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Diabetes Management
Adult II EXAM III
| Question | Answer |
|---|---|
| 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
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