Brain, Spleen, Pancreas, Liver
Why does the fact that some organs do NOT require Insulin to use Glucose make Glucose balance IMPERATIVE? could lead to excessive glucose intake by Brain, Spleen, Pancreas, and Liver
How does Type 1 DM usually onset? as result of Illness, Injury, or Stress
How does Type 2 DM usually onset? slow/insidious onset, NO or None-Specific Symptoms
What type of Diabetes do Polydipsia, Polyuria, and Polyphagia as symptoms apply to? Type 1 AND Type 2 DM
What characterizes the weight of a patient with Type 1 DM? weight loss; usually thin at time of diagnosis
What usually characterizes the weight of a patient with Type 2 DM? usually obese
What symptoms do Type 1 and Type 2 DM have in common? Fatigue and "Poly's"
What usually describes the onset of Type 1 DM? ACUTE - presents in DKA
In which type of Diabetes is DKA more common? Type 1 DM
What symptoms are unique to Type 2 DM? Fatigue; Prolonged wound healing/Recurrent Infection; BLURRED VISION (vision changes); Numbness/Tingling in Extremities; DRY,ITCHY Skin; Sexual dysfunction
In which type of Diabetes is Hyperglycemic-Hyperosmolar State (HHS) (HHNS) more common? Type 2 DM
Why is DKA more common in one type of Diabetes than the other? DKA is D/T lack of Insulin needed to get Glucose into cells = Fat breakdown to Glucose = Ketones in blood = DKA; Type 1 DM has TOTAL or Nearly total lack of Insulin, Type 2 usually has ENOUGH Insulin to keep DKA form occurring
What are four Acute Complications of Diabetes that require IMMEDIATE ATTENTION!!!!? Hyperglycemia; Hypoglycemia; DKA; Hyperglycemia-Hyperosmolar State (HHS) (HHNS)
How is Hyperglycemia treated? Insulin
How is Insulin administration Dosage usually determined in an acute-care setting? Sliding scale
How is DKA treated? Insulin and Fluid
Definition: "DKA" "Diabetic KetoAcidosis"; sugars run high long enough that a high level of blood acid called ketones develop as a result of fat breakdown in an attempt to create fuel; ketones spill into urine and can be checked at home
How is Hypoglycemia treated if patient is AWAKE? Juice or other Carbohydrate (CHO) source first, then Protein 30 minutes later
How is Hypoglycemia treated if patient is UNCONSCIOUS? D50 or Glucagon
How long do you wait before giving Protein when treating a patient with Hypoglycemia? 30 minutes
What are the Symptoms of HHNS? DKA symptoms WITHOUT Ketones: Hyperglycemia, Poly's (urea positive for sugar)
What can HHNS lead to? Dehydration, Seizures, Coma, and eventually DEATH
What are the Symptoms of Hypoglycemia? Shaky; Dizzy; Sweaty; Hungry; Irritable/Moody; Anxious/Nervous; Headache
What is the physiological function of Polydypsia and Polyurea in Hyperglycemia? decrease blood sugar concentration: Polydypsia = increased thirst = increased fluid volume = decreased sugar concentration Polyurea = increased urination = increased sugar excretion = decreased sugar concentration
Are Polydypsia and Polyurea symptoms of Hypoglycemia (why/why not)? no; purpose of Polydypsia and Polyurea are to decrease sugar concentration in blood; Hypoglycemia means we already have too little sugar
Which is Hunger (Polyphagia) a symptom of: Hypoglycemia or Hyperglycemia? both
What is the physiological purpose of Hunger (Polyphagia)? cells need fuel/glucose; cells aren't getting it, so body assumes you need to eat something to get glucose
Why do Hypoglycemia and Hyperglycemia both have Hunger (Polyphagia) as a symptom? because both conditions are ones in which the cells do not have enough Glucose; Hypoglycemia = not enough in blood so not enough in cells; Hyperglycemia = cells can't get the glucose out of the blood; EITHER WAY, if Cells are Starving THEN SO ARE YOU
Why does Hypoglycemia have Sweatiness (Diaphoresis) as a symptom? Hypoglycemia is a condition of too little Blood Glucose, or too much fluid in relation to Blood Glucose; Sweating is a physiological compensation to Reduce Blood Volume/Fluid and INCREASE concentration of Glucose
Why does Hyperglycemia have Dry Skin as a symptom? Hyperglycemia is a condition of too much Blood Glucose, or too much Glucose in relation to Fluid; Dry Skin is a result of Physiological compensation of Water Retention in Blood to DECREASE concentration of Glucose
What symptoms are unique to Hyperglycemia (not shared by Hypoglycemia)? Blurred Vision Drowsiness (memory: sugar attack) Nausea (memory: too much sugar)
What symptoms are unique to Hypoglycemia (not shared by Hyperglycemia)? Shaky/Dizzy (memory: I'm starving for sugar) Irritable/Moody/Anxious/Nervous (memory: I'm starving) Headache (brain DOESN'T have any food; brain can get Glucose WITHOUT Insulin, and it literally doesn't have any Glucose available in Hypoglycemia)
What are Chronic Complications of Hyperglycemia? "Pathies": Nerve, Eye, Kidney, Skin PVD CVD and stroke Infection/Delayed healing - (hypersugar = increased likeliness for bacteria to like you, and with Neuropathy, you might not know there is an injury)
How can risks of Hyperglycemia be reduced? risks SIGNIFICANTLY reduced if patients keep their Blood Sugar levels as close to normal as possible (less than 150)
What "Hyper's" are included in Metabolic Syndrome (Syndrome X) Hyper: -lipids/triglycerides (lipidemia) -tension (HTN) -pigmentation (usually Neck, Axilla, Groin - may disappear with tx)
What are symptoms (non "Hyper's" included in Metabolic Syndrome? Polycystic Ovary Disease/ Irregular Menses Central Obesity/Apple shape/Waist > 35" Increased FACIAL Hair in Women INSULIN RESISTANCE Low HDL
Metabolic Syndrome (Syndrome X) syndrome describing a cluster of health problems related to Diabetes
What things affect Blood Sugar? "MEDS" Medication (decrease blood sugar) Exercise (decrease blood sugar) Diet (anything you eat increases blood sugar) Stress (ANY form of stress increases blood sugar)
What kind of medications are we thinking about when we say they decrease Blood Sugar? Insulin and Oral Antidiabetic medications
What does exercise effect, specifically? insulin resistance; decreases it
What kind of diet is often used for Diabetics? Consistent Carbohydrate
What does a Consistent Carbohydrate diet do? help control Blood Sugar and REDUCE Weight
In many people with Type 2 DM, what is sufficient to control blood sugar? Diet and Exercise
What types of Stress affect Blood Sugar and how? ANY type of Stress whether Emotional or Physical; presence of Stress = higher Metabolic need of Glucose = higher Food intake (without elevated Insulin intake) = elevated Blood Glucose
What types of Diabetes ALWAYS require Insulin Monitoring? Types 1 AND 2 DM
What does Type 1 DM ALWAYS require? Insulin
How is the frequency of Blood Glucose monitoring determined for Type 2 DM? patient-by-patient basis; depends on Severity of disease and treatment; IMPORTANT to determine Day-to-Day levels and make Appropriate ADJUSTMENTS
What is included in Treatment for Type 2 DM? Diet/Exercise/WEIGHT LOSS Oral Antidiabetic Agents Insulin Injectable NEW DM Meds (GLP-1) AGGRESSIVE Preventative Healthcare
What does HGA1C measure? average blood glucose level over the past 6 weeks
What does HGA1C ASSESS? assessment of overall control and risk factor
How often is HGA1C usually done? every 3-6 months
For every% increase in HGA1C, how much of an increase in risk of complications is there? 30-35% increase
What is the normal HGA1C value range? 4.0-5.7%
How low should HGA1C be kept to Prevent Complications often associated with Diabetes? below 6.5%
Created by: HESTONA001