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Diabetes Exam

What is the main feature of diabetes? Hyperglycemia
What is the main description of how type 1 diabetes causes hyperglycemia? Beta cell destruction
With type 2 diabetes, what is the main reason for hyperglycemia? Insulin resistance
What are 4 main symptoms of diabetes? The P's and weight loss. Polydipsia, polyuria and polyphagia.
Name three main things that insulin does. 1. Promotes movement and storage or CHO, fat, and protein. 2. Makes glucose available to they body. 3. Helps to maintain F&E balance.
What is the main cornerstone of diabetes management? Diet
What three food groups is the exchange system based on? Carbs, protein and fats.
How does exercise affect blood glucose? It lowers it.
Name four consideration in Sick day management of a diabetic? Notify MD, monitor BS q4, test urine for ketones, continue with meds, consume 8 to 12 oz of fluids while awake, rest, and notify MD if N&V persistane, moderate or large ketones, BS high after 2 doses of insulin and temp of 101.5 for 24 hours.
What renal lab work would we monitor in a patient with diabetes? BUN and Creatinine
What is the onset, peak time and duration of regular insulin? Onset- 30min to 1 hour Peak- 2 to 3 hours Duration- 3 to 6 hours
Name two ways that Lantus insulin differs from other insulins? Long-acting insulin, Cannot be mixed with other insulins and has no peak.
What is the other name for Humalog insulin? Lispro
What type of diabetic agent is glucophage and what procedure do we want to avoid with this drug? Biguanide-insulin and we would want to avoid contract dye due to the risk of lactic acidosis.
What type of medications are Starlix and Prandin? When does the patient need to take these? What is the unique feature of this group of meds? Secretagogue/meglitides At the beginning of each meal Fast- acting within 1 hour; omit dose if skipped a meal
DKA occurs with which Type of Diabetes? Type 1
What is the treatment of DKA? IV fluids and insulin and K replacement as needed.
Name four symptoms of hypoglycemia? Confusion, headache, decreased concentration, irritability, poor coordination, seizures, pale, drowsiness, sweating, palpitations and hunger.
What is the treatment for sever hypoglycemia? IV or IM glucose, follow with rapid acting CHO and protein and monitor BG level.
Explain the two types of microvascular complications. Retinopathy, nephropathy and neuropathy.
What value do we want foe HgA1C? Less than 7%
What is the liver's role on blood glucose levels? When blood glucose levels get low, the liver releases glycogen which converts into glucose.
what are the three main criteria for DM diagnosing? 1. A fasting BG of 126 or higher on two occasions. 2. A random glucose of 200 or higher with signs or symptoms on 2 occasions. 3. A two hour GTT of 200 or higher on two occasions.
Explain the Dawn Phenomenon. Hyperglycemia upon awakening, between 2 and 4 am.
What are five symptoms of HHNS? Hypotension, Dehydration, Tachycardia, Decreased mentation, Coma, BS>800 and low K+
A hormone produced by the body is called this? Endogenous
What is diabetes mellitus? A chronic multisystem disease related to 1. Abnormal insulin production 2. Impaired insulin utilization 2. Both
What are a few diabetic risk factors? 65 years and older, race or ethnic background, family history, high BMI, low activity, high blood pressure, and Hx of diabetes during pregnancy.
Where is normal insulin produced? In the beta cells in the Islets of Langerhans.
When is insulin released? Continuously, with large amounts released after food intake.
What is a stable glucose range? 80-120 mg/dl
What is the average daily secretion of insulin? 0.6 units/kg of body weight.
What does insulin do? Promotes glucose transport from bloodstream across cell membrane to cytoplasm of cell.
What does insulin do first? It decreases glucose in the bloodstream.
What are insulin-dependent tissues in the body? Skeletal muscle and adipose tissue.
What are some of the other tissues that do not directly depend on insulin for glucose transport? brain, liver and blood cells.
What do counter-regulatory hormones do? Oppose effects of insulin, increase blood glucose levels, provide a regulated release of glucose levels.
What are some examples of counter-regulatory hormones? Glucagon, epinephrine, growth hormone, cortisol.
In what organ is insulin produced? In the pancreas.
What is the only hormone that lowers blood glucose? Insulin
What are some hormones that work to oppose the effect of insulin? Glucagon, epinephrin, growth hormone and cortisol.
Where is glucagon produced? In the pancreas in the islets of Langerhans by the alpha cells.
When is glucagon activated? During periods of fasting.
What does glucagon do? It stimulates glycolysis and gluconeogenesis via the liver.
What is the most predominant source of energy in the body primarily absorbed as glucose? Carbs.
How much carbs does the brain use to sustain function? 6 grams/hour
How are proteins primarily absorbed? As amino acids.
Why are proteins necessary? For cellular vitality.
Is protein a efficient source of energy? No
How much of the bodies proteins can be transformed to glucose? About 50%
How are fats primarily absorbed? As fatty acids and glycerol to form triglycerides.
Where are fats stored? In adipose tissue.
Are fats considered a source of energy for the body? No.
What are the normal BS levels? 80-120
What is type 1 diabetes? Juvenile or earily on-set diabetes.
What causes type 1 diabetes? Autoimmune response to virus and destruction of beta cells.
How much insulin does the pancreas secrete in type 1 diabetes? None.
Who is mostly effected with type 1 diabetes? Young patients.
What are pt. with type 1 diabetes prone to? Ketosis.
Can a person with type 1 insulin take oral antidiabetic agents? No.
When is the on-set of type 1 diabetes? Rapid onset of symptoms present at ER with ketoacidosis.
What is the treatment of type 1 diabetes? Insulin
Where will the pt. with type 1 diabetes get the insulin? From an exogenous source.
Is type 1 diabetes life-threatening? Yes
What are some signs of ketoacidosis? Severe dehydration, smell of keytones, acidotic breathing(Kussmaul), abdominal pain, vomiting, drowsiness and coma.
What are some signs of hyperglycemia? Malaise, headache, weakness, irritability, polydipsia, polyuria, polyphagia, wt. loss, dry skin, and blurred vision.
What are some signs of hypoglycemia? Shakiness, tachycardia, diaphoresis, anxiety, dizziness, hunger, impaired vision,weakness, fatigue, irritability, and headache.
Can prediabetes be reversed? Yes
Does the body produce insulin in type 2 diabetes? Yes
Is the insulin sufficient for the body in a pt. with type 2 diabetes? No, it is either insufficient or poorly utilized by the tissues.
What is type 2 diabetes caused by? Insulin deficiency and insulin resistance.
What is a large risk factor for type 2 diabetes? Obesity.
Is the pt. with type 2 diabetes ketosis prone? No
In type 2 diabetes what does insulin resistance result in? Hyperglycemia
What are two main adipokines? Adiponectin and leptin
What is a severe risk of type 2 diabetes? Osmotic F&E loss from hyperglycemia that may result in hyperosmolar coma.
What is secondary diabetes? Treatment of a medical condition that causes abnormal blood glucose levels.
When does gestational diabetes develop and return to normal? It is detected at 24-28 weeks of gestation and returns to normal at around 6 weeks postpartum.
What is a hemoglobin A1C test and what does it help to show? A test that measures the amount of glucose attached to hemoglobin molecules over the life span of the RBC. It is used to determine the glycermic levels over time and tell if the treatment is successful.
What is considered to be a normal Hemoglobin A1C level? Less than 7%
What are three acute complication of diabetes? 1.Diabetic Ketoacidosis (DKA) 2. Hyperosmolar hyperglycemic Syndrome (HHS) 3. Hypoglycemia
What is the treatment of DKA? Patient airway, administer O2, IV access, begin fluids, insulin IV, and monitor K+ levels.
What is HHNS? A life-threatening syndrome that can occur in a pt. with diabetes who is able to produce enough insulin to prevent DKA, but not enough to prevent severe hyperglycemia, osmotic diuresis, and extracellular fluid depletion.
Created by: hlawrence59