Blood Glucose Regulation

Question 1

diabetes mellitus

Answer 1

a disorder of carbohydrate metabolism and results in high levels of blood glucose

Question 2

carbohydrate metabolism

Answer 2

• insulin supported process of facilitated diffusion moves glucose from blood into cells
• after eating: synchronous rise and fall of glucose and insulin

Question 3

glucose

Answer 3

energy, stored as glycogen, or component or of lipid molecules

Question 4

insulin

Answer 4

• produced by beta cells
• facilitated diffusion moves glucose from blood into cells

Question 5

glycogenesis

Answer 5

glycogen formation in the liver

Question 6

glycogenolysis

Answer 6

• glycogen breakdown into glucose
• occurs when blood glucose falls and body needs energy

Question 7

hypoglycemia

Answer 7

• BG less than 70 mg/dL
• compensatory response by the liver and hypothalamus to raise BG
• epinephrine, glucagon, activation of SNS
• need to administer fast acting carbs
• avoid fats bc they delay glucose absorption
• IV glucose can be provided
• glucagon by subq injection
• hypoglycemia is a MEDICAL EMERGENCY

Question 8

hyperglycemia

Answer 8

blood glucose greater than 100 mg/dL

Question 9

Diabetic Ketoacidosis

Answer 9

occurs when there isnt enough insulin in the body
- think strenuous exercise
- fatigue
- weakness

Question 10

Somogyi effect

Answer 10

• nighttime BG normal —> hypoglycemia —> BG doubles by morning
• epinephrine, cortisol, and hormones are released and BG levels double

Question 11

s/s type 1 diabetes

Answer 11

• polydipsia
• polyuria
• polyphagia
• fatigue
• possible infection

Question 12

patho type 1 diabetes

Answer 12

• T cell mediated attack of beta cells
• blood sugar goes up while insulin goes down (0)
• genetic influence
• autoimmune
• insulin deficient/ not enough to do its job

Question 13

presenting sign of type 1 diabetes

Answer 13

DKA- because the early signs are not recognized
- will develop in people with no insulin reserves and the liver starts to mobilize fats

Question 14

tx for type 1 diabetes

Answer 14

insulin replacement

Question 15

s/s type 2 diabetes

Answer 15

• polydipsia
• polyphagia
• polyuria
• blurred vision
• electrolyte imbalance- hyperkalemia
• glycogenolysis
• gluconeogenesis

Question 16

diagnostic testing type 2 diabetes

Answer 16

• blood and urine tests
• fasting BG greater than 126 on 2 separate occasions
• random BG greater than 200 more than 1 time
• OGTT(oral glucose tolerance test) greater than 200
• A1c above 6.5%
• glucosuria (sugar in urine, dipstick test)
• ketonuria (ketones in urine, dipstick test)

Question 17

what foods are appropriate for the glycemic index diet

Answer 17

• foods low in carbohydrates!
• dried beans
• legumes
• whole grains
• some fruits- watermelon, apple, nectarines
• avocado
• dates

Question 18

tx type 2 diabetes

Answer 18

• exercise, maintain ideal body weight, reduce insulin before physical activity (exercise before administering insulin)
• diet changes: 40-50% carbs, 25-30% fats, low fat/low salt diet
• self monitor glucose levels

Question 19

examples of fast acting carbs in the event of hypoglycemia

Answer 19

• 4 glucose tablets
• glucose gel
• 4 oz fruit juice
• 4 oz regular soda
• 8 oz milk
• 5-6 pieces hard candy
• 1-2 tsp honey or sugar
• 2 tbsp raisins

Question 20

causes of hypoglycemia

Answer 20

• too much insulin use
• excessive physical activity
• surgery
• antibiotics

Question 21

risk factors for diabetes

Answer 21

• obesity
• sedentary lifestyle
• polygenic disorder (T1)
• environmental triggers: diet, infection

Question 22

role of insulin

Answer 22

• facilitates glucose uptake by cells
• facilitates glucose storage in the liver (glucose cannot get into the liver without insulin)
• promotes glycogen formation
• decreases utilization of fat
• anabolic hormone- muscle building function

Question 23

patho of type 2 diabetes

Answer 23

• insulin resistance
• increased insulin levels
• metabolic syndrome
• blood sugar up, insulin up
• can go undiagnosed for years

Question 24

diabetic foot complications

Answer 24

• most common cause of nontraumatic lower extremity amputation
• peripheral neuropathy, poor circulation, suppressed immune response
• increase infection susceptibility
• can lead to gangrene and amputation
• osteomyelitis can occur
• postprandial hyperglycemia puts pts at risk for these issues

Question 25

dermatology complications of DM

Answer 25

• prolonged wound healing and ulcer formations
• poor circulation
• diabetic skin spots
• lipoatrophy can occur at injection sites

Question 26

what disorders are included in metabolic syndrome

Answer 26

• hypertension
• dyslipidemia
• hyperinsulinism
• central obesity
• glucose intolerance
• predisposition to DM2

Question 27

diagnostics for metabolic syndrome

Answer 27

• pt must have the presence of 3 OR MORE these components

Question 28

what must the waist circumference for men be to diagnose metabolic syndrome

Answer 28

greater than 40 in

Question 29

what must the waist circumference for women be to diagnose metabolic syndrome

Answer 29

greater than 35 in

Question 30

what must triglycerides be to diagnose metabolic syndrome

Answer 30

greater than 150 mg/dL

Question 31

what must HDL be lower than for men to diagnose metabolic syndrome

Answer 31

less than 40 mg/dL

Question 32

what must HDL be lower than for women to diagnose metabolic syndrome

Answer 32

less than 50 mg/dL

Question 33

what must blood pressure be higher than to diagnose metabolic syndrome

Answer 33

greater than 130/85 mmHg

Question 34

what must fasting blood glucose be higher than to diagnose metabolic syndrome

Answer 34

greater than 100 mg/dL