Diabetes

Question 1

what is diabetes

Answer 1

• it is an endocrine disorder of the pancreas r/t to the relative or absolute deficiency of endogenous insulin
• there is an impaired or no insulin release from beta cells in islets of Langerhans

Question 2

what is insulin resistance?

Answer 2

defect in insulin receptors, made worse by obesity

Question 3

what happens when someone has diabetes?

Answer 3

glucose is not transported from blood into muscle, adipose cells go to the brain as there are no insulin key

Question 4

what is cellular starvation

Answer 4

breakdown of fats and proteins for energy, ketones are produced

Question 5

what is type 1 diabetes?

Answer 5

-little or no endogenous insulin supply. 10% of people with diabetes

Question 6

what are the risk factors for type 2 diabetes?

Answer 6

• heredity
• aging
• obesity
• sedentary lifestyle
• ethnicity
• hypertension
• gestational diabetes
• polycystic ovarian syndrome
• depression
• insulin resistance

Question 7

what are the signs and symptoms of type 1 diabetes?

Answer 7

polyphagia, polydipsia, polyuria, weight loss, fatigue, blurring of vision

Question 8

what are the signs and symptoms of type 2 diabetes?

Answer 8

the poly’s, blurring of vision, fatigue, parathesis, yeast infections, UTI

Question 9

what is the target blood glucose range for individuals?

Answer 9

4-7 mmol/L

Question 10

what is often the first line medication used for diabetes?

Answer 10

metaformin

Question 11

what is important to remember about insulin administration?

Answer 11

-rotate sites, keep at room temp, unopened in fridge

Question 12

describe the short-acting/regular insulin Humulin R

Answer 12

onset = 30 mins
peak = 2-3 hours
duration = 6.5 hours
meal = bolus insulin
basal = rest of the time

Question 13

describe rapid acting insulin

Answer 13

-includes humalog, novarapid, glulisine, fiasp
-onset = 10-15 mins
peak=60-90 mins
duration = 3-5 hours

Question 14

explain extended long-acting basal insulin

Answer 14

-lantus, insulin levemir, humulin N
- given once daily often at HS
-is clear, more consistent action and better absoprtion
onset = 90 mins
- there are no peaks as it is released into the blood stream at a consistant rate

Question 15

what is hypoglycemia?

Answer 15

low blood sugar usually 4 mmol/L or less

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Question 16

what are the signs, symptoms and complications of hypoglycemia?

Answer 16

signs & symptoms = weakness, shakiness, pale, cool skin, tachycardia, nausea, hunger, headache, dizziness, lethargy
complications = seizures, loss of consciousness and death

Question 17

how do you treat hypoglycemia?

Answer 17

it is always considered an emergency, if pt is conscious and can swallow give 15 gm of sugar (3 or 4 glucose tablets, 1tbsp of honey), treat with an additionaly 15 gm of carbs if needed

Question 18

what are the possible chronic complications of diabetes?

Answer 18

neuropathy, retinopathy, kidney problems, microvascular problems and macrovascular problems

Question 19

what are macrovascular complications?

Answer 19

large vessel disease.

- those with diabetes are 2-4 x more likely to experience heart failure

Question 20

what is retinopathy?

Answer 20

it includes the eyes, nerves, and kidneys.
- damage to the blood vessels in the retina caused by chronic high blood glucose. the vessels are weak and leak fluid and bleed which can lead to hemorrhage and edema

Question 21

what is neuropathy?

Answer 21

it include boths peripheral and autonomic

- loss of protective sensory ability, can lead to amputations

Question 22

what are the symptoms of neuropathy?

Answer 22

describing neuropathic pain as burning, pins & needles, sharp and can’t locate or localize the pain

Question 23

how can neuropathy be treated?

Answer 23

by elavil, gabapentin pregablic

Question 24

how can retinopathy be treated?

Answer 24

by laser, vitrectomy and medications

Question 25

what are microvascular complications of diabetes?

Answer 25

nephropathy which is chronic kidney disease