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Clinical Dental Hygiene II > Chapter 69- Diabetes Mellitus > Flashcards

Chapter 69- Diabetes Mellitus Flashcards

1
Q

Dental professionals have a responsibility to what?

A
  • Recognize signs and symptoms of diabetes for early diagnosis
    -Asses and control diabetes to determine the impact on treatment and oral health of p.t.
    -Provide preventive oral care and prevent infections and emergencies
    -understand infection
    treat and identify acute emergencies
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2
Q

A groups of metabolic diseases associated with hyperglycemia

A

diabetes mellitus

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3
Q

What does hyperglycemia result from?

A

an insulin deficiency, resistance to insulin action, or both

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4
Q

People with poorly controlled diabetes are at risk of what complications?

A

-blindness
-kidney failure
-heart disease
-stroke
amputation of toes, feet, legs

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5
Q

How many people in the united states have diabetes?

A

29 million

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6
Q

How many cases of diabetes is undiagnosed?

A

1 in 4 ppl

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7
Q

How many cases in the united states have pre diabetes?

A

1 and 3 adults

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8
Q

Death risks are _______% higher for those with diabetes compared to those without

A

50

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9
Q

How is diabetes and periodontal disease related?

A

the inflammatory process involving the pathogenesis of both disease

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10
Q

Patients with diabetes are how much of a greater risk for more severe periodontal disease than those without?

A

2-4 times

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11
Q

patients with diabetes have more severe what?

A

periodontal disease and A1c

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12
Q

nonsurgical perio therapy and management of perio has resulted in what?

A

an average decrease of A1c of 0.6%.

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13
Q

Is well-controlled diabetes a contraindication to a placement of a implant?

A

nope

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14
Q

a hormone produced in the pancreas. It directly or indirectly affects every organ in the body

A

insulin

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15
Q

What is responsible for releasing insulin when stimulated by nutrients, primarily glucose?

A

beta cells in pancreas

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16
Q

What acts like a key to unlock the cell to allow uptake of glucose to use as energy?

A

insulin

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17
Q

what is the normal glucose levels in a healthy individual?

A

60-100 ml

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18
Q

normal hemoglobin A1c is less than what

A

5.7%

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19
Q

results from the destruction of insulin-producing cells in the pancreas

A

type 1 diabetes

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20
Q

Most prevalent type of diabetes, accounts for 90-95% patients with diabetes

A

type 2 diabetes

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21
Q

How is type 1 usually identified ?

A

after acute symptoms of hyperglycemia

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22
Q

screening in asymptomatic adults is recommended for who?

A

pre diabetes and type 2

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23
Q

What is the former name of type 2 diabetes?

A

non insulin dependent or adult onset

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24
Q

any degree of glucose intolerance first recognized during pregnancy

A

gestational diabetes

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25
Q

whats the onset of gestational diabetes?

A

related to genetics, obesity, and hormones causing insulin resistance

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26
Q

true or false- more than 50% of women with GDM go on to develop type 2 diabetes within 5-10 yrs

A

true

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27
Q

In gestational diabetes, infants can have these issues:

A
  • larger
  • premature birth
  • congenital deformaties
  • perinatal death
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28
Q

If not treated, this can lead to diabetic coma?

A

metabolic acidosis

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29
Q

functions of insulin

A
  • facilitates glucose uptake from blood into tissues, which lowers blood glucose level
  • speeds the oxidation of glucose within the cells to use for energy
  • speeds the conversion of glucose to glycogen to store in liver and skeletal muscles
  • facilitates conversion of glucose to fat in adipose tissues
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30
Q

too much insulin

A

hyperinsullnism

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31
Q

what is the most likely emergency to occur in the dental setting?

A

hypoglycemia

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32
Q

True or False: Clinician wants to review the medical history well and use follow-up questions to identify risk factors and symptoms of diabetes.

A

TRUE

33
Q

What are the 3 Classic symptoms of Diabetes (Known as the 3 P’s)?

A
  1. Polyphagia (Excessive Hunger)
  2. Polydipsia (Excessive Thirst)
  3. Polyuria (Excessive Urination)
34
Q

What are the Diagnostic test for Diabetes?

A

HbA1c or the A1c

35
Q

What does the A1c do?

A

Measures the quantity of high glucose bond to a hemoglobin molecule.

36
Q

What does A1c value do?

A

Provides an average of blood glucose levels over a 2-3 month period.

37
Q

The HbA1c test is used to do what?

A

Diagnose prediabetes and diabetes.

38
Q

Prediabetes is diagnosed with an A1c value from

A

5.7 to 6.4%

39
Q

A1c greater than 6.5% is used to diagnose what?

A

Diabetes

40
Q

A1c is also used for what?

A

to monitor diabetes control

41
Q

Those with good control of diabetes is recommended tone tested how many times a year?

A

2

42
Q

Patients with unstable control of diabetes may need to be tested

A

Every 3 months

43
Q

What are the Risk Factors for diabetes?

A

Adults overweight with a BMI greater than 25 and have other risk factors like:
• Physical inactivity.
• First degree relative with diabetes.
• High risk race/ethnicity such as African American,
• Hispanic, Native American, Asian, Pacific Islander.
• Women who have delivered a baby over 9 pounds or had gestational diabetes during pregnancy.
• Hypertension (>140/90 mm Hg) or taking antihypertensive medications.
• Women with polycystic ovarian syndrome (PCOS).
• History of cardiovascular disease.
• A1c > 5.7%

44
Q

True or False: Dental visits provide an opportunity to screen patients for undiagnosed diabetes.

A

TRUE

45
Q

Individuals who have glucose levels above normal, but do not meet the criteria for dx. of diabetes are considered to have what?

A

Prediabetes

46
Q

What does prediabetes mean?

A

The patient is at risk for developing diabetes

47
Q

What is suggested to those who are prediabetic?

A

lifestyle changes such as being more active, reaching health weight and making healthy food choices.

48
Q

What is the latest medication used to manage the blood glucose levels?

A

Metformin

49
Q

What is Medical Nutrition Therapy?

A

it is individualized for patients to manage and control diabetes.

50
Q

The ADA recommends nutrition therapy be provided by who?

A

a registered dietitian/nutritionalist or certified diabetes educator.

51
Q

All patients with type 1 diabetes require what for survival?

A

Insulin

52
Q

Patients with type 2 diabetes may need insulin for what?

A

Control

53
Q

What are the different types of insulin?

A

rapid acting, regular or short acting, intermediate acting, or long acting

54
Q

Dosage of insulin depends on

A

The individual

55
Q

What are the factors that affect the need for insulin?

A

Food intake, illness, stress, variations in exercise, or infections

56
Q

What are the methods for insulin administration?

A
  • Subcutaneous injection with syringe.
  • Insulin pen
  • Continuous subcutaneous insulin infusion with a battery- operated insulin Pump
  • Inhalable insulin (Brand name Afrezza).
  • Future modes for insulin administration include an insulin patch, and implantable insulin pumps.
57
Q

What is an Insulin Pump?

A

a pump that delivers preprogrammed continuous rate of insulin when needed.
It is small cellphone-sized pump that’s worn in a pocket or on a belt or waistband,

58
Q

How do they treat type 2 diabetes?

A

Oral medications taken in combination or individually and in conjunction with diet, exercise, and s.t. injection of insulin

59
Q

True or False: Patients with well-controlled blood glucose levels tend to develop fewer complications later in life than those whose diabetes is less well controlled.

A

TRUE

60
Q

Patients with diabetes are more susceptible to what?

A

infections and impaired healing, which can worsen prognosis.

61
Q

What can affect glucose levels?

A

Stress, trauma, and infections

62
Q

Failure to treat an infection in a diabetic infection can what?

A

infection intensify the symptoms and increases severity of diabetes; can progress to life- threatening infections/diabetic coma.

63
Q

The amount of insulin needed can increase with what conditions?

A

fever, infection, inflammation, trauma, bleeding, pain, or stress.

64
Q

Diabetics can also have what?

A

impaired immune response, alterations in metabolism of carbs and protein, vascular changes and impaired circulation, and altered nutritional state.

65
Q

What can Neuropathy cause?

A

pain, numbness, or tingling of mouth, face, and extremities.

66
Q

What are the symptoms of peripheral Neuropathy?

A

Symptoms vary depending on the sensory nerve fibers affected and may cause loss of sensation in the feet, hands, and fingers.

67
Q

Neuropathy can make Oral Hygiene difficult due to what?

A

numbness in the hands/fingers

68
Q

True or False: As many as 50% of people with peripheral neuropathy may be asymptomatic and not recognize the loss of sensation which can put them at risk for injury and resulting infection.

A

TRUE

69
Q

People not recognizing the loss of sensation can lead to infection which can lead to what?

A

Amputation

70
Q

What are the Manifestations of Autonomic. Neuropathy?

A

tachycardia, orthostatic hypotension, gastroparesis, and hypoglycemic unawareness.

71
Q

Nephropathy is known as what?

A

Kidney disease

72
Q

What is a leading cause of renal disease, and the most common cause of end-stage renal disease in the U.S. Dialysis or kidney transplant is needed?

A

Diabetes

73
Q

Patients diagnosed with diabetes is screened for what?

A

Protein in urine

74
Q

What is a leading cause of blindness thru the progression of diabetic retinopathy?

A

Diabetes

75
Q

People with diabetes are more likely to have what?

A

Glaucoma and cataracts

76
Q

Individuals with diabetes are at high risk for what?

A

cardiovascular disease

77
Q

Heart conditions common in people with diabetes include

A
  • Hypertension.
  • High total cholesterol
  • High triglycerides
  • May lead to myocardial infarction and stroke.
  • Risk of coronary heart disease.
78
Q

What is recommended for the prevention of cardiovascular disease in its with diabetes?

A

Low-dose aspirin

79
Q

What is to be recorded in notes during appointment?

A
  • Record status of blood glucose control, including most recent HbA1c and other daily monitoring such as fasting blood glucose levels the patient has performed.
  • Update current medications and doses.
  • Confirm compliance of medication intake and food consumption.
  • Record discussion about relationship between oral health status, oral hygiene status, risk factors, and diabetes.

Clinical Dental Hygiene II (14 decks)

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