Diabetes 1 Flashcards
T/F: Hypoglycemia causes damage throughout the body to small vessels (microvascular) and large vessels (macrovascular)
True
What are examples of microvascular disease caused by hyperglycemia
Retinopathy, Nephropathy, Neuropathy, Autonomic Neuropathy (ED, gastroparesis, loss of bladder and UTIs)
What are examples of microvascular
Atherosclerosis to ASCVD (Coronary Artery Disease, Cerebrovascular Disease, and Peripheral Artery Disease)
What is Type 1 diabetes
An autoimmune disease where a patient’s own antibodies attack and destroy beta cells (islet cells) in the pancreas causing no insulin production
What happens to the body if there is no insulin
Glucose cannot enter muscle cells, fat is metabolized into ketones and used as an alternative energy source
What is a serious complication of uncontrolled diabetes
Diabetic Ketoacidosis (DKA)
How is Type 1 diabetes diagnosed in adults
Patients are tested and have LOW OR ABSENT C-PEPTIDE levels (c-peptide is released by the pancrease only when insulin is released)
What are the major contributors to Type 2 diabetes
Low level of physical activity, being overweight and obese
What happens to the pancreas if the patient has Type 2 diabetes
Pancreas will produce more insulin leading to more INSULIN RESISTANCE, soon the insulin production DECREASES and blood glucose continue to increase
What is primary goal for patients with prediabetes
Weight management and regular physical activity
What medication was given for someone who has prediabetes, when would it be given
Metformin/ Patients who are younger than 60 years but have an BMI greater than 35 and/or a history of a diabetes diagnosis during pregnancy
What is the best test for Gestational Diabetes
Oral Glucose Tolerance Test
What are the classic symptoms caused by high blood glucose (HINT: 3P’s
Polydipsia: Excessive Thirst
Polyuria: Excessive Urination
Polyphagia: Excessive hunger or increased appetite
How is Diabetes Mellitus diagnosed
An A1C greater than 6.5% or FPG greater than 126 mg/dL or greater than 200 mg/dL after 2-hour PPG: MUST BE CONFIRMED WITH A 2ND TEST
T/F: If A1C is not at goal A1C should be monitored every 3 months if not at goal BUT EVERY 12 months if at goal
False: If A1C is not at goal A1C should be monitored EVERY 3 MONTHS if not at goal but EVERY 6 MONTHS if at goal
What are the A1C goal, Prepandial goal, and two hour Postprandial goal
A1C: Less than 7 percent
Prepandial: 80-130 mg/dL
2-hour Postprandial: Less than 180 mg/dL
T/F: An A1C of 6% is equivalent to an estimated average glucose of 126 mg/dL and each additional 1% increases the eAG by 28 mg/dL
True
What is the first line medication for Type 2 diabetes
Metformin
When would insulin be given initially for a patient diagnosed for diabetes
A1C greater than 10% or BG is greater than 300 mg/dL
If a patient has ASCVD and type 2 diabetes what are the 2nd line medications that are recommended
An SGLT2 inhibitor or GLP-1 agonist
If a patient has HF or CKD and type 2 diabetes what are the 2nd line medications
SGLT2 inhibitor
If a patient wants to lose weight which diabetes medications should be considered first
SGLT2 inhibitors and GLP-1 agonist
T/F: if there is a high risk of hypoglycemia patients can be given SGLT2-inhibitors and GLP-1 agonist
False: If there is a high risk of hypoglycemia use DPP-4 inhibitors, GLP-1 agonist, SGLT2 inhibitors, or TZDs
What is the algorithm for adding insulin when necessary
1) Add Basal insulin or bedtime NPH: 10 units a day OR 0.1 to 0.2 units/kg per day
2) Add prandial insulin: 4 units a day or 10% of basal insulin dose
3) Proceed to full basal-bolus regimen
How should the basal insulin be adjusted to reach FPG target without hypoglycemia, how should basal insulin be changed if hypoglycemia is present
Increased by 2 units every 3 days// Decrease dose by 10 to 20%
How should the prandial insulin be adjusted if A1C is above target
Increase the dose by 1 to 2 units or 10 to 15% twice weekly// Decrease dose by 10 to 20%
