غدد Flashcards
1
Q
FBS in pre- diabetes?
A
5.6 (100 mg)- 6.9
2
Q
In a diabetic patient on Metformin, optimum and target of A1c?
A
Optimum= < 6.5
Target= < 7
3
Q
Canadian guideline for targets in diabetes (on medication)?
FBS ? PP? Lipid? BP??
A
FBS: 4-7 mmole/ dL
PP: 5-10
Lipid: as moderate to high risk group
BP: 130/80
4
Q
Canadian guidelines for energy intake in diabetes?
A
for Diet daily carbohydrate intake 45-60% of energy, protein 15-20% of energy and fat ‹35% of energy o intake of saturated fats <7% and polyunsaturated fats ‹10% of total calories each
5
Q
OGTT in whom?
A
Pre-diabetic + RF
6
Q
What is the
recommended first-line
medication if HbA1c is ≥8.5% a diabetic patient?
A
Metformin
7
Q
What is the glucose threshold for gestational diabetes on a glucose challenge test?.
A
≥7.8 mmol/L on a 50g glucose test
8
Q
How do SGLT2 inhibitors benefit diabetic patients with
heart failure?
A
They lower blood glucose and reduce heart failure risk.
9
Q
What medication is commonly used to manage gestational diabetes?
A
Glyburide
10
Q
What is the average
HbA1c reduction achieved
with SGLT2 inhibitors?
A
By 1.5%
11
Q
What is the main function of GLP-1 analogues in diabetes management?
A
They stimulate insulin secretion and reduce appetite, helping manage diabetes.
12
Q
When should an OGTT be considered for a pre-diabetic patient?
A
An OGTT is recommended if the patient has additional risk factors
OGTT stands for Oral Glucose Tolerance Test.
13
Q
What is required for a diabetes diagnosis?
A
Two abnormal tests: fasting glucose ≥7 mmol/L or HbA1c ≥6.5%
These tests confirm the presence of diabetes based on established criteria.
14
Q
What is the recommended medication for HbA1c ≥8.5% or fasting glucose ≥7 mmol/L?
A
Metformin
Metformin is often the first-line medication for managing elevated blood glucose levels.
15
Q
What indicates gestational diabetes?
A
Glucose challenge test
This test helps diagnose gestational diabetes during pregnancy.
16
Q
What are SGLT2 inhibitors effective for?
A
Diabetes and heart failure
SGLT2 inhibitors help lower HbA1c by approximately 1.5%.
17
Q
Fill in the blank: Regular _______ checks are important for managing pre-diabetes.
A
HbA1c
Monitoring HbA1c levels helps track glucose control over time.
18
Q
What lifestyle modifications should be advised for pre-diabetic patients?
A
Diet and exercise
These changes can significantly impact glucose levels and overall health.
19
Q
What does OGTT stand for?
A
Oral Glucose Tolerance Test
OGTT is used to assess how well the body metabolizes glucose.
20
Q
What are the two components of OGTT?
A
Tolerance and fasting glucose levels
These components help differentiate between normal, impaired, and diabetic ranges.
21
Q
What is the significance of waist circumference in metabolic syndrome?
A
It helps identify abdominal obesity
Waist circumference is a key measurement for assessing metabolic syndrome risk.
22
Q
Which medications are commonly discussed for managing diabetes?
A
- Metformin
- SGLT2 inhibitors
- GLP-1 analogs
Each medication has different mechanisms and effects on blood glucose levels.
23
Q
True or False: Insulin is used for metabolically decompensated patients with pH <7.3.
A
True
Insulin administration is critical in severe metabolic imbalances.
24
Q
What risks are associated with high HbA1c levels during pregnancy?
A
Congenital abnormalities
High HbA1c can lead to complications for both the mother and fetus.
25
What are 2 lifestyle modifications in managing pre-diabetes?
Dietary advice and avoiding fasting
## Footnote
These modifications can help lower blood glucose and prevent diabetes progression.
26
Fill in the blank: The first-line treatment for elevated blood glucose levels includes _______.
Metformin
## Footnote
Metformin is often prescribed as an initial treatment for diabetes.
27
What is the classification used in risk stratification?
High, moderate, and low-risk groups
## Footnote
Identifying risk levels helps tailor preventive measures and treatment plans.
28
What are the criteria for diagnosing diabetes?
* Symptoms
* Random blood sugar levels
* HbA1c
## Footnote
Multiple criteria are used to ensure accurate diagnosis.
29
What is the importance of monitoring blood glucose levels?
To adjust insulin doses as needed
## Footnote
Regular monitoring is essential for effective diabetes management.
30
What is the emergency management approach for diabetes?
Use of arterial blood gas tests and insulin administration
## Footnote
Recognizing metabolic decompensation is crucial for timely intervention.
31
What is the main approach to managing pre-diabetes?
Lifestyle modifications, including diet and exercise, are the primary approach to managing pre-diabetes.
32
How frequently should HbA1c be tested in a pre-diabetic patient?
HbA1c should be tested more frequently in pre-diabetic patients to monitor progression.
33
When should an OGTT be considered for a pre-diabetic patient?
An OGTT is recommended if a pre-diabetic patient has additional risk factors.
34
What advice should be given to a patient with impaired fasting glucose (IFG) regarding fasting duration?
Patients with IFG should avoid extended fasting periods to prevent glucose spikes.
35
What is the primary criterion for diagnosing pre-diabetes in a 42-year-old patient with a fasting blood glucose of 6.5 mmol/L?
A fasting blood glucose of 6.5 mmol/L meets the threshold for pre-diabetes.
36
Why are regular HbA1c checks important for pre-diabetes?
Regular HbA1c checks help track glucose levels and prevent progression to diabetes.
37
What are the two main components of an OGTT?
The OGTT includes tolerance to glucose intake and fasting glucose levels.
38
What is the range for impaired glucose tolerance (IGT) in an OGTT?
IGT is indicated when glucose levels fall between normal and diabetic thresholds after glucose intake.
39
What role does the liver play in glucose production during fasting?
The liver releases glucose during fasting, affecting blood sugar levels, especially in IFG.
40
What dietary modifications are recommended for patients with pre-diabetes?
A low-carb, low-fat diet is recommended to manage pre-diabetes.
41
What is metabolic syndrome, and why is it relevant in pre-diabetes?
Metabolic syndrome includes risk factors like abdominal obesity and high blood pressure, increasing the risk of diabetes and cardiovascular disease.
42
What are the diagnostic criteria for diabetes based on fasting glucose?
Diabetes is diagnosed if fasting glucose is ≥7 mmol/L.
43
How many abnormal test results are required to confirm a diabetes diagnosis?
Two abnormal results are necessary to confirm a diabetes diagnosis.
44
What is the recommended first-line medication if HbA1c is ≥8.5% in a diabetic patient?
Metformin is recommended as first-line therapy for HbA1c ≥8.5%.
45
When is insulin indicated for diabetic patients based on pH levels?
Insulin is used if the patient is metabolically decompensated with a pH <7.3.
46
What is the role of long-acting insulin in managing fasting glucose levels?
Long-acting insulin helps control liver glucose production, stabilizing fasting glucose.
47
Why should insulin use be reported to the Ministry of Transport?
Reporting is legally required to ensure safe driving due to hypoglycemia risks.
48
What is the glucose threshold for gestational diabetes on a glucose challenge test?
The threshold varies but typically a value ≥7.8 mmol/L on a 50g glucose test indicates gestational diabetes.
49
What medication is commonly used to manage gestational diabetes?
Glyburide is commonly prescribed for managing blood glucose in gestational diabetes.
50
Why is close monitoring of HbA1c levels important during pregnancy?
High HbA1c levels increase risks of congenital abnormalities in the fetus.
51
What type of specialist should be consulted for managing diabetes during pregnancy?
Collaboration with an obstetrician is recommended for managing diabetes during pregnancy.
52
How do SGLT2 inhibitors benefit diabetic patients with heart failure?
SGLT2 inhibitors lower blood glucose and reduce heart failure risk.
53
What is the average HbA1c reduction achieved with SGLT2 inhibitors?
SGLT2 inhibitors can reduce HbA1c by approximately 1.5%.
54
What is the main function of GLP-1 analogs in diabetes management?
GLP-1 analogs stimulate insulin secretion and reduce appetite, helping manage diabetes.
55
What are the key side effects of Metformin?
Common side effects include gastrointestinal symptoms such as nausea and diarrhea.
56
What is the benefit of combining medications for diabetes management?
Combination therapies help achieve optimal glucose control by targeting different pathways.
57
What dietary advice complements medication therapy in diabetes management?
A balanced diet low in processed sugars and fats supports medication efficacy.
58
How is risk stratification used in diabetes care?
Risk stratification identifies high-risk patients for preventive treatments like statins.
59
What is a key factor in classifying metabolic syndrome related to diabetes risk?
Waist circumference is a primary measure, indicating abdominal obesity risk.
60
What role do the Framingham studies play in diabetes risk assessment?
These studies help classify patients into high, moderate, and low-risk groups.
61
Why is emergency management of diabetes important?
Rapid intervention can prevent complications during metabolic decompensation.
62
What test is used to assess pH and bicarbonate levels in diabetic emergencies?
Arterial blood gas (ABG) tests are used to evaluate metabolic decompensation.
63
Why might a venous blood gas test be used instead of an ABG in emergencies?
Venous blood gas can be a less invasive alternative, providing quick pH assessments.
64
What department is primarily responsible for managing acute diabetes complications?
The emergency department handles acute diabetes-related emergencies.
65
Why is it important to have at least two abnormal glucose tests to diagnose diabetes?
Multiple tests ensure accuracy and reduce the likelihood of false positives.
66
What are the ideal fasting glucose levels for managing diabetes with lifestyle alone?
Fasting glucose should ideally be <7 mmol/L for lifestyle-based management.
67
How often should HbA1c be monitored in diagnosed diabetes?
HbA1c should be checked every 3–6 months to monitor diabetes control.
68
What is the target HbA1c level for most diabetes patients?
The target HbA1c is typically <7% to minimize complication risks.
69
What is the main glucose-lowering effect of SGLT2 inhibitors?
They increase glucose excretion in the urine, lowering blood glucose levels.
70
What precautions are necessary when prescribing SGLT2 inhibitors to heart failure patients?
Monitor for signs of dehydration and electrolyte imbalances.
71
What are the benefits of adding GLP-1 analogs to insulin therapy?
They reduce insulin dose requirements and help manage weight.
72
How does pregnancy affect diabetes management in terms of insulin needs?
Insulin requirements often increase due to hormonal changes.
73
What is the primary action of Metformin in diabetes?
Metformin reduces hepatic glucose production, aiding blood sugar control.
74
When is combination therapy typically considered for diabetes?
When lifestyle and single-drug therapy fail to maintain target HbA1c levels.
75
What monitoring is required for patients on combination therapies?
Regular glucose and HbA1c checks are necessary to prevent hypoglycemia.
76
How can high-risk diabetes patients benefit from statins?
Statins lower cardiovascular risk, which is often elevated in diabetes.
77
What lifestyle changes can help in managing metabolic syndrome?
Reducing abdominal obesity through diet and exercise is key.
78
What is the main goal of emergency diabetes treatment in the ED?
Stabilize blood glucose and address any pH or bicarbonate imbalances.
79
Why is close coordination with specialists recommended for high-risk diabetic patients?
Specialized input helps tailor treatment, especially with comorbidities.
80
What is the risk of untreated gestational diabetes?
It can lead to fetal complications, such as macrosomia and hypoglycemia.
81
What dietary pattern is recommended to help manage diabetes and pre-diabetes?
A Mediterranean or low-carb diet is often recommended, as it supports blood sugar control and heart health.
82
Why is regular monitoring of HbA1c levels important in diabetes management?
It allows healthcare providers to assess long-term blood glucose control and adjust treatment if needed.
83
What effect does Metformin have on the body’s insulin sensitivity?
Metformin improves insulin sensitivity, especially in the liver, helping lower blood glucose levels.
84
How can weight loss impact HbA1c levels in patients with type 2 diabetes?
Weight loss generally lowers HbA1c, often resulting in better blood sugar control and possibly reduced medication needs.
85
What is the primary goal of diabetes management in pregnant women?
To maintain blood glucose within target ranges to reduce the risk of complications for both mother and baby.
86
How does physical activity affect insulin resistance?
Exercise increases insulin sensitivity, allowing muscles to better absorb glucose from the bloodstream.
87
What is the recommended fasting blood glucose range for most diabetes patients?
The typical target is 4.4–7.2 mmol/L, though individual goals may vary.
88
Why are SGLT2 inhibitors beneficial for diabetes patients with heart failure?
SGLT2 inhibitors reduce blood sugar, decrease blood pressure, and lower the risk of heart failure hospitalization.
89
How often should patients with diabetes monitor their blood glucose levels?
Frequency depends on treatment, but many are advised to check at least once daily, especially those on insulin.
90
Why is it important to test both fasting and postprandial (after-meal) glucose levels in diabetes management?
Monitoring both helps identify blood sugar trends and manage diabetes more effectively by adjusting diet or medication.
91
What is the role of continuous glucose monitoring (CGM) in diabetes care?
CGM provides real-time blood glucose readings, helping patients and providers make more timely management decisions.
92
How does stress management contribute to better blood glucose control in diabetes?
Reducing stress can lower cortisol levels, which can help decrease blood glucose levels.
93
Why should patients with diabetes avoid excessive alcohol consumption?
Alcohol can cause hypoglycemia, especially in patients taking insulin or certain oral diabetes medications.
94
What are the primary signs of diabetic neuropathy?
Symptoms include numbness, tingling, pain, and weakness, especially in the feet and hands.
95
How does sleep quality affect blood sugar levels in people with diabetes?
Poor sleep can worsen insulin resistance, leading to higher blood glucose levels.
96
What is the purpose of the glucose challenge test in diagnosing gestational diabetes?
The test assesses how well a pregnant woman’s body handles glucose to detect gestational diabetes.
97
How does high blood pressure affect diabetes complications?
High blood pressure can worsen diabetes complications, such as kidney disease and cardiovascular issues.
98
Why is portion control important for diabetes patients?
It helps prevent overeating, which can lead to blood sugar spikes and weight gain.
99
What is the effect of combining GLP-1 analogs with Metformin in diabetes treatment?
Combining these medications often results in better blood glucose control and weight loss.
100
How can diabetic patients prevent hypoglycemia when exercising?
They can monitor blood glucose levels before and after exercise and adjust food intake or insulin doses as needed.
101
What role does dietary protein play in managing diabetes?
Protein helps stabilize blood sugar and can prevent spikes when eaten with carbohydrates.
102
Why is it important for people with diabetes to regularly monitor cholesterol levels?
High cholesterol increases the risk of cardiovascular complications, which are more common in diabetes.
103
How does fiber intake affect blood sugar levels?
Fiber slows down the absorption of sugar, helping to maintain more stable blood glucose levels.
104
What is the target HbA1c level for most people with type 2 diabetes?
The general target is <7%, but this may vary depending on individual health factors.
105
Why is regular foot examination crucial for diabetes patients?
Diabetic neuropathy and poor circulation increase the risk of foot injuries and infections, which can lead to serious complications.
106
How does a high-salt diet impact diabetes patients?
Excessive salt can raise blood pressure, which can worsen diabetes-related complications.
107
What are the main dietary sources of simple sugars that people with diabetes should limit?
Foods high in added sugars, such as sugary drinks, desserts, and candies.
108
How can a diabetes care team support effective disease management?
The team can provide medical, nutritional, and psychological guidance tailored to the patient’s needs.
109
What are the benefits of GLP-1 receptor agonists for diabetes management?
They help lower blood glucose, promote weight loss, and may reduce cardiovascular risk.
110
What symptoms might indicate high blood sugar in a person with diabetes?
Symptoms include frequent urination, increased thirst, blurred vision, and fatigue.
111
Why is it important for diabetes patients to have regular kidney function tests?
Diabetes can damage kidneys, and regular testing can help detect early signs of kidney disease.
112
How do statins benefit diabetes patients at high risk for cardiovascular disease?
Statins lower cholesterol, reducing the risk of heart attack and stroke in diabetes patients.
113
What role does hydration play in blood glucose management for diabetes patients?
Staying hydrated helps kidneys flush out excess glucose and supports better glucose control.
114
How does aerobic exercise benefit blood glucose levels in diabetes?
Aerobic exercise improves insulin sensitivity and can help lower blood sugar.
115
What is the purpose of diabetes self-management education?
It equips patients with knowledge and skills for daily management, including monitoring, diet, and exercise.
116
Why should diabetes patients avoid trans fats?
Trans fats increase the risk of heart disease and worsen insulin resistance.
117
What is hyperosmolar hyperglycemic state (HHS) and its symptoms?
HHS is a severe form of hyperglycemia with symptoms like extreme dehydration, confusion, and high blood sugar.
118
Why is it important to monitor blood glucose before bed in diabetes?
It helps prevent nocturnal hypoglycemia, particularly in patients using insulin.
119
What are the common side effects of Metformin?
Side effects include gastrointestinal issues such as nausea, diarrhea, and stomach discomfort.
120
How do GLP-1 agonists help with weight loss in diabetes?
They decrease appetite and slow gastric emptying, promoting satiety and reducing calorie intake.
121
What are the symptoms of diabetic ketoacidosis (DKA)?
Symptoms include nausea, vomiting, abdominal pain, rapid breathing, and a fruity odor on the breath.
122
How does regular physical activity benefit blood pressure control in diabetes?
It helps lower blood pressure, reducing the risk of complications in diabetes patients.
123
Why is early detection of pre-diabetes important?
Early detection allows for lifestyle changes to prevent or delay the onset of diabetes.
124
What is the effect of dehydration on blood glucose levels?
Dehydration can cause blood glucose to become concentrated, raising blood sugar levels.
125
Why are combination therapies often used in diabetes management?
Combination therapies provide better glucose control by targeting different mechanisms of glucose regulation.
126
What dietary adjustment is recommended for diabetes patients with kidney disease?
Reducing protein intake can help prevent further kidney damage.
127
Why is it essential to monitor blood glucose levels after meals in diabetes?
Post-meal monitoring helps identify how different foods impact blood sugar and manage glucose spikes.
128
What is the Dawn Phenomenon in diabetes?
It is a natural rise in blood sugar in the early morning hours due to hormonal changes.
129
Why should diabetes patients avoid skipping medications without consulting a doctor?
Skipping medications can lead to uncontrolled blood sugar and increase the risk of complications.
130
How does regular resistance training benefit people with diabetes?
Resistance training improves muscle strength, increases insulin sensitivity, and aids in glucose control.
131
What is the impact of consuming high-glycemic-index foods for someone with diabetes?
High-glycemic foods cause rapid spikes in blood sugar, making glucose control more challenging.
132
Why is meal planning important in diabetes management?
Planned meals help maintain consistent blood sugar levels and reduce the risk of glucose spikes.
133
How do beta cells in the pancreas relate to diabetes?
Beta cells produce insulin, and their dysfunction or loss is a key factor in diabetes.
134
What is the typical duration of action for rapid-acting insulin?
Rapid-acting insulin usually works within 15 minutes and lasts 2–4 hours.
135
How does insulin resistance develop in type 2 diabetes?
Cells become less responsive to insulin over time, leading to elevated blood glucose levels.
136
What is the primary difference between type 1 and type 2 diabetes?
Type 1 diabetes is an autoimmune condition with insulin deficiency, while type 2 involves insulin resistance.
137
Why is carbohydrate counting beneficial for people with diabetes?
It helps patients estimate the insulin needed for meals and control blood sugar levels.
138
What role does the liver play in blood glucose regulation?
The liver releases stored glucose, helping maintain normal blood sugar during fasting.
139
How does high blood sugar affect vision in diabetes patients?
It can cause blurry vision and, over time, damage the blood vessels in the retina.
140
Why are diabetes patients advised to limit saturated fats?
Saturated fats can worsen insulin resistance and increase heart disease risk.
141
What is an insulin pump, and who might benefit from it?
An insulin pump is a device for continuous insulin delivery, beneficial for those requiring tight glucose control.
142
What are ketones, and why are they monitored in diabetes?
Ketones are byproducts of fat metabolism, which can accumulate and indicate diabetic ketoacidosis.
143
Why is it essential to address high cholesterol in diabetes patients?
High cholesterol contributes to cardiovascular complications, a common risk in diabetes.
144
How can fiber in the diet help manage blood sugar levels?
Fiber slows sugar absorption, helping to prevent rapid increases in blood glucose.
145
What are the primary goals of diabetes education programs?
To provide knowledge and skills for effective blood sugar management, including diet, exercise, and medication.
146
How does obesity increase the risk of developing type 2 diabetes?
Excess fat contributes to insulin resistance, a key factor in type 2 diabetes development.
147
What is basal insulin, and when is it used?
Basal insulin is long-acting insulin used to control blood sugar between meals and overnight.
148
What are the potential risks of untreated gestational diabetes?
It increases risks for both mother and baby, including high birth weight and future type 2 diabetes.
149
How does stress impact blood glucose levels?
Stress raises cortisol, which can increase blood glucose and make diabetes harder to manage.
150
What are some common causes of hypoglycemia in diabetes patients?
Causes include skipping meals, excessive insulin, increased physical activity, or alcohol consumption.
151
What is the Somogyi effect in diabetes?
It is a rebound hyperglycemia that occurs after a hypoglycemic episode, often overnight.
152
Why is high blood pressure dangerous for people with diabetes?
It increases the risk of kidney disease, heart disease, and stroke.
153
How often should people with diabetes see an eye specialist?
An annual eye exam is recommended to monitor for diabetic retinopathy.
154
Why is it essential to rotate insulin injection sites?
Rotating sites prevents lipodystrophy, which can interfere with insulin absorption.
155
What is the impact of consuming protein with carbohydrates for blood sugar control?
Protein can help slow carbohydrate absorption, leading to a more gradual increase in blood sugar.
156
Why are foot exams critical for diabetes patients?
Diabetes can cause nerve damage and poor circulation, increasing the risk of foot injuries and infections.
157
What lifestyle changes are often recommended to manage pre-diabetes?
Lifestyle changes include a balanced diet, regular exercise, weight management, and reducing sugar intake.
158
Why is Metformin often the first-line medication for type 2 diabetes?
Metformin is effective, has a favorable safety profile, and improves insulin sensitivity.
159
What is the main difference between rapid-acting and long-acting insulin?
Rapid-acting insulin works quickly to manage blood sugar after meals, while long-acting insulin provides steady control.
160
How does physical activity benefit people with type 2 diabetes?
Exercise improves insulin sensitivity, lowers blood glucose, and supports weight management.
161
What is a diabetic foot ulcer, and why is it a concern?
It’s an open sore that can become infected and lead to serious complications if untreated.
162
Why is it important to avoid smoking in diabetes?
Smoking worsens insulin resistance and increases the risk of heart and vascular complications.
163
What is the purpose of a glycemic target in diabetes care?
It provides a blood sugar goal to reduce the risk of complications and improve quality of life.
164
How does bariatric surgery impact diabetes?
It can significantly improve or even resolve type 2 diabetes in some individuals.
165
Why are postprandial glucose levels monitored in diabetes?
Postprandial monitoring helps assess blood sugar response to meals, guiding dietary and medication adjustments.
166
What is insulin-to-carbohydrate ratio, and why is it used?
It’s a personalized calculation to determine insulin needed per carbohydrate gram, helping manage meal-related glucose levels.
167
Why is protein important in a diabetic diet?
Protein has minimal effect on blood glucose and helps maintain satiety and muscle mass.
168
What symptoms might indicate hypoglycemia in someone with diabetes?
Symptoms include sweating, shaking, confusion, and irritability.
169
Why are combination medications beneficial in diabetes management?
They target different aspects of glucose regulation, often achieving better control.
170
What is gestational diabetes, and how is it diagnosed?
It’s high blood sugar during pregnancy, diagnosed with an oral glucose tolerance test.
171
How does alcohol affect blood glucose levels in people with diabetes?
Alcohol can cause hypoglycemia, especially when combined with diabetes medications or on an empty stomach.
172
What is diabetic retinopathy?
It’s a diabetes complication affecting the eyes, caused by damage to the blood vessels in the retina.
173
Why is it important to eat meals at regular intervals for diabetes?
Regular meals help maintain stable blood sugar and prevent large fluctuations.
174
How do artificial sweeteners impact blood sugar levels?
Most artificial sweeteners do not raise blood glucose, making them a low-calorie alternative.
175
Why should patients with diabetes get vaccinated against the flu?
Illnesses like the flu can worsen blood glucose control and lead to complications.
176
What does an A1c of 8.5% indicate in diabetes?
An A1c of 8.5% indicates poor blood sugar control and increased risk of complications.
177
Why is blood pressure control important in diabetes management?
Controlling blood pressure reduces the risk of heart and kidney complications in diabetes patients.
178
What is the difference between type 1 and type 1.5 diabetes?
Type 1.5 diabetes, or LADA, is a slower-progressing autoimmune form of diabetes that may initially be mistaken for type 2.
179
How does kidney disease affect diabetes management?
Kidney disease can affect medication choices and requires careful blood glucose and blood pressure management.
180
What is the role of omega-3 fatty acids in diabetes management?
Omega-3s support heart health, which is especially important in people with diabetes.
181
What is the purpose of regular dental check-ups for diabetes patients?
Diabetes can increase the risk of gum disease, so regular dental care helps maintain oral health.
182
Why is it important to manage cholesterol levels in diabetes?
High cholesterol increases cardiovascular risk, which is already elevated in diabetes.
183
What is hypoglycemia unawareness?
It’s a condition where individuals don’t feel typical low blood sugar symptoms, increasing risk of severe hypoglycemia.
184
How does a high-fiber diet benefit diabetes patients?
High fiber helps slow digestion, stabilize blood sugar, and improve satiety.
185
Why should diabetes patients limit processed foods?
Processed foods often contain added sugars and unhealthy fats, which can worsen blood sugar control.
186
What is the recommended daily intake of carbohydrates for someone with diabetes?
Carbohydrate intake varies by individual needs but is often between 45–60 grams per meal.
187
How does dehydration affect blood glucose levels in diabetes?
Dehydration can cause blood glucose levels to rise due to lower fluid volume in the blood.
188
What are some high-fiber foods beneficial for diabetes management?
Foods such as whole grains, legumes, fruits, and vegetables are rich in fiber and help regulate blood sugar.
189
Why is protein intake particularly important in diabetic diets?
Protein helps stabilize blood sugar levels and can promote satiety, reducing the likelihood of overeating.
190
What impact does smoking have on blood glucose control?
Smoking can increase insulin resistance and exacerbate vascular complications in people with diabetes.
191
What are the effects of alcohol on blood glucose levels for those with diabetes?
Alcohol can cause blood sugar to drop, especially when consumed without food, posing a risk for hypoglycemia.
192
How does stress management contribute to better diabetes control?
Managing stress reduces cortisol levels, which can help lower blood sugar and improve insulin sensitivity.
193
What is the recommended carbohydrate intake per meal for people with diabetes?
Generally, 45-60 grams per meal, depending on individual needs and activity levels.
194
What are the warning signs of diabetic ketoacidosis (DKA)?
Symptoms include excessive thirst, frequent urination, nausea, abdominal pain, and confusion.
195
How often should HbA1c be monitored in patients with diabetes?
Typically every 3-6 months, depending on how well blood sugar is controlled.
196
What lifestyle modification is recommended to reduce the risk of diabetes complications?
Regular physical activity, a balanced diet, smoking cessation, and weight management.
197
Why is it important for people with diabetes to monitor their feet daily?
Daily checks help detect minor injuries or infections early, reducing the risk of severe complications.
198
What effect does regular exercise have on blood glucose levels?
Exercise increases insulin sensitivity, helping muscles absorb glucose and lowering blood sugar levels.
199
What is the Dawn Phenomenon in diabetes?
It’s an early-morning rise in blood sugar due to hormonal changes, often seen in diabetes patients.
200
How does fiber benefit blood glucose control in diabetes patients?
Fiber slows down carbohydrate absorption, helping prevent blood sugar spikes.
201
What is the difference between hypoglycemia and hyperglycemia?
Hypoglycemia is low blood sugar, while hyperglycemia is high blood sugar.
202
Why should diabetes patients limit their intake of sugary beverages?
Sugary drinks cause rapid blood sugar spikes and provide empty calories without nutritional benefits.
203
What role does the liver play in blood glucose regulation?
The liver stores glucose and releases it as needed, helping to maintain stable blood sugar levels.
204
Why are foot infections dangerous for diabetes patients?
Poor circulation and neuropathy can lead to severe infections and delayed healing.
205
What are ketones, and why are they dangerous in diabetes?
Ketones are byproducts of fat metabolism that can accumulate and lead to ketoacidosis if uncontrolled.
206
How can diabetes increase the risk of heart disease?
High blood sugar damages blood vessels and increases cholesterol, raising cardiovascular risk.
207
What is metabolic syndrome, and how is it related to diabetes?
Metabolic syndrome is a group of conditions (high blood pressure, cholesterol, waist circumference) that raise diabetes risk.
208
How does high blood pressure affect diabetes patients?
High blood pressure can worsen kidney damage and increase the risk of cardiovascular events.
209
Why is it essential for diabetes patients to stay hydrated?
Hydration helps kidneys remove excess glucose from the blood and supports overall blood sugar control.
210
What is the goal of blood sugar management in diabetes?
To maintain blood glucose within a target range to prevent complications and promote well-being.
211
What are the two main types of diabetes?
Type 1 diabetes, which is autoimmune, and type 2 diabetes, which is often related to insulin resistance.
212
What is the primary function of insulin in the body?
Insulin helps cells absorb glucose from the blood to be used for energy.
213
Why is protein important in a diabetes diet?
Protein helps slow carbohydrate digestion and prevents rapid blood sugar increases.
214
What is the purpose of an HbA1c test in diabetes management?
HbA1c measures average blood glucose over 2-3 months, indicating overall glucose control.
215
Why is it important for people with diabetes to avoid processed foods?
Processed foods often contain hidden sugars and unhealthy fats that can worsen blood glucose control.
216
What effect does caffeine have on blood glucose?
Caffeine may raise blood glucose levels in some people by increasing adrenaline.
217
What is the purpose of the Oral Glucose Tolerance Test (OGTT)?
The OGTT helps diagnose diabetes and pre-diabetes by measuring glucose response after drinking a sugary solution.
218
What are common symptoms of diabetes?
Symptoms include excessive thirst, frequent urination, fatigue, blurred vision, and slow wound healing.
219
Why is it crucial for diabetes patients to manage cholesterol levels?
High cholesterol can exacerbate the risk of cardiovascular complications associated with diabetes.
220
What is basal insulin?
Basal insulin is long-acting insulin that maintains steady glucose levels between meals.
221
How does high blood glucose affect kidney function in diabetes?
Chronic high glucose damages kidney blood vessels, leading to diabetic nephropathy.
222
What are GLP-1 receptor agonists, and how do they help in diabetes management?
GLP-1 agonists increase insulin secretion and reduce appetite, aiding in glucose control and weight loss.
223
Why is regular blood sugar monitoring essential in diabetes?
It helps patients understand their glucose trends and adjust their treatment as needed.
224
How does high blood sugar damage nerves in diabetes?
Prolonged high glucose damages the nerve’s blood supply, leading to neuropathy.
225
What is the primary cause of type 1 diabetes?
An autoimmune attack on insulin-producing beta cells in the pancreas.
226
How can losing weight improve blood sugar control in type 2 diabetes?
Weight loss reduces insulin resistance, helping lower blood glucose levels.
227
What is the main treatment goal for gestational diabetes?
To control blood sugar levels and minimize risks for both mother and baby.
228
What role does the pancreas play in diabetes?
The pancreas produces insulin, which regulates blood sugar levels.
229
How does Metformin work in managing diabetes?
Metformin lowers blood glucose by reducing liver glucose production and improving insulin sensitivity.
230
What is diabetic retinopathy?
It’s an eye condition caused by damage to blood vessels in the retina due to high blood sugar.
231
How can managing stress benefit blood glucose control?
Lowering stress can reduce cortisol levels, leading to better glucose regulation.
232
Why is it important for people with diabetes to maintain a healthy weight?
Healthy weight reduces insulin resistance and lowers the risk of complications.
233
What are the common side effects of Metformin?
Common side effects include gastrointestinal issues like nausea and diarrhea.
234
Why is it important to rotate insulin injection sites?
Rotating sites prevents skin complications and ensures consistent insulin absorption.
235
How does exercise help lower blood glucose levels in diabetes?
Exercise increases insulin sensitivity and helps muscles use glucose for energy.
236
What are the benefits of combining medications in diabetes treatment?
Combination therapy can address different aspects of blood glucose regulation more effectively.
237
Why is it important for diabetes patients to have regular check-ups?
Regular check-ups help monitor blood glucose, check for complications, and adjust treatment plans.
238
What is insulin resistance?
It’s when cells do not respond effectively to insulin, leading to high blood sugar.
239
How does the HbA1c test differ from a blood glucose test?
HbA1c reflects average blood glucose over months, while a blood glucose test gives a single-time result.
240
What is diabetic nephropathy?
Kidney damage caused by high blood glucose.
241
Why is blood pressure control important in diabetes management?
High blood pressure can exacerbate kidney and cardiovascular complications in diabetes.
242
What is the 'Rule of 15' for treating hypoglycemia?
If blood sugar is low, consume 15 grams of carbs, wait 15 minutes, and recheck blood sugar.
243
What is insulin stacking, and why is it dangerous?
Insulin stacking is taking additional doses before previous insulin has fully absorbed, risking hypoglycemia.
244
How does diabetes increase the risk of infections?
High glucose impairs immune response, making it harder to fight infections.
245
What is the role of carbohydrates in diabetes management?
Carbs impact blood sugar the most, so counting and timing intake helps control glucose levels.
246
Why is foot care critical for people with diabetes?
Neuropathy can prevent them from feeling injuries, which can lead to infections and ulcers.
247
What does an insulin pump do?
It delivers insulin continuously and can be programmed to match individual blood sugar patterns.
248
What dietary pattern is often recommended for type 2 diabetes?
A balanced diet with controlled portions of carbohydrates, fiber, protein, and healthy fats.
249
What is a major risk factor for type 2 diabetes?
Obesity, as excess body fat increases insulin resistance.
250
How does sleep impact blood sugar levels?
Poor sleep can raise blood sugar by increasing insulin resistance and stress hormones.
251
What are ketones, and why are they monitored in diabetes?
Ketones are produced when fat is used for energy instead of glucose; high levels can indicate ketoacidosis.
252
What is lipohypertrophy, and how does it relate to insulin use?
It’s a thickening of skin from repeated injections at the same site, affecting insulin absorption.
253
How does Metformin affect glucose production?
It decreases glucose production in the liver, helping lower blood glucose.
254
What is basal-bolus insulin therapy?
A regimen combining long-acting (basal) and short-acting (bolus) insulin to manage blood glucose.
255
Why should people with diabetes limit saturated fats?
They can increase cholesterol, raising the risk of heart disease, which is already higher in diabetes.
256
What is a low glycemic index (GI) food, and why is it beneficial in diabetes?
Low GI foods cause slower blood sugar rises, helping manage glucose levels.
257
How does resistance training help manage diabetes?
It builds muscle, which increases insulin sensitivity and helps control blood sugar.
258
What is the goal of diabetes management in pregnancy?
To maintain blood glucose levels to avoid complications for both mother and baby.
259
How often should people with diabetes test their blood glucose?
Frequency varies; some may test multiple times daily, while others check less often based on their treatment plan.
260
What is the Somogyi effect?
It’s a rebound high blood sugar following low blood sugar, often due to excess insulin at night.
261
Why are regular eye exams recommended for people with diabetes?
To detect early signs of diabetic retinopathy and prevent vision loss.
262
What are some common symptoms of hypoglycemia?
Symptoms include shakiness, sweating, confusion, and, in severe cases, unconsciousness.
263
What impact does smoking cessation have on diabetes management?
Quitting smoking improves blood vessel health, reducing the risk of complications.
264
How does stress influence blood sugar in diabetes?
Stress raises cortisol, which can increase blood sugar and worsen glucose control.
265
What is insulin resistance, and how does it affect diabetes?
It’s when cells don’t respond well to insulin, making it hard to lower blood sugar levels.
266
Why is it essential to have a consistent meal schedule in diabetes management?
Consistent meals help maintain stable blood glucose levels throughout the day.
267
How does alcohol affect blood glucose levels?
It can cause hypoglycemia, especially when consumed without food, as the liver prioritizes processing alcohol over glucose production.
268
What is the significance of triglyceride levels in diabetes?
High triglycerides often accompany diabetes and increase cardiovascular risk.
269
Why is the waist-to-hip ratio relevant in assessing diabetes risk?
A higher ratio indicates central obesity, which is linked to insulin resistance.
270
What is hyperosmolar hyperglycemic state (HHS)?
A severe complication of diabetes with very high blood glucose, often without ketosis, leading to dehydration and confusion.
271
How does fiber benefit blood glucose control?
Fiber slows digestion, helping prevent rapid spikes in blood sugar.
272
What is the primary goal of medical nutrition therapy in diabetes?
To manage blood glucose, cholesterol, and blood pressure through a balanced diet.
273
Why is hydration particularly important for diabetes patients?
Proper hydration helps flush out excess blood sugar through urine.
274
What is the 'dawn phenomenon,' and how does it affect blood sugar?
It’s an early morning rise in blood glucose due to hormone changes, often requiring medication adjustments.
275
How do GLP-1 receptor agonists assist in type 2 diabetes management?
They stimulate insulin release, reduce appetite, and slow stomach emptying to lower blood sugar.
276
Why is insulin important for managing type 1 diabetes?
Type 1 diabetes patients lack insulin production, so it must be provided externally.
277
What is diabetic ketoacidosis (DKA)?
A serious complication where lack of insulin leads to high blood glucose and ketones, causing acidosis.
278
How does regular physical activity help manage diabetes?
It improves insulin sensitivity and helps control blood glucose.
279
Why are blood lipids monitored in diabetes patients?
Diabetes increases the risk of high cholesterol, which can contribute to cardiovascular disease.
280
What is the benefit of counting carbohydrates in diabetes?
It helps manage post-meal blood sugar by controlling carbohydrate intake.
281
What is an insulin pen, and how is it used?
It’s a device for injecting insulin that allows for easier and more accurate dosing.
282
Why is foot care education critical for people with diabetes?
Foot care education helps prevent complications from injuries that may go unnoticed due to neuropathy.
283
What does improved insulin sensitivity do?
It helps control blood glucose.
284
Why is foot care education critical for people with diabetes?
Neuropathy and poor circulation increase the risk of severe foot complications, requiring preventive care.
285
How can weight loss help prevent type 2 diabetes in at-risk individuals?
Weight loss reduces insulin resistance, which can lower the risk of developing diabetes.
286
What are 'free foods' in diabetes management?
Foods low in carbs and calories that don’t significantly affect blood glucose, like certain vegetables.
287
What is the first step in managing a patient with diabetic ketoacidosis (DKA)?
The first step is initial fluid resuscitation with normal saline due to severe dehydration.
288
Why should potassium not be added to the initial IV fluid in DKA management?
Potassium is not added initially because potassium levels need to be assessed and monitored first to avoid hyperkalemia.
289
What is the recommended insulin dose for DKA management?
The recommended insulin dose for DKA is 0.1 units/kg/hour.
290
Which markers should be closely monitored during DKA management?
Serum glucose, potassium, bicarbonate, and anion gap should be monitored closely.
291
At what blood glucose range should DKA treatment aim to maintain levels?
Blood glucose should be maintained between 130 and 160 mg/dL to avoid complications like cerebral edema.
292
What is the importance of monitoring anion gap in DKA?
Monitoring the anion gap helps determine if acidosis is resolving and guides adjustments in treatment.
293
In the absence of volume overload, should diuretics be used in DKA management?
No, diuretics should generally be avoided as kidneys can excrete chloride effectively unless there is volume overload.
294
What clinical features are common in diabetic ketoacidosis?
Common features include polyuria, polydipsia, polyphagia, fatigue, nausea, vomiting, and orthostatic changes.
295
What role does insulin play in decreasing serum potassium during DKA treatment?
Insulin promotes potassium uptake by cells, which can lead to hypokalemia if not monitored.
296
What should be monitored closely when transitioning from IV to subcutaneous insulin in DKA?
Blood glucose, ketone levels, and anion gap should be stable to avoid rebound hyperglycemia or ketoacidosis.
297
Why is bicarbonate generally avoided in DKA management?
Bicarbonate can increase risk of hypokalemia and paradoxical CNS acidosis.
298
What indicates the need to restart insulin therapy if hyperglycemia returns after DKA resolution?
An increase in blood glucose above 250 mg/dL with symptoms or lab signs of acidosis may indicate relapse.
299
What is the initial target blood glucose level in HHS treatment?
Blood glucose should be gradually lowered to around 250–300 mg/dL initially to prevent rapid shifts.
300
What potential cardiovascular complication is a concern in HHS due to hyperviscosity?
The risk of thromboembolism is higher in HHS due to blood hyperviscosity.
301
What mental status changes are associated with severe DKA and HHS?
Confusion, lethargy, and coma can occur due to hyperosmolarity or acidosis.
302
Why might DKA patients present with tachycardia?
Dehydration and acidosis stimulate the sympathetic nervous system, leading to tachycardia.
303
How can AKI (acute kidney injury) complicate DKA management?
AKI impairs the kidneys’ ability to clear glucose and ketones, worsening hyperglycemia and acidosis.
304
What clinical signs suggest fluid overload during DKA treatment?
Peripheral edema, jugular venous distension, and crackles in the lungs indicate fluid overload.
305
Why is frequent electrolyte monitoring essential in DKA?
Rapid shifts in potassium and other electrolytes can cause dangerous imbalances during treatment.
306
How is polyuria in DKA related to hyperglycemia?
High glucose levels exceed renal glucose reabsorption, leading to glucose in urine and osmotic diuresis.
307
What is the target serum potassium level to maintain during DKA treatment?
A serum potassium level between 4.0-5.0 mEq/L is ideal to avoid hypokalemia.
308
What other electrolyte besides potassium should be monitored closely due to insulin’s effects?
Magnesium should be monitored, as insulin may cause it to shift into cells, risking hypomagnesemia.
309
When is phosphate supplementation considered in DKA management?
Phosphate supplementation may be needed if levels drop significantly or if there’s respiratory muscle weakness.
310
What respiratory pattern is commonly seen in severe DKA?
Kussmaul respirations, a deep and labored breathing pattern, are a common compensatory response.
311
What is the typical pH range indicating severe acidosis in DKA?
A pH below 7.0–7.2 indicates severe acidosis in DKA cases.
312
Why should subcutaneous insulin be started before discontinuing IV insulin in DKA?
This ensures insulin levels remain stable to prevent rebound ketoacidosis.
313
How does hypoglycemia risk increase as DKA treatment progresses?
As glucose is lowered, failure to add dextrose to IV fluids can lead to hypoglycemia.
314
What complication is particularly associated with rapid fluid and electrolyte shifts in HHS?
Cerebral edema can occur due to rapid osmotic changes during rehydration.
315
Why is fever monitoring important in patients with DKA?
Fever can indicate underlying infection, a common precipitant of DKA.
316
How does untreated infection worsen DKA?
Infection triggers stress hormones like cortisol and epinephrine, worsening hyperglycemia and ketogenesis.
317
Why is DKA often associated with elevated serum lactate?
Severe dehydration can reduce tissue perfusion, leading to anaerobic metabolism and lactate production.
318
What is the significance of abdominal pain in DKA?
Abdominal pain may be due to acidosis or, rarely, pancreatitis as a complication of DKA.
319
How does elevated anion gap help in diagnosing DKA?
An elevated anion gap indicates metabolic acidosis, typical of DKA due to ketone production.
320
What’s the role of hyperventilation in DKA?
Hyperventilation helps compensate for metabolic acidosis by expelling CO2.
321
How does nausea and vomiting affect DKA patients?
Nausea and vomiting exacerbate dehydration and electrolyte imbalances in DKA.
322
What role does cortisol play in the pathophysiology of DKA?
Cortisol promotes gluconeogenesis and lipolysis, contributing to hyperglycemia and ketogenesis.
323
When is insulin infusion discontinued in DKA?
When blood glucose is stable, the anion gap is closed, and the patient is ready for subcutaneous insulin.
324
Why should insulin be titrated carefully in HHS patients?
Insulin should be adjusted to avoid rapid glucose shifts, preventing osmotic complications.
325
What laboratory marker helps to track renal recovery in HHS patients?
A decrease in BUN and creatinine with treatment indicates improved renal function.
326
What initial IV fluid is recommended for HHS?
Normal saline is recommended initially to restore intravascular volume in HHS patients.
327
What is the general mortality rate for DKA if untreated?
Untreated DKA has a mortality rate of up to 5–10%, which increases with delayed intervention.
328
Why does DKA cause fatigue and weakness?
Cellular glucose deprivation due to insulin deficiency results in energy depletion and weakness.
329
What is the risk of over-correction of acidosis in DKA?
Over-correction can cause metabolic alkalosis, leading to electrolyte disturbances.
330
How does polyphagia (increased appetite) present in DKA?
Despite high blood glucose, cells are starved of glucose, leading to increased appetite.
331
What is the main clinical sign of hydration improvement in DKA?
Increased urine output and normalized vital signs indicate improved hydration.
332
How does stress affect insulin requirements in hospitalized DKA patients?
Stress increases cortisol and epinephrine, often requiring higher insulin doses.
333
Why should close monitoring continue even after DKA resolution?
Relapse can occur if underlying issues (e.g., infection, missed insulin) are not addressed.
334
Why is glucose monitoring essential for preventing DKA relapse post-discharge?
Frequent monitoring helps ensure insulin dosing is effective and glucose remains stable.
335
What imaging study may be considered in DKA patients presenting with abdominal pain?
An abdominal CT scan can rule out pancreatitis or other acute abdominal conditions.
336
Why is bicarbonate therapy controversial in DKA management?
Bicarbonate can worsen hypokalemia and has been associated with an increased risk of cerebral edema in children.
337
How does hyperglycemia-induced osmotic diuresis affect electrolytes in DKA?
It leads to significant loss of sodium, potassium, and chloride in the urine.
338
What is the primary cause of acidosis in DKA?
Accumulation of ketone bodies (beta-hydroxybutyrate and acetoacetate) due to lack of insulin.
339
Why should patients with DKA be monitored for signs of sepsis?
Infection is a common precipitating factor for DKA, and sepsis can complicate recovery.
340
How does dehydration in HHS compare to that in DKA?
Dehydration in HHS is typically more severe and prolonged, often requiring cautious fluid resuscitation.
341
Why is a slow correction of hyperglycemia recommended in HHS?
Rapid correction can lead to cerebral edema due to sudden changes in serum osmolality.
342
How is hypernatremia managed in HHS?
Hypernatremia is managed with gradual fluid replacement using hypotonic solutions if needed.
343
Why is it essential to calculate corrected serum sodium in hyperglycemic patients?
Corrected sodium provides a true indication of sodium levels in the presence of hyperglycemia.
344
What is the most common electrolyte disturbance in DKA?
Hypokalemia is common due to insulin therapy and osmotic diuresis.
345
Why are elderly patients at higher risk of HHS?
Age-related renal impairment and decreased thirst response increase the risk of severe dehydration.
346
What are the main goals of DKA management?
Goals include correcting dehydration, electrolyte imbalances, hyperglycemia, and acidosis.
347
How does stress hyperglycemia contribute to DKA?
Stress hormones like cortisol increase blood glucose, exacerbating hyperglycemia in insulin deficiency.
348
When can patients with DKA transition from IV to subcutaneous insulin?
Transition is appropriate once the anion gap has closed, and blood glucose is stable.
349
Why is frequent monitoring of blood glucose necessary during DKA treatment?
To avoid rapid drops in glucose that can lead to hypoglycemia and cerebral edema.
350
What does a high WBC count in DKA patients indicate?
It may suggest an underlying infection or be a response to stress; further evaluation is needed.
351
How is volume status assessed in DKA patients?
Volume status can be assessed by monitoring vital signs, skin turgor, urine output, and blood pressure.
352
Why is close monitoring of urine output important in HHS?
It provides insights into hydration status and kidney function, critical in managing HHS.
353
Why is cerebral edema a higher risk in children with DKA?
Children have a lower tolerance for osmotic shifts and fluid changes, increasing their risk of cerebral edema.
354
How does prolonged hyperglycemia affect brain cells in HHS?
Chronic hyperglycemia increases blood osmolarity, causing water to shift out of brain cells, leading to dehydration of brain tissue.
355
How is hypokalemia prevented during DKA treatment?
Potassium is added to IV fluids once levels drop below 5.3 mEq/L to avoid hypokalemia.
356
What neurological signs may indicate cerebral edema in DKA?
Headache, confusion, altered mental status, and papilledema can signal cerebral edema.
357
What is a hallmark symptom of HHS not commonly seen in DKA?
Severe neurological impairment, including seizures or coma, is more common in HHS.
358
Why is continuous ECG monitoring sometimes used in DKA treatment?
ECG monitoring helps detect arrhythmias due to electrolyte imbalances, particularly potassium changes.
359
How does insulin deficiency contribute to ketone production in DKA?
Insulin deficiency leads to unrestrained lipolysis, resulting in free fatty acids converted to ketones.
360
How is the anion gap used in monitoring DKA?
The anion gap helps track resolution of ketoacidosis, with closure indicating improvement.
361
Why might beta-hydroxybutyrate levels be checked in DKA?
It is the main ketone body in DKA and provides a more accurate measure of ketosis.
362
Why does HHS have a higher mortality rate than DKA?
HHS patients are often older, with more comorbidities, and face greater risks from severe dehydration and hyperosmolarity.
363
What is the role of dextrose in IV fluids during DKA treatment?
Dextrose is added when blood glucose falls to prevent hypoglycemia and ensure safe insulin continuation.
364
What is osmotic diuresis, and why does it occur in DKA?
Osmotic diuresis is the increased urine output due to high blood glucose, which pulls water into the urine.
365
How does hyperosmolality contribute to neurological symptoms in HHS?
Hyperosmolality causes fluid shifts out of brain cells, leading to neurological symptoms such as confusion.
366
What factors influence the fluid resuscitation rate in HHS?
Factors include the degree of dehydration, electrolyte status, renal function, and cardiac status.
367
Why is bicarbonate only given in severe DKA cases?
Bicarbonate may worsen acidosis through shifts in CO2 and is generally reserved for severe acidosis.
368
How is serum ketone measurement helpful in managing DKA?
It helps assess the degree of ketosis and monitor response to therapy.
369
Why might HHS patients be more prone to thrombosis?
Hyperosmolarity increases blood viscosity, raising the risk of thrombosis.
370
How do you differentiate between mild and severe DKA?
Severity is based on pH, bicarbonate levels, and mental status, with severe cases having pH < 7.0.
371
What are the first signs of effective DKA treatment?
Improved mental status, decreased anion gap, and better hydration are signs of effective treatment.
372
How does cortisol influence DKA pathophysiology?
Cortisol promotes gluconeogenesis, increasing blood glucose and contributing to DKA.
373
Why should a diabetic patient avoid missing insulin doses?
Missed doses can lead to insulin deficiency, triggering ketosis and potentially leading to DKA.
374
Why does polyuria occur in both DKA and HHS?
Elevated glucose levels lead to osmotic diuresis, causing excessive urination and fluid loss.
375
How does severe dehydration in HHS impact kidney function?
Dehydration reduces renal blood flow, impairing kidney function and potentially leading to acute kidney injury.
376
What changes in breathing patterns occur with DKA?
Kussmaul breathing, or deep and rapid breaths, occurs as a compensatory response to acidosis.
377
How does hypovolemia in DKA affect heart rate?
Hypovolemia leads to tachycardia as the body attempts to maintain blood pressure.
378
Why might insulin requirements be higher in patients with infection-induced DKA?
Infection raises stress hormones that increase insulin resistance, necessitating higher insulin doses.
379
What physical sign might indicate dehydration in a DKA or HHS patient?
Dry mucous membranes and poor skin turgor indicate dehydration.
380
What clinical scenario often triggers HHS?
HHS is often triggered by infections, myocardial infarctions, or stroke in patients with type 2 diabetes.
381
What role does patient education play post-DKA or HHS?
Education on insulin administration, glucose monitoring, and recognizing symptoms can prevent recurrence.
382
Why is fluid administration slower in HHS compared to DKA?
Gradual rehydration is essential in HHS to avoid fluid overload and minimize neurological risks.
383
Why is frequent reassessment critical in DKA/HHS management?
Continuous monitoring helps adjust therapy to prevent complications like hypoglycemia and cerebral edema.
384
How can the risk of recurrent DKA be minimized?
Adherence to insulin therapy, regular glucose monitoring, and managing precipitating factors reduce the risk.
385
What is the goal in managing blood glucose levels in DKA to prevent cerebral edema?
The goal is to avoid rapid blood glucose level drops and maintain gradual correction.
386
How does the management of non-ketotic hyperosmolar state (NKHS) differ from DKA?
NKHS management involves a slower rate of fluid administration due to its chronic nature and potential comorbidities.
387
Which patients are more likely to experience NKHS?
NKHS is more common in type 2 diabetics.
388
What is the focus of fluid administration in NKHS management?
The focus is on rehydration, but with a slower approach compared to DKA due to the risk of overloading in chronic cases.
389
How should insulin therapy be adjusted in NKHS management?
Insulin is typically adjusted based on blood glucose levels using a sliding scale.
390
What is the mortality rate for diabetic ketoacidosis?
The mortality rate for DKA is around 5%.
391
What is the mortality rate for non-ketotic hyperosmolar state (NKHS)?
The mortality rate for NKHS is higher, around 50%, often due to underlying comorbidities and age.
392
Why is gradual correction important in DKA and NKHS management?
Gradual correction helps prevent complications like cerebral edema and electrolyte imbalance.
393
Which complications are managed with statins in diabetes?
Statins are used to manage macrovascular complications, such as coronary artery disease, by controlling lipid levels.
394
What are the primary microvascular complications of diabetes?
Microvascular complications include retinopathy, nephropathy, and peripheral neuropathy.
395
What LDL level target is recommended to prevent macrovascular complications in diabetes?
The target LDL level is less than 70 mg/dL.
396
Why is monitoring urinary output important in DKA management?
Urinary output indicates kidney function and helps assess hydration status and renal response to therapy.
397
Why is it crucial to monitor potassium levels in both DKA and NKHS?
Potassium levels fluctuate with insulin and fluid therapy; monitoring helps prevent hypokalemia or hyperkalemia.
398
How does insulin therapy affect potassium levels in DKA?
Insulin shifts potassium into cells, which can decrease serum potassium levels, necessitating careful monitoring and replacement if needed.
399
What role does bicarbonate play in DKA management?
Bicarbonate is monitored as it reflects acid-base status and helps assess the resolution of metabolic acidosis.
400
When is bicarbonate replacement considered in DKA?
Bicarbonate replacement is considered only in severe cases with a pH < 6.9 due to potential risks of rapid correction.
401
What is the significance of a high anion gap in DKA?
A high anion gap indicates ongoing metabolic acidosis, which requires continued management with fluids and insulin.
402
At what glucose level should the insulin infusion rate be reduced in DKA?
Insulin infusion rate is typically reduced when blood glucose approaches 200-250 mg/dL to prevent hypoglycemia.
403
Why is cerebral edema a risk in DKA and NKHS?
Rapid shifts in osmolarity due to aggressive fluid or glucose management can cause brain swelling, especially in young patients.
404
What factors increase the risk of cerebral edema in DKA patients?
Rapid correction of blood glucose, high initial glucose levels, and young age increase cerebral edema risk.
405
How is hydration assessed during DKA management?
Hydration is assessed through clinical signs (e.g., skin turgor, blood pressure) and urine output monitoring.
406
Why is a slower fluid administration approach used in NKHS?
NKHS patients are often elderly with comorbidities, so a slower approach reduces the risk of fluid overload and heart failure.
407
What are typical serum osmolarity levels in NKHS?
Serum osmolarity in NKHS is often above 320 mOsm/kg, indicating significant hyperosmolarity.
408
What initial laboratory tests are essential in evaluating DKA and NKHS?
Blood glucose, electrolyte panel, BUN, creatinine, serum osmolarity, and arterial blood gas (ABG) are critical initial tests.
409
How often should blood glucose be monitored in DKA?
Blood glucose should be monitored hourly initially to guide insulin therapy adjustments.
410
What is the goal of anion gap closure in DKA management?
The goal is to reach an anion gap within the normal range, indicating resolution of metabolic acidosis.
411
Why might urinary ketones persist even after clinical resolution of DKA?
Urinary ketones lag behind serum ketone clearance and may remain positive despite metabolic recovery.
412
What is the primary cause of NKHS in type 2 diabetes?
NKHS is often precipitated by infections, dehydration, or stress in patients with poorly controlled type 2 diabetes.
413
How does infection influence the management of DKA or NKHS?
Infections can worsen hyperglycemia and dehydration, so they must be identified and treated concurrently.
414
Why are antibiotics often considered in DKA or NKHS patients?
Infection is a common precipitant, so empiric antibiotics may be started if an infection is suspected.
415
How does severe dehydration present in NKHS?
Severe dehydration in NKHS may present as dry mucous membranes, tachycardia, hypotension, and altered mental status.
416
What is a major complication associated with severe NKHS?
Thromboembolic events, such as deep vein thrombosis (DVT), are common due to high blood viscosity from dehydration.
417
Why is the goal glucose level lower in NKHS than in DKA?
Since NKHS patients are not ketotic, glucose reduction should be more gradual to avoid osmotic shifts.
418
When should insulin therapy be paused in DKA treatment?
Insulin may be paused if potassium falls below 3.3 mmol/L, as hypokalemia can cause dangerous cardiac arrhythmias.
419
What are common electrolyte abnormalities in DKA?
DKA often presents with hyperkalemia initially, followed by hypokalemia as insulin shifts potassium into cells.
420
Why should glucose be added to IV fluids as DKA resolves?
Adding glucose prevents hypoglycemia as insulin is continued to clear ketones and close the anion gap.
421
What mental status changes may indicate progression to NKHS?
Confusion, lethargy, and even coma can occur in NKHS due to hyperosmolarity and dehydration.
422
What is the purpose of ABG testing in DKA?
ABG testing helps evaluate acid-base status and severity of acidosis, which guides treatment adjustments.
423
Why is gradual reduction of blood glucose crucial in DKA/NKHS management?
A gradual reduction prevents osmotic shifts that could lead to cerebral edema, especially in children.
424
What urine output level indicates adequate renal function during DKA treatment?
A urine output of at least 0.5-1 mL/kg/hr suggests adequate renal perfusion and response to fluid therapy.
425
What are the primary goals in managing DKA and NKHS?
The primary goals are rehydration, electrolyte stabilization, blood glucose control, and resolution of acidosis (in DKA).
426
How does dehydration contribute to hyperglycemia in DKA and NKHS?
Dehydration reduces renal clearance of glucose, exacerbating hyperglycemia in both conditions.
427
What type of IV fluid is commonly used after initial saline in DKA?
After initial saline, dextrose with saline may be used to maintain blood glucose and continue ketosis correction.
428
In what situation should lactated Ringer’s be avoided in DKA management?
Lactated Ringer’s is avoided if acidosis is severe, as it contains lactate, which can increase lactic acid levels.
429
Why is frequent re-evaluation of electrolytes necessary in DKA/NKHS?
Insulin and fluids shift electrolytes, so frequent checks prevent imbalances, especially for potassium.
430
What does a normal anion gap signify in a DKA patient?
A normal anion gap indicates resolution of ketoacidosis.
431
How does DKA differ from NKHS in terms of ketone levels?
DKA has high ketone levels due to fatty acid breakdown, while NKHS typically has little to no ketones.
432
What clinical signs indicate effective rehydration in NKHS?
Improved blood pressure, heart rate normalization, and increased urine output suggest effective rehydration.
433
Why might metabolic acidosis persist even after initial treatment in DKA?
Acidosis can persist due to continued ketone production or delayed renal clearance of acids.
434
What symptom suggests hypovolemic shock in DKA?
Severe hypotension, tachycardia, and poor perfusion suggest hypovolemic shock from dehydration.
435
Why are regular capillary blood glucose checks essential during insulin infusion?
Frequent checks help adjust insulin and prevent hypoglycemia as blood glucose levels fluctuate.
436
When should subcutaneous insulin be started after IV insulin in DKA?
Subcutaneous insulin can start when the patient is eating, and anion gap has normalized to transition off IV insulin.
437
What are the signs of hyperglycemic hyperosmolar state (HHS) that distinguish it from DKA?
HHS typically lacks ketoacidosis but presents with extreme hyperglycemia, severe dehydration, and high serum osmolarity.
438
What blood glucose level is often seen in HHS patients?
Blood glucose levels in HHS often exceed 600 mg/dL, much higher than in typical DKA cases.
439
Why should patients with DKA or HHS be monitored for infection?
Infections are common precipitating factors for DKA and HHS, and they can worsen hyperglycemia and dehydration.
440
How does dehydration in HHS affect blood viscosity?
Dehydration increases blood viscosity, raising the risk of thromboembolic events.
441
What neurological symptoms might develop in HHS due to hyperosmolarity?
Symptoms can include confusion, seizures, and even coma as hyperosmolarity affects brain function.
442
When might central venous pressure (CVP) monitoring be helpful in DKA/HHS management?
CVP monitoring may be used in severe cases to guide fluid resuscitation and prevent fluid overload.
443
How is renal function typically impacted in patients with HHS?
Severe dehydration can lead to prerenal azotemia, characterized by elevated BUN and creatinine levels.
444
What is the effect of glucagon release during DKA?
Glucagon promotes lipolysis and ketone production, worsening ketoacidosis.
445
Why are fluids usually switched to half-normal saline in DKA after initial resuscitation?
Half-normal saline helps prevent hypernatremia and continues rehydration more gradually after initial volume replacement.
446
What is the primary reason for polyuria in DKA?
High glucose levels lead to osmotic diuresis, resulting in significant fluid loss and dehydration.
447
How does low insulin contribute to the development of DKA?
Low insulin levels lead to increased lipolysis and ketogenesis, causing ketoacidosis.
448
Why is urine ketone testing less accurate than serum ketone testing in DKA?
Urine ketones lag behind serum changes and may not reflect real-time ketone levels.
449
What can an elevated BUN/creatinine ratio indicate in DKA or HHS?
An elevated ratio suggests prerenal azotemia due to dehydration.
450
How does metabolic acidosis manifest on an ABG in DKA?
Metabolic acidosis presents with a low pH and low bicarbonate on ABG testing.
451
What can cause hypophosphatemia during DKA treatment?
Insulin shifts phosphate into cells, potentially leading to hypophosphatemia as rehydration and insulin therapy progress.
452
Why is it important to avoid a rapid reduction in serum osmolarity in HHS?
A rapid decrease can cause osmotic shifts and cerebral edema, especially in elderly patients.
453
What are the target glucose levels for transitioning from IV to subcutaneous insulin in DKA?
Target levels are around 200 mg/dL, along with a closed anion gap and the ability to tolerate oral intake.
454
What role does sodium bicarbonate play in severe acidosis?
Sodium bicarbonate can buffer acidosis in life-threatening cases, though it’s typically avoided unless pH < 6.9.
455
How do ketones contribute to the development of acidosis in DKA?
Ketones release hydrogen ions into the bloodstream, causing metabolic acidosis.
456
What is the main clinical concern with persistent hyperglycemia in HHS?
Persistent hyperglycemia can cause severe dehydration and risk for thrombotic complications.
457
How should fluids be adjusted as blood glucose levels decrease in DKA?
458
How should fluids be adjusted as blood glucose levels decrease in DKA?
Once glucose drops below 250 mg/dL, fluids should be switched to include dextrose to prevent hypoglycemia.
459
What is a safe rate of glucose reduction in HHS to prevent complications?
A gradual reduction of 50-75 mg/dL per hour is recommended to prevent rapid osmotic shifts.
460
What are some signs of recovery in DKA patients?
Improved mental status, reduced anion gap, and stabilized electrolytes indicate recovery.
461
What laboratory value is key to confirm the resolution of ketoacidosis in DKA?
The normalization of the anion gap is key to confirming ketoacidosis resolution.
462
Why is regular mental status evaluation critical in HHS?
Changes in mental status may indicate worsening hyperosmolarity or potential complications like cerebral edema.
463
How does polyphagia manifest in patients with DKA?
Polyphagia, or increased hunger, is due to cellular glucose starvation from lack of insulin.
464
What electrolyte must be replaced cautiously due to risk of arrhythmias in DKA?
Potassium must be replaced carefully to prevent arrhythmias, especially as insulin is administered.
465
When is phosphate replacement considered in DKA?
Phosphate replacement may be considered if levels are very low or if there are signs of weakness or respiratory failure.
466
How often should electrolytes be monitored in DKA patients initially?
Electrolytes should be monitored every 2-4 hours initially to guide therapy adjustments.
467
What can cause elevated lactate levels in DKA patients?
Elevated lactate may result from tissue hypoxia due to poor perfusion from severe dehydration.
468
Why is hypomagnesemia a concern in DKA and HHS?
Hypomagnesemia can exacerbate arrhythmias and should be corrected if low.
469
What role does insulin play in stopping ketone production in DKA?
Insulin inhibits lipolysis, reducing free fatty acid release and thus stopping ketone production.
470
What initial fluid bolus is recommended for adult DKA patients with severe dehydration?
An initial bolus of 1-2 liters of normal saline is recommended to address severe dehydration.
471
When can DKA patients be safely discharged?
Discharge is considered once patients are clinically stable, ketone-free, and can manage diabetes with subcutaneous insulin.
472
Why is blood pH monitored in DKA?
Blood pH helps assess the severity of acidosis and response to treatment.
473
What serum osmolality level indicates severe hyperosmolarity in HHS?
Serum osmolality >320 mOsm/kg indicates severe hyperosmolarity.
474
How should fluids be modified in cases of pulmonary edema risk during DKA or HHS management?
Fluid administration should be slowed, and diuretics considered if pulmonary edema is a concern.
475
Why might patients in DKA experience Kussmaul respirations?
Kussmaul respirations are a compensatory response to metabolic acidosis, helping expel CO2.
476
How can hypoglycemia be prevented during the resolution phase of DKA treatment?
Adding dextrose to IV fluids when glucose falls below 250 mg/dL helps prevent hypoglycemia.
477
Why is multidisciplinary care important in DKA and HHS management?
Multidisciplinary care ensures comprehensive management, including addressing underlying causes and complications.
478
Why should arterial blood gases (ABG) be checked in severe DKA cases?
ABG can help assess the severity of acidosis and the need for aggressive intervention.
479
What is the role of serum bicarbonate in evaluating the severity of DKA?
Low bicarbonate levels indicate a more severe metabolic acidosis, common in DKA.
480
How does dehydration contribute to high blood glucose levels in HHS?
Dehydration reduces renal clearance of glucose, exacerbating hyperglycemia.
481
Why is insulin administration delayed in some severe HHS cases?
Fluids are prioritized initially to correct dehydration; insulin is added after some fluid replacement.
482
When should potassium be added to IV fluids during DKA treatment?
Potassium should be added once serum potassium falls below 5.3 mEq/L to prevent hypokalemia.
483
What effect does hyperglycemia have on serum sodium levels in DKA?
Hyperglycemia causes pseudohyponatremia due to osmotic fluid shifts, lowering serum sodium.
484
Why is serum osmolality important to monitor in HHS?
Serum osmolality helps gauge dehydration severity and risks of cerebral edema or neurological symptoms.
485
How is pseudohyponatremia corrected in cases of severe hyperglycemia?
Sodium can be corrected by adding 1.6 mEq/L for every 100 mg/dL increase in glucose above normal.
486
What might a positive urine ketone test in a DKA patient indicate?
It indicates ongoing ketogenesis and acidosis due to lack of insulin.
487
How can excessive fluid resuscitation impact a DKA patient with renal impairment?
Overhydration can worsen renal function.
488
What are common signs of peripheral sensory neuropathy?
Numbness, loss of temperature sensation, pain, and reduced pressure sensation.
489
Which test is used to assess pressure sensation in patients with peripheral neuropathy?
The monofilament test.
490
Why is it important to check foot pulsation in patients with peripheral neuropathy?
To assess for peripheral arterial disease, which can worsen neuropathy.
491
What does Romberg's test assess in the context of peripheral sensory neuropathy?
It evaluates sensory ataxia, helping determine if a patient can maintain balance when vision is removed.
492
What role does proprioception play in the body?
Proprioception helps maintain balance and body awareness by sensing position and movement.
493
What are the primary types of symptoms in diabetic neuropathy?
Sensory, motor, and autonomic symptoms.
494
What is diabetic amyotrophy, and what are its symptoms?
A form of diabetic neuropathy causing pain, weakness, and muscle wasting.
495
What are common autonomic symptoms in diabetic neuropathy?
Bladder and stomach issues, erectile dysfunction, and orthostatic hypotension.
496
Why is glycemic control important in diabetic neuropathy?
It helps manage neuropathic pain and slow the progression of symptoms.
497
What is Whipple's triad, and what is its relevance to diabetes?
A diagnostic indicator of hypoglycemia, involving sweating, numbness, and palpitations that are relieved by glucose.
498
At what blood glucose level do symptoms in Whipple's triad typically occur?
Below 60 mg/dL.
499
Why is it important to promptly recognize and treat hypoglycemia?
To prevent severe complications and potential loss of consciousness.
500
What does the monofilament test evaluate?
It assesses pressure sensation in the feet to detect peripheral sensory neuropathy.
501
How does peripheral arterial disease contribute to diabetic neuropathy?
It can worsen neuropathy by decreasing blood flow to the nerves, further impairing sensation.
502
What does a positive Romberg's test indicate?
Sensory ataxia, suggesting a loss of proprioception and balance issues.
503
What are the sensory symptoms of diabetic neuropathy?
Numbness, tingling, burning sensations, and loss of sensation in the extremities.
504
What is the role of motor neuropathy in diabetes?
It can cause muscle weakness, atrophy, and reduced coordination.
505
How does autonomic neuropathy manifest in diabetes?
Symptoms such as gastroparesis, urinary incontinence, erectile dysfunction, and orthostatic hypotension.
506
Why is it important to monitor urinary output in diabetic neuropathy patients?
It helps assess kidney function and detect early signs of diabetic nephropathy.
507
What is the effect of poor glycemic control on diabetic neuropathy?
It accelerates the progression of neuropathy and worsens symptoms.
508
How can autonomic neuropathy affect blood pressure regulation in diabetics?
It can lead to orthostatic hypotension due to impaired vascular response to changes in position.
509
What is the primary treatment strategy for diabetic neuropathy?
Glycemic control, pain management, and symptom relief.
510
What is the link between glycemic control and neuropathic pain in diabetes?
Good glycemic control helps reduce the intensity and progression of neuropathic pain.
511
How can controlling blood glucose levels help prevent further nerve damage?
It prevents the accumulation of advanced glycation end products, which damage nerves.
512
What is the role of medications in managing diabetic neuropathy?
Medications such as anticonvulsants, antidepressants, and pain relievers are used to manage neuropathic pain.
513
What is the significance of regular foot exams in diabetic patients?
They help detect early signs of peripheral neuropathy and prevent complications like ulcers and infections.
514
How does the loss of proprioception affect balance and coordination in diabetic neuropathy?
It leads to difficulty in maintaining body position and increases the risk of falls.
515
What other conditions should be evaluated when diagnosing diabetic neuropathy?
Peripheral arterial disease and other vascular complications that can exacerbate neuropathy.
516
What lifestyle modifications can help manage diabetic neuropathy?
Regular exercise, good glycemic control, and proper foot care.
517
What tests are commonly used to diagnose diabetic neuropathy?
Monofilament testing, nerve conduction studies, and sensory testing.
518
What is the risk of untreated diabetic neuropathy?
It can lead to ulcers, infections, amputations, and permanent nerve damage.
519
How does the presence of diabetic neuropathy affect a patient's quality of life?
It can impair mobility, cause chronic pain, and affect daily activities, reducing overall quality of life.
520
How can patients with diabetic neuropathy protect their feet from injury?
Regularly checking their feet for injuries, wearing proper footwear, and avoiding walking barefoot.
521
What role does smoking play in diabetic neuropathy?
Smoking exacerbates vascular problems and worsens neuropathy by reducing blood flow to nerves.
522
Why is it important to manage blood pressure in patients with diabetic neuropathy?
High blood pressure can worsen neuropathy by damaging blood vessels and reducing circulation to the nerves.
523
How can physical therapy help diabetic neuropathy patients?
It can improve strength, flexibility, and balance, helping to reduce falls and improve mobility.
524
What is the importance of early detection of diabetic neuropathy?
Early detection allows for interventions that can slow progression and manage symptoms effectively.
525
What dietary changes can help manage diabetic neuropathy?
A balanced diet to maintain stable blood glucose levels and prevent nutrient deficiencies that can worsen neuropathy.
526
What role does vitamin supplementation play in managing diabetic neuropathy?
Certain vitamins, such as B12, can support nerve health and reduce symptoms of neuropathy.
527
How can stress management techniques help with diabetic neuropathy?
Reducing stress can lower blood glucose levels and help with pain management and sleep disturbances.
528
Why is foot care particularly important for diabetic neuropathy patients?
Diabetic neuropathy can cause loss of sensation in the feet, leading to unnoticed injuries and infections.
529
What is the first step in the management of diabetic neuropathy?
Achieving good glycemic control to prevent further nerve damage.
530
What complications can arise from untreated diabetic neuropathy?
Infections, ulcers, amputations, and significant impairments in mobility and sensation.
531
How often should diabetic patients check their feet?
Daily, to detect any injuries, ulcers, or changes in the condition of the feet.
532
How does sleep apnea affect diabetic neuropathy?
Sleep apnea can worsen glycemic control and increase the severity of neuropathic symptoms.
533
Why should blood glucose not drop below 60 mg/dL in diabetic patients?
It can cause hypoglycemic symptoms, including dizziness, confusion, and seizures.
534
What is the impact of uncontrolled blood sugar on the progression of diabetic neuropathy?
Uncontrolled blood sugar accelerates nerve damage and the development of symptoms.
535
What is the significance of regular blood glucose monitoring for diabetic neuropathy patients?
It helps track glycemic control and prevent fluctuations that could exacerbate neuropathic symptoms.
536
How do antioxidants benefit diabetic neuropathy patients?
Antioxidants may help reduce oxidative stress and protect nerve cells from further damage.
537
How can managing cholesterol levels benefit diabetic neuropathy patients?
Lowering cholesterol can improve circulation, which helps reduce the impact of neuropathy.
538
What is the role of nerve conduction studies in diagnosing diabetic neuropathy?
They assess the speed and strength of nerve signals to identify nerve damage or dysfunction.
539
How can regular exercise benefit patients with diabetic neuropathy?
It improves circulation, reduces blood sugar levels, and can help alleviate neuropathic pain.
540
What impact does uncontrolled blood sugar have on nerve endings?
It leads to the formation of advanced glycation end products that damage nerve endings.
541
What type of diabetes is most associated with neuropathy complications?
Type 2 diabetes, due to the prolonged exposure to high blood glucose levels.
542
What role do antioxidants play in preventing diabetic neuropathy?
Antioxidants can reduce oxidative stress, which contributes to nerve damage in diabetes.
543
Why should diabetics with neuropathy avoid smoking?
Smoking reduces circulation and exacerbates vascular damage, worsening neuropathy.
544
How does dyslipidemia relate to diabetic neuropathy?
High cholesterol and triglyceride levels can impair blood flow to nerves, increasing neuropathic symptoms.
545
What is the relationship between high blood pressure and diabetic neuropathy?
High blood pressure worsens the vascular complications of diabetes, accelerating nerve damage.
546
How often should blood pressure be monitored in diabetic patients with neuropathy?
Regularly, as hypertension can exacerbate neuropathy symptoms.
547
What are the benefits of weight management for diabetic neuropathy patients?
Maintaining a healthy weight can help reduce the strain on nerves and improve blood glucose control.
548
What is the first line of treatment for managing neuropathic pain in diabetes?
Tight glycemic control to prevent further nerve damage and the use of pain-relieving medications like antidepressants or anticonvulsants.
549
How does glycemic variability affect nerve health in diabetics?
Frequent fluctuations in blood sugar levels can exacerbate nerve damage and worsen neuropathic symptoms.
550
What is the role of the B12 vitamin in diabetic neuropathy?
Vitamin B12 helps maintain nerve health and its deficiency can worsen neuropathy symptoms.
551
How can a diabetic diet help manage neuropathic symptoms?
A well-balanced diet with controlled carbohydrate intake helps maintain stable blood glucose levels, reducing nerve damage.
552
What is the goal of pain management in diabetic neuropathy?
To improve quality of life by reducing pain, preventing further nerve damage, and managing other symptoms.
553
What are the common treatments for neuropathic pain in diabetic patients?
Medications such as gabapentin, pregabalin, and duloxetine, alongside proper glycemic control.
554
How can controlling triglyceride levels benefit diabetic neuropathy patients?
Reducing triglyceride levels can improve circulation, helping prevent nerve damage.
555
Why is it important to manage stress in diabetic patients with neuropathy?
Stress can raise blood glucose levels and worsen the severity of neuropathic pain.
556
How can massage therapy help with diabetic neuropathy?
It can improve circulation, reduce muscle tension, and alleviate pain.
557
How does sleep apnea affect neuropathy in diabetics?
Sleep apnea can worsen glycemic control, increasing the risk of developing neuropathy.
558
How often should patients with diabetic neuropathy be checked for foot ulcers?
Daily, as early detection can prevent complications like infections and amputations.
559
What is the significance of glycemic variability in neuropathy progression?
Frequent high and low blood glucose fluctuations increase the risk of nerve damage and worsen symptoms.
560
How does diabetes affect small and large nerve fibers?
Small fibers are typically affected early in diabetic neuropathy, leading to sensory changes, while large fibers contribute to motor and autonomic symptoms.
561
What impact does uncontrolled diabetes have on the development of ulcers in patients with neuropathy?
Poor blood sugar control leads to poor wound healing and increases the risk of developing ulcers, particularly in the feet.
562
What is the role of foot care education for diabetic patients with neuropathy?
It helps prevent injuries and complications like infections by educating patients on proper footwear, skin care, and daily foot checks.
563
How does the loss of protective sensation affect the risk of injury in diabetic patients?
Loss of sensation increases the likelihood of unnoticed injuries, which can lead to infections and ulcers.
564
How does the use of physical therapy help manage diabetic neuropathy?
It can improve strength, reduce pain, enhance balance, and prevent falls in patients with diabetic neuropathy.
565
What is the role of blood glucose monitoring in diabetic neuropathy management?
It allows for tight control of blood sugar levels, preventing further nerve damage and worsening symptoms.
566
How does foot deformity contribute to diabetic neuropathy complications?
Deformities, such as Charcot foot, can cause misalignment and increase the risk of pressure sores, leading to ulcers and infections.
567
How can patients with diabetic neuropathy manage burning sensations in their feet?
Medications like pregabalin, gabapentin, or topical treatments can be used to alleviate burning sensations.
568
How does vitamin D deficiency impact diabetic neuropathy?
Vitamin D deficiency can worsen neuropathic symptoms and overall nerve health.
569
How does vitamin D deficiency impact diabetic neuropathy?
Vitamin D deficiency may exacerbate pain and worsen symptoms in diabetic neuropathy by impairing nerve function.
570
Why should diabetics with neuropathy monitor for changes in vision?
Diabetes can lead to diabetic retinopathy, which can worsen neuropathy due to the compromised circulation.
571
How does neuropathic pain from diabetes differ from other types of pain?
It is typically described as burning, tingling, stabbing, or shooting pain and may occur without a clear external cause.
572
How does alcohol consumption affect diabetic neuropathy?
Chronic alcohol consumption can worsen neuropathy by increasing blood sugar levels and contributing to nerve damage.
573
What are the risks associated with untreated diabetic neuropathy?
Increased risk of infections, amputations, ulcers, and significant functional impairments.
574
What is the importance of a multidisciplinary approach in managing diabetic neuropathy?
Involvement of a team, including endocrinologists, podiatrists, and physical therapists, helps provide comprehensive care and improves outcomes.
575
How can glycemic control reduce the risk of amputations in diabetic patients?
Tight blood sugar control prevents the progression of neuropathy and reduces the risk of complications that may lead to amputations.
576
What should diabetics with neuropathy do if they notice changes in their skin color or temperature?
They should consult a healthcare provider to rule out infections, poor circulation, or other complications.
577
How does chronic hyperglycemia lead to diabetic neuropathy?
It causes increased blood sugar levels, which lead to nerve damage due to the accumulation of harmful substances like sorbitol.
578
What is the role of pain management in preventing the progression of diabetic neuropathy?
Effective pain management can improve quality of life and help patients remain active, which may prevent further complications.
579
How can controlling blood lipids help in the management of diabetic neuropathy?
It can reduce the risk of vascular complications, which may contribute to worsening neuropathy.
580
How does reducing blood pressure help prevent diabetic neuropathy progression?
It helps improve circulation, reducing the strain on nerves and slowing the progression of neuropathy.
581
What is the benefit of physical therapy for improving balance in diabetic patients with neuropathy?
It can help patients regain stability and prevent falls by strengthening muscles and improving coordination.
582
How does diabetes affect the autonomic nervous system?
It can lead to autonomic neuropathy, causing problems with heart rate, digestion, and other involuntary functions.
583
What is the role of regular eye exams for diabetic neuropathy patients?
To detect diabetic retinopathy and other vision issues that may complicate neuropathy management.
584
What is the significance of a high HbA1c level in diabetic neuropathy patients?
A high HbA1c indicates poor blood sugar control, increasing the risk of neuropathy progression.
585
What are the long-term effects of uncontrolled diabetes on nerve health?
Prolonged high blood glucose levels can cause permanent nerve damage and increase the risk of amputations.
586
Why should diabetic neuropathy patients avoid excessive heat on their feet?
Due to loss of sensation, they may not feel burns or injuries, which could lead to complications.
587
What is the role of continuous glucose monitoring (CGM) in managing diabetic neuropathy?
CGM helps maintain stable blood glucose levels, reducing the risk of neuropathy progression.
588
How can a diabetic patient reduce the risk of developing ulcers on their feet?
By wearing well-fitting shoes, avoiding walking barefoot, and performing daily foot checks.
589
What is Charcot foot, and how does it relate to diabetes?
Charcot foot is a deformity caused by neuropathy, leading to joint destruction and misalignment in diabetic patients.
590
How does diabetic nephropathy affect neuropathy progression?
Kidney damage from diabetes can worsen circulation, thereby increasing the risk of nerve damage.
591
How can tight blood glucose control slow the progression of diabetic neuropathy?
It reduces the accumulation of harmful substances in the body, protecting nerve function.
592
Why is it important for diabetic patients to monitor their foot temperature?
Changes in temperature may indicate poor circulation or infection, which require prompt attention.
593
How do blood sugar spikes impact nerve function?
Sudden increases in blood glucose can lead to nerve inflammation, causing pain and discomfort.
594
What is the relationship between blood glucose levels and nerve regeneration in diabetic neuropathy?
Maintaining optimal blood glucose levels promotes nerve repair and reduces further damage.
595
What is the significance of glycemic control in preventing diabetic foot infections?
Stable blood glucose levels enhance immune function and help prevent infections.
596
How do blood sugar fluctuations contribute to the development of neuropathy in diabetics?
Constant changes in blood sugar levels can damage nerves over time, increasing the risk of neuropathy.
597
What is the connection between vitamin B12 deficiency and diabetic neuropathy?
Vitamin B12 is essential for nerve health, and its deficiency can exacerbate neuropathy symptoms.
598
How does metabolic syndrome contribute to diabetic neuropathy?
Metabolic syndrome, which includes insulin resistance, increases the risk of nerve damage through poor glucose control.
599
What is the role of glucosamine sulfate in diabetic neuropathy management?
It may help in alleviating joint pain and improving circulation, though more research is needed.
600
What is the role of exercise in managing diabetic neuropathy?
Exercise improves blood circulation, reduces pain, and helps maintain healthy blood glucose levels.
601
How does the use of statins help in managing diabetic neuropathy?
Statins lower cholesterol levels, improving circulation and reducing the risk of further nerve damage.
602
What is the significance of daily foot inspections for diabetic patients with neuropathy?
Early detection of foot injuries or ulcers can prevent complications such as infections and amputations.
603
How does autonomic neuropathy affect the digestive system in diabetics?
It can lead to gastroparesis, causing delayed stomach emptying, nausea, and bloating.
604
Why are regular eye exams important for diabetic neuropathy patients?
Diabetes can cause diabetic retinopathy, which can worsen neuropathy due to poor circulation.
605
How does alcohol consumption worsen neuropathy in diabetics?
Alcohol increases blood sugar variability and can lead to nerve damage when consumed in excess.
606
What role does maintaining a healthy weight play in diabetic neuropathy prevention?
Healthy weight reduces the burden on nerves and improves blood circulation, helping prevent neuropathy.
607
What is the role of a podiatrist in the care of diabetic patients with neuropathy?
Podiatrists help manage foot care, prevent ulcers, and treat deformities such as Charcot foot.
608
How can diabetic neuropathy affect a patient’s ability to sense injuries?
Loss of sensation in the feet can lead to undetected wounds, increasing the risk of infection and complications.
609
Why is it important to maintain normal blood pressure in diabetic patients with neuropathy?
High blood pressure can worsen the blood flow to nerves, accelerating nerve damage.
610
What is the effect of glycemic variability on peripheral neuropathy?
Fluctuating glucose levels can increase oxidative stress, exacerbating neuropathy symptoms.
611
How can diabetic patients reduce the risk of developing diabetic foot ulcers?
By wearing appropriate footwear, avoiding walking barefoot, and keeping feet clean and dry.
612
What is the role of the A1C test in managing diabetic neuropathy?
The A1C test helps monitor long-term blood glucose control, which is crucial in preventing neuropathy.
613
How does metabolic control impact the risk of developing diabetic neuropathy?
Poor metabolic control increases the risk of nerve damage, while good control can delay or prevent neuropathy.
614
What is the role of gabapentin in managing diabetic neuropathy pain?
Gabapentin is commonly prescribed to help manage nerve-related pain by reducing nerve excitability.
615
How does insulin resistance contribute to neuropathy in diabetes?
Insulin resistance leads to high blood glucose levels, which can damage nerves over time.
616
How does neuropathy contribute to functional impairments in diabetics?
Neuropathy causes pain, muscle weakness, and balance problems, making daily activities difficult.
617
How does diabetic neuropathy impact foot care in patients with poor circulation?
Poor circulation, combined with neuropathy, increases the risk of foot ulcers and infections.
618
What is the role of pregabalin in treating diabetic neuropathy?
Pregabalin helps reduce pain and improve quality of life for patients with neuropathic pain.
619
Why is it important for diabetic patients to maintain regular follow-ups with healthcare providers?
Regular checkups ensure that any complications, including neuropathy, are detected early and managed effectively.
620
How does vitamin E deficiency affect diabetic neuropathy?
Vitamin E is an antioxidant that helps protect nerve tissue from damage caused by oxidative stress.
621
How can pain management improve the quality of life for diabetic neuropathy patients?
Effective pain relief allows patients to maintain independence, engage in physical activities, and prevent depression.
622
What are some non-pharmacological approaches to managing diabetic neuropathy pain?
Approaches include physical therapy, acupuncture, and transcutaneous electrical nerve stimulation (TENS).
623
How can controlling triglyceride levels benefit neuropathy patients?
Lowering triglycerides can improve blood circulation, which helps slow down the progression of neuropathy.
624
What is the impact of neuropathy on diabetic wound healing?
Neuropathy impairs the ability to feel injuries, leading to delayed healing and increased risk of infection.
625
How does high blood sugar contribute to oxidative stress in diabetic neuropathy?
High blood sugar leads to the formation of free radicals, which damage nerve tissues and worsen neuropathy.
626
Why is it crucial for diabetics to monitor their blood glucose levels frequently?
Regular monitoring helps maintain stable glucose levels, reducing the risk of complications like neuropathy.
627
How does neuropathy influence balance and coordination in diabetics?
Sensory loss from neuropathy can lead to poor balance and coordination, increasing the risk of falls.
628
What are the complications of untreated diabetic neuropathy?
Untreated neuropathy can lead to severe foot ulcers, amputations, chronic pain, and disability.
629
How can a balanced diet aid in preventing neuropathy in diabetics?
A balanced diet helps control blood glucose levels and provides essential nutrients that support nerve health.
630
What is the role of the monofilament test in assessing diabetic neuropathy?
The monofilament test checks for loss of sensation in the feet, helping identify early signs of neuropathy.
631
What are the most common symptoms of diabetic autonomic neuropathy?
Symptoms include erectile dysfunction, bladder problems, gastrointestinal issues, and orthostatic hypotension.
632
How does managing cholesterol levels impact diabetic neuropathy management?
Lower cholesterol improves blood flow, reducing the risk of nerve damage and worsening neuropathy.
633
What is the significance of early diagnosis in preventing diabetic neuropathy progression?
Early detection allows for prompt treatment, which can prevent or delay nerve damage and related complications.
634
How does low blood sugar (hypoglycemia) contribute to diabetic neuropathy?
Recurrent hypoglycemia can lead to nerve cell injury.
635
What is the role of antioxidants in managing diabetic neuropathy?
Antioxidants help reduce oxidative stress, protecting nerve cells from damage caused by high blood glucose levels.
636
How does tight glucose control help prevent diabetic neuropathy?
Tight glucose control reduces the amount of advanced glycation end products (AGEs), which can damage nerves.
637
Why should diabetic patients avoid smoking to manage neuropathy?
Smoking constricts blood vessels, worsening circulation and exacerbating nerve damage.
638
What is the effect of uncontrolled blood sugar on nerve fibers?
Chronic hyperglycemia damages nerve fibers, impairing their function and causing symptoms of neuropathy.
639
How does the use of ACE inhibitors help prevent diabetic nephropathy and neuropathy?
ACE inhibitors improve kidney function and blood flow, which may also help reduce the risk of nerve damage.
640
What is the connection between kidney disease and diabetic neuropathy?
Diabetic kidney disease can reduce circulation, worsening the progression of neuropathy.
641
Why is it important to check for peripheral artery disease in diabetic patients with neuropathy?
Peripheral artery disease can worsen circulation and increase the risk of infections and amputations in patients with neuropathy.
642
What is the importance of managing high cholesterol levels for diabetic neuropathy patients?
High cholesterol levels contribute to poor circulation, which can exacerbate nerve damage and delay healing.
643
How does neuropathy affect the sensory system in diabetics?
Neuropathy damages the sensory nerves, leading to reduced ability to feel pain, temperature, and pressure.
644
What is the relationship between sleep disturbances and diabetic neuropathy?
Chronic pain from neuropathy can lead to sleep problems, which in turn can worsen symptoms of neuropathy.
645
How does managing blood pressure help reduce the risk of diabetic neuropathy?
Maintaining normal blood pressure improves blood flow to the nerves, which helps prevent or slow down nerve damage.
646
What is the role of alpha-lipoic acid in diabetic neuropathy management?
Alpha-lipoic acid is an antioxidant that can help reduce symptoms of diabetic neuropathy, such as pain and tingling.
647
Why is it essential for diabetic patients with neuropathy to monitor their blood pressure regularly?
Uncontrolled high blood pressure can damage nerves and worsen the symptoms of neuropathy.
648
What is diabetic retinopathy, and how is it related to neuropathy?
Diabetic retinopathy is damage to the blood vessels in the eyes, often linked to poor blood glucose control, which also increases the risk of neuropathy.
649
How does obesity contribute to the development of diabetic neuropathy?
Obesity worsens insulin resistance and inflammation, both of which contribute to nerve damage in diabetic patients.
650
What is the significance of vitamin D in diabetic neuropathy management?
Vitamin D plays a role in nerve health, and deficiency can worsen neuropathic symptoms in diabetics.
651
Why is regular physical activity important for managing diabetic neuropathy?
Physical activity helps improve blood flow, maintain weight, and manage blood sugar levels, reducing the progression of neuropathy.
652
What role does the lipid profile play in managing diabetic neuropathy?
Abnormal lipid levels can contribute to vascular problems, worsening the progression of neuropathy in diabetic patients.
653
How does poor glycemic control affect the kidneys in diabetic patients?
Poor glucose control leads to kidney damage, which can worsen neuropathy due to reduced circulation.
654
What is the role of the monofilament test in detecting neuropathy?
The monofilament test assesses the loss of sensation in the feet, helping detect early-stage neuropathy.
655
How does the consumption of omega-3 fatty acids help in diabetic neuropathy management?
Omega-3 fatty acids reduce inflammation and improve blood flow, potentially alleviating neuropathy symptoms.
656
What is the relationship between diabetes and small fiber neuropathy?
Small fiber neuropathy, affecting the small nerve fibers responsible for pain and temperature sensations, is common in diabetics, especially with poor glucose control.
657
Why is it important for diabetic patients to maintain a healthy diet to prevent neuropathy?
A balanced diet helps control blood glucose, cholesterol, and blood pressure, all of which are critical in preventing or managing neuropathy.
658
How can increasing fiber intake benefit diabetic neuropathy patients?
A high-fiber diet helps control blood glucose and cholesterol, potentially improving circulation and reducing neuropathy symptoms.
659
What is the role of sodium in the management of diabetic neuropathy?
Excess sodium intake can raise blood pressure and worsen neuropathy by affecting blood circulation.
660
How does poor circulation contribute to the progression of diabetic neuropathy?
Poor circulation impairs nerve health by reducing oxygen and nutrient delivery to nerve tissues, accelerating damage.
661
What is the significance of managing comorbidities in patients with diabetic neuropathy?
Managing comorbidities such as hypertension, hyperlipidemia, and kidney disease is essential in preventing further nerve damage.
662
How can controlling inflammation help in managing diabetic neuropathy?
Inflammation accelerates nerve damage.
663
How can controlling inflammation help in managing diabetic neuropathy?
Inflammation accelerates nerve damage in diabetic neuropathy, so controlling inflammation with diet or medication can help reduce symptoms.
664
What is the role of SGLT2 inhibitors in managing diabetic neuropathy?
SGLT2 inhibitors improve glycemic control and may have protective effects on nerves by improving vascular health.
665
How does the presence of infections complicate diabetic neuropathy?
Infections can exacerbate neuropathy symptoms, especially in the feet, by causing further damage and reducing circulation.
666
What is the link between stress and diabetic neuropathy?
Chronic stress can increase blood sugar levels and inflammation, which may accelerate the progression of neuropathy.
667
What role does physical therapy play in managing diabetic neuropathy?
Physical therapy helps improve strength, flexibility, and balance, which can help reduce the functional impact of neuropathy.
668
How do diabetic patients with neuropathy benefit from wearing custom orthotics?
Custom orthotics provide support, reduce pressure, and help prevent foot injuries, which are common in neuropathic patients.
669
Why is it important to manage alcohol consumption in diabetic neuropathy?
Alcohol can affect blood glucose levels, exacerbate nerve damage, and lead to poor nutritional intake, which worsens neuropathy.
670
How can cognitive behavioral therapy (CBT) aid in managing neuropathic pain?
CBT helps patients cope with the emotional aspects of chronic pain and develop strategies to manage symptoms.
671
What is the role of corticosteroids in treating diabetic neuropathy?
Corticosteroids may be used to reduce inflammation, but their use is limited due to potential side effects such as increased blood sugar levels.
672
How does foot care education reduce the risk of complications in diabetic neuropathy patients?
Educating patients on proper foot care techniques can prevent injuries, infections, and complications like amputations.
673
Why is neuropathy often underdiagnosed in diabetic patients?
Symptoms of neuropathy may be subtle at first, and patients may not recognize the importance of early intervention.
674
How does diuretic use in diabetic patients impact neuropathy?
Diuretics can affect electrolyte balance and circulation, potentially worsening neuropathy symptoms.
675
What is the role of antioxidant-rich foods in preventing diabetic neuropathy?
Antioxidants help neutralize free radicals, reducing oxidative damage to nerves and preventing neuropathy progression.
676
Why is tight glycemic control particularly important during pregnancy for women with diabetes?
Tight control helps prevent complications like diabetic neuropathy, preeclampsia, and fetal issues associated with uncontrolled blood glucose.
677
What are the risks of untreated diabetic neuropathy?
Untreated neuropathy can lead to severe complications, such as foot ulcers, infections, amputations, and chronic pain.
678
How does diabetes-induced neuropathy impact the autonomic nervous system?
Autonomic neuropathy can cause problems with digestion, heart rate, and blood pressure regulation in diabetic patients.
679
How does regular monitoring of blood glucose help in preventing diabetic neuropathy?
Regular monitoring allows for early adjustments to diet, medication, and lifestyle to maintain stable glucose levels and prevent nerve damage.
680
What is the role of diet in managing blood pressure for diabetic neuropathy patients?
A healthy diet can help control blood pressure, which in turn improves circulation and reduces the risk of nerve damage.
681
What is the potential benefit of using duloxetine in diabetic neuropathy management?
Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that can reduce neuropathic pain and improve quality of life in diabetic neuropathy patients.
682
How does vitamin B12 deficiency contribute to neuropathy in diabetic patients?
Vitamin B12 deficiency can worsen nerve function by impairing nerve regeneration and causing additional neurological damage, potentially exacerbating diabetic neuropathy.
683
How does maintaining a healthy weight help prevent or manage diabetic neuropathy?
Maintaining a healthy weight helps improve insulin sensitivity, control blood glucose levels, and reduce strain on nerves, lowering the risk of neuropathy.
684
Why are regular foot exams crucial for diabetic neuropathy patients?
Regular foot exams can help detect early signs of nerve damage or infection, preventing complications like ulcers or amputations.
685
How do certain medications, like pregabalin, assist in managing diabetic neuropathy pain?
Pregabalin reduces the release of excitatory neurotransmitters, which helps decrease neuropathic pain by calming overactive nerve signals.
686
What is the role of compression stockings in managing diabetic neuropathy?
Compression stockings improve circulation in the legs and feet, helping prevent the progression of neuropathy and reducing swelling.
687
How can managing comorbid conditions, like hypothyroidism, help in treating diabetic neuropathy?
Proper management of hypothyroidism ensures better nerve function and reduces additional stress on the nervous system, which may help alleviate neuropathic symptoms.
688
What is anovulation?
No corpus luteum production of progesterone
## Footnote
This leads to unopposed estrogen, hyperplastic endometrium, and irregular bleeding, increasing the risk of endometrial cancer.
689
What is the effect of increased testosterone on LH levels?
Increased T LH levels lead to theca cell production of androgens
## Footnote
This process suppresses hepatic production of SHBG, resulting in elevated total testosterone and free testosterone.
690
What is the consequence of unopposed estrogen due to anovulation?
Hyperplastic endometrium and irregular bleeding
## Footnote
This condition predisposes individuals to endometrial cancer.
691
Fill in the blank: Anovulation results in _______ which can lead to endometrial cancer.
unopposed estrogen
692
True or False: Increased testosterone levels suppress SHBG production.
True
693
What does increased T LH levels indicate?
Theca cell production of androgens
## Footnote
This is a key part of the hormonal regulation in the ovaries.
