4- Diabetes Mellitus

Question 1

What is the definition diabetes?

Answer 1

It is a group of metabolic diseases characterized by high blood glucose levels (hyperglycemia) & the inability to produce and/or use insulin

Question 2

What are the 3 types of classification of diabetes?

Answer 2

1.) Prediabetes/bordeline
2.) Type 1 diabetes
3.) Type 2 diabetes

Question 3

What does the prediabetes/bordeline classification encompass?

Answer 3

It is the metabolic stage between normal glucose & diabetes (high risk for developing diabetes).

Question 4

What does type 1 diabetes classification encompass?

Answer 4

It is the result from the beta-cell destruction usually leading to defective production of either the autoimmune or idiopathic.

*insulin deficient, insulin-dependent diabetes mellitus (IDDM), or juvenile diabetes

Question 5

What does the type 2 diabetes classification encompass?

Answer 5

When there is a progress loss of beta-cell insulin secretion frequently with insulin resistance.

(They are insulin resistant, non insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes)
aka: they produce too little insulin or can’t use their insulin

Question 6

What is gestational diabetes mellitus?

Answer 6

There are any degree of glucose intolerance with onset or first recognition during pregnancy (4% of all pregnancies).

Question 7

In type II diabetes, what would follow if blood glucose levels continue to rise greater than 22.2mmol/L?

Answer 7

It may follow hyperglycemia

Question 8

At what blood glucose level would the kidney tubules prevent resorption?

Answer 8

> 8.3mmol/L

Question 9

What are the signs & symptoms of type 1 diabetes?

Answer 9

Onset symptoms are sudden, and acute often developing over days or weeks.
typical diagnosis made in non-obese children or young adults less 40 years of age

Question 10

What are the signs & symptoms of type 1 diabetes?

Answer 10

Generally occurs after age 40 & more often affects obese individuals.

Question 11

What are some early clinical manifestations of Type 1 diabetes?

Answer 11

1.) Polydipsia
2.) Polyuria
3.) Polyphagia
4.) Weight loss
5.) Loss of strength

Question 12

What are some more dangerous signs of type 1 diabetes?

Answer 12

1.) Numbness or tingling in the feet
2.) Blurred vision
3.) Low blood sugar/hypoglycemia
4.) Loss of consciousness

Question 13

What is diabetic ketoacidosis in type 1 diabetes?

Answer 13

they are the high levels of acid in our blood & the other abnormalities resulting in a change in the blood’s pH level.

Question 14

What is the given life expectancy a person is expected to be given more years of relative to their age & presence of diabetes?

Answer 14

That the younger we are & present diabetes, the more years lost due to diabetes.

Question 15

What percentage of people with diabetes die as a result of heart disease or stroke?

Answer 15

~80%

Question 16

What occurs if we cannot produce insuline in Type II diabetes?

Answer 16

The glucose remains in the bloodstream, causing hyperglycemia

Question 17

Will hyperglycemia result into a medical consultation?

Answer 17

Yes, as it may lead to immediate appointment between patient & physician or to hospitalization.

Question 18

What encompasses hypoglycemia?

Answer 18

When there is not enough glucose in the bloodstream.

Question 19

What is observed in a patient with hypoglycemia, & how can we aid a person with hypoglycemia?

Answer 19

Bizzare behavior or changes in personality.

If they are conscious: administer oral carbohydrates & observe the patient after the following administration.

If they are unconscious: Call 911

Question 20

Why do patients with type 1 diabetes need insulin injections?

Answer 20

So that the body can process blood sugar.

Question 21

How can an insulin shock arise?

Answer 21

When a patient with diabetes fails to eat in accordance to their given meal plan & continues to take regular insulin injections (leading to an experience of hypoglycemic reactions)

Question 22

What are the mild symptoms of insulin reactions?

Answer 22

1.) Hunger
2.) Weakness
3.) Tachycardia
4.) Pallor
5.) Sweating
6.) Paresthesia’s

Question 23

What are the moderate symptoms of insulin reactions?

Answer 23

1.) Incoherence:
- uncooperativeness
- belligerence
- lack of judgment
- poor orientation

Question 24

What are the severe symptoms of insulin reactions?

Answer 24

1.) Unconsciousness
2.) Tonic or clonic movements
- hypotension
- hypothermia
3.) Rapid pulse

Question 25

What does the pancreatic islet transplant encompass?

Answer 25

It involves the transfer of healthy insulin-producing cells from a donor into the pancreas of someone with type 1 diabetes.

Question 26

What are the 4 drug classes used to treat type 2 diabetes?

Answer 26

1.) Insulin sensitizers: oral agent acting in the liver
2.) Insulin secretagogues: oral agent which causes secretion of insulin from the pancreas
3.) any drug slowing the absorption of carbohydrates
4.) Incretins - injectabes increasing release from beta cells in pancreas.

Question 27

What is metformin?

Answer 27

It is an insulin sensitizer in which actions to suppress hepatic glucose output & gluconeogenesis (lowers blood glucose levels without increasing insulin levels)

Question 28

What is the pharmacologic advantage of metformin?

Answer 28

Not associated with significant risk of hypoglycemia as it does affect the insulin levels when blood glucose levels are decreasing.

• it works to enhance insulin sensitivity of muscle & fat & hand has weight-neutral effects

Question 29

What is a normal blood glucose concentration?

Answer 29

~4 to 6mmol/L

Question 30

How can stress be a contributing factor to patients with diabetes?

Answer 30

Stress can cause the release of epinephrine, which mobilizes glucose from glycogen stored in the liver.

*This can therefore contribute to a hyperglycemic condition becoming ketoacidotic

Question 31

What are effective ways to manage dental hygiene process of care when it comes to stress & patients with diabetes?

Answer 31

Reduce waiting & treatment time to reduce the stress.