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PTAP Woundcare > Diabetes > Flashcards

Diabetes Flashcards

1
Q

The body’s preferred, primary energy source for cellular metabolism

A

Glucose

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2
Q

What are the functions of the Pancreas

A

Exocrine and Endocrine function: Somatostatin - regulates release of insulin and glucagon

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3
Q

What is the function of Insulin

A

Stimulates cellular absorption of glucose.

  • transport glucose into cells
  • turns glucose into fats
  • promotes transport of glucose to liver
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4
Q

What is the function of Glucagon

A

Released during Hypoglycemia

Promotes conversion of glycogen into glucose: Raises blood sugar level

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5
Q

Type of DM that occurs when the immune system attacks the insulin-producing beta cells in the pancreas

A

Type 1 DM

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6
Q

Insulin resistance even though insulin present
AND Altered response to glucose
Results
Hyperglycemia
Onset: Adult (seen in obese children)
Gradual increase of resistance to insulin

A

Type 2 DM

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7
Q

What are the extrinsic risk factors of Type 2 DM?

A

obesity
sedentary lifestyle
diet

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8
Q

What are the intrinsic risk factors of Type 2 DM

A

Ethnicity: African-American, Asian, Pacific Islander, Latin
Males >45yo
HTN, Hyperlipidemia
Family history of DM

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9
Q

What are the treatments involved with Type 2 DM?

A

Medication: Oral and insulin injection
Nutritional Counseling
Stress management
Exercise

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10
Q

What are the delivery devices for insulin?

A

Insulin syringe
Insulin pen
Insulin pump
Jet injector

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11
Q

What are the effects of Stress Cortisol Release?

A

increases visceral obesity, low grade inflammation, leptin, and insulin resistance.

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12
Q

What benefits does exercise have on Type 2 DM?

A 
Increases
-beta-cell mass
-insulin
-insulin sensitivity
-glucose uptake
-glucose and fatty acid oxidation
Decreases
-glucagon
-blood glucose
-hemoglobin A1c
-fat mass
-hepatic glucose production
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13
Q

What is Gestational Diabetes?

A 
Developed during pregnancy
Causes
Weight gain
Genetic predisposition 
Resistance to insulin 2° hormone changes
Low HDL, elevated triglycerides
MAY be more likely to develop Type 2 DM later in life
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14
Q

Where is glycogen stored?

A

The Liver

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15
Q

T/F: During periods of hypoglycemia, glucagon is released by the pancreas.

A

True

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16
Q

What are the Big 3 Signs and Symptoms of DM?

A 
Polydipsia (thirst)
Polyuria (urination)
Polyphagia (hunger)
*also...
Hyperglycemia
Hyperglycosuria (high excretion of glucose in urine)
Weight loss
Increased appetite
Nausea
Blurred vision
Amenorrhea (absence of menstrual period)
ED
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17
Q

Created by the liver when the body has decreased glucose levels for use by cells, and used as an energy source for cellular function

A

Ketones

18
Q

The effect of Ketones used as an energy source are?

A

Hyperglycemia
Hyperketonemia (ketones in blood)
Hyperketonuria (ketones in urine)
Ketoacidosis (lowers blood PH level acidic levels

19
Q

What are the symptoms of Ketoacidosis?

A 
headache confusion
sleepiness, LOC
weakness
diarrhea
shortness of breath
arrythmia
increased HR
nausea
vomiting
20
Q

What are the Systemic Complications of DM?

A
  • gradual destruction of small blood vessels and nerves throughout the body
  • 2 degree sugar crystal formation during hyperglycemia
  • Affects ALL systems
  • PVD (LE blood flow)
21
Q

What are the Neurologic complications of DM?

A

Sensory neuropathy (Paresthesia, pain, sensation loss)
Motor neuropathy (Muscle atrophy)
Autonomic neuropathy (Sweat/oil production, digestion, stress etc.)
Diabetic Neuropathy
(LE and feet)

22
Q

Additional Systemic Complications of DM?

A 
Integumentary
Visual
CNS
Cardiac
Digestive
Renal (uncontrolled HTN)
Dental
Urinary/Reproductive
Mental
23
Q

What are the lab values for FPG (fasting plasma glucose)?

A

Mg/dL: Milligram per Deciliter
Normal: <100mg/dL
Prediabetic: 100 to 125mg/dL
Diabetic: >125mg/dL

24
Q

What is the normal value for A1C Testing? *also known as hemoglobin A1C

A

Normal: 4 to 5.6%
At Risk: 5.7 to 6.4%
Diabetes: 6.5%

25
Q

What are the symptoms of Hyperglycemia?

A 
>200 - 300mg/dL
gradual onset
extreme thirst
dry skin
hungry
need to urinate often
blurry vision
drowsy
slow-healing wounds
flushed, dry
26
Q

What are the symptoms of Hypoglycemia?

A 
>70mg/dL
sudden onset
extreme fatigue
blurred vision
sweating
mood changes
dizziness
increased pulse
shaky/trembling
27
Q

When is exercise contraindicated for hypoglycemia or hyperglycemia?

A

hypo: < 70mg/dL
hyper: > 300mg/dL with ketones

28
Q

What are some exercise guidelines for a patient that is hyperglycemic and on oral meds?

A

Oral

  • 10 to 15 min of activity
  • BG rises, STOP.
  • BG drops, continue while rechecking BG every 10 to 15 min
29
Q

What are some exercise guidelines for a patient that is hyperglycemic and on insulin?

A

Should be checked for ketones* (via urine dip stick or glucose meter)
If (+) ketones: avoid activity
If (-) ketones: participate with close BG monitoring

30
Q

T/F? One cause of ketoacidosis is low blood glucose availability for tissues to use and is a medical emergency.

A

True

31
Q

What are the benefits of exercise with Type 2 DM?

A
  • Improve mild to moderate HTN
  • Increased energy expenditure
  • Cardio conditioning
  • Increased strength and flexibility
  • Improve well-being and quality of life.
32
Q

What are Diabetic exercise risks?

A

hypoglycemia
hyperglycemia
onset/exacerbation of cardiovascular diseases
Autonomic neuropathy

33
Q

Guidelines for Cardiovascular Training for DM patients.

A
  • gradual increase of intensity
  • 40 to 60% of MHR
  • walking, aquatic, treadmill, bike, UBE, tai-chi
  • 3 to 5x weekly
  • build to 30 min
  • 1000-2000 kcal/week
34
Q

Guidelines for Resistance Training for DM patients.

A
  • Gravity
  • Free weights
  • Elastic Bands
  • Exercise Machines
  • Aquatic Exercises (water as resistance)
  • Gym Ball
    10 to 15 reps/set
    2 sets per major muscle group
    1 min rest minimum
    2-3x weekly
    30 minutes
35
Q

What should you educate the Diabetic patient on?

A
  • foot care
  • energy conservation
  • reinforce functional activities of interest
36
Q

What are the foot hygiene practices you should teach your patient?

A
  • Inspect feet daily for injury or pressure areas
  • Wash feet with mild soap
  • Dry between toes
  • Don’t go barefoot
  • Caution with cutting toenails
  • Need Podiatrist?
37
Q

What are the Ulcer Prevention methods?

A 
Control diabetes
Foot hygiene
Proper socks
Proper shoes
Pressure relief
Wound care
Monofilament testing
38
Q

Complication of neuropathy resulting in a complex of sensory, motor, and autonomic changes that lead to structural and vascular changes

A

Charcot Foot

39
Q

What are characteristics of Charcot Foot?

A
  • Multiple osteoarthropathy
  • joint dislocation
  • pathological fractures
  • osteopenia
  • deformities (convex bottom of foot)
  • gait pattern changes
  • different pressure points
40
Q

What are the important questions to ask a patient with DM prior to exercising?

A

How do you feel?
Did you monitor your glucose level this morning? What was it?
Did you take your diabetes med today?
Last time you ate?
Do you have a snack or glucose tablets with you?
Do you have your glucose monitor with you?

PTAP Woundcare (9 decks)

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