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endocrine > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Rapid acting insulin and onset, peak, duration

A 
Aspart 
Novolog
O- 15 min
P- 1-3
D- 3-5
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2
Q

Regular insulin onset peak duration

A 
Regular insulin
Humulin R
O- 30 mins
P-2-4
D- 6-8
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3
Q

intermediate insulin Onset peak duration

A 
NPH
Humulin N
O- 1-2 hours
P- 6-12
D-24 hours
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4
Q

Long acting insulin onset peak duration

A 
Glargine
Lantus
O-1
P- None
D- 24 hrs
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5
Q

Clinical manifestations of type 1 DM and why

A

Polydipsia- intracellar dehydration, stimulate thirst in hypothalamus
Polyuria- hyperglycemia acts as osmotic diuretic
Polyphagia- depletion of cellular stores of carbs, proteins, fats= cellular starvation
weight loss- secondary to osmotic fluid loss, fats protein used for energy
Fatigue- metabolic changes result in poor use of food products for energy

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6
Q

Which diabetic disorder has an abrupt onset?

A

DM type 1

Long pre clinical period with abrupt onset of clinical manifestations

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7
Q

Who is at higher risk for DM type 2

A

American Indians, Hispanic, African descent, migrants to western lifestyle
Strongly connection to those that have weight excess, obesity

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8
Q

Patho of type 2 DM

A

Decreased responsiveness of beta cells to glucose, either decrease in mass and/or function. Alteration in insulin receptors. Impaired ability of insulin to suppress glucose production and stimulate glucose use

Beta cells become over worked, can no longer produce insulin on its own to keep up with glycogenesis/glucose. This causes an increase of glucose in the blood as it cannot be taken up by insulin to be transported to cells to be used for energy

Very small amount of insulin is still produced, this is why they do not produce ketones when in a state of hyperglycemia

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9
Q

What is the onset and age type 2 usually present

A

Usually insidious onset, gradual
Mostly affecting those over 40, increased weight
Rising cases in children being diagnosed

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10
Q

Clinical manifestations of type 2 DM

A

Frequently no s/s
Recurrent infections in skin, microorganisms are stimulated by increased glucose
Prolonged wound healing, impaired blood supply hinders healing
General pruritus
Hyperglycemia favors fungal growth
Visual changes- retinopathy, water in eye fluctuates
Parathesis r/t neuropathy
Fatigue, poor energy production

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11
Q

Gestational DM

A

Glucose intolerance developed during pregnancy

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12
Q

What happens post pregnancy for those dx with gestational diabetes

A

May return to normal, remain impaired or progress to DM

60% will develop DM within 15 years

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13
Q

Which hormones raise BG levels

A

Cortisol
Epinephrine
Growth Hormone
Glucagon

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14
Q

What is a 1% change equivalent to regarding A1C in DM

A

30mg/dl

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15
Q

What is a healthy A1C

A

Below 5.7%

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16
Q

Prediabetic and diabetic A1C levels?

A
  1. 7-6.4 Pre

6. 4% < DM

17
Q

What are the times to self monitor BG levels

A

Before meals and bedtime

18
Q

4 common causes for hypoglycemia

A

Medication- insulin excess or oral DM drugs not taken correctly
Deficient food intake or absorption
Exercise- Increases rate of cellular uptake for several hours
Alcohol- Inhibits liver gluconeogenesis

19
Q

S/S hypoglycemia

A 
bg <60/ <70
cool, clammy, diaphoretic, HA
irritable, anxious -->confusion!!
Shaky tremors
Weak, hungry, tingling
Tachy, palpations
20
Q

TX for hypoglycemia if conscious

A

10-15 grams of rapid carbs, 4oz juice

15 RULE- Give 15 g carbs, check in 15

21
Q

TX for hypoglycemia if unconcious

A

Glucagon sq or im

50% dextrose push

22
Q

3 stages of retinopathy

A

Nonproliferative-increased capillary permeability, vein dilation, microaneurysm formation, hemorrhages
Preproliferative- poor perfusion, accumulation of infarcts
Proliferative- neovascularization and fibrosis in retina and optic disc, traction may cause retinal detachment, hemorrhage in vitreous humor

May lead to loss of vision!

23
Q

What is considered a microvascular disease r/t DM

A

Retinopathy

Nephropathy

24
Q

list the types of macrovascular disease r/t DM

A

CAD - coronary artery disease
CVD - cerebral vascular disease
PAD - Peripheral vascular diease

25
Q

Periodontal disease r/t DM, manifestations, teaching

A

Principal oral complication in association with microangiopathy, anaerobic microorganisms find this condition optimal for growth
Bone loss, tooth mobility, migration of teeth and tooth loss

Teach- dental care follow up- critical to overall health

26
Q

Diabetic foot statistics

A

50% amputations in US r/t DM
57% mortality rate w/in 3 years of amputation of limb, 75% w/in 5 years
Associated with lack or circulation and sensation

endocrine (5 decks)

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