Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Human Diseases > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is diabetes?

A

Raised blood glucose level due to problem with insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is insulin?

A

A hormone secreted into the blood by the beta cells of the pancreatic islets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does insulin stimulate?

A

Uptake of glucose into cells, particularly liver, muscle and adipose tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is type 1 diabetes insulin-dependent or non-insulin dependent?

A

Insulin-dependent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What causes type 1 diabetes?

A

The autoimmune destruction of beta cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When does type 1 diabetes occur?

A

Juvenile onset (from childhood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Is type 2 diabetes insulin-dependent or non-insulin dependent?

A

Non-insulin-dependent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Is type 1 or type 2 diabetes more commonly seen?

A

Type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the main onset of type 2 diabetes?

A

Maturity onset (usually middle age)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which type of children/teenagers can develop early onset of type 2 diabetes?

A

Overweight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What causes type 2 diabetes?

A

Combination of insulin resistance and relative insulin lack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is gestational diabetes?

A

Diabetes in pregnant women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the symptoms presented in type 1 diabetes?

A

Polyuria
Polydipsia
Weight loss
Blurred vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the symptoms presented in type 2 diabetes?

A

May be asymptomatic
Similar to type 1 but less rapid and dramatic
Long term complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are predisposing infections of type 2 diabetes?

A

Candida in urine and mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the prevalence of diabetes in percentage in the population of the UK?

A

6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which racial groups are particularly predisposed to diabetes?

A

South Asians (Indian, Sri Lankan)
Native Americans (Pima, Arizona)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the peak onset age of type 1 diabetes?

A

10 to 14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the test used to diagnose type 2 diabetes?

A

75-gram oral glucose tolerance test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does the 75-gram oral glucose tolerance test work?

A

Fast patient overnight
Measure blood glucose in a fasted state in the morning (<6.0 is normal; 6.0-7.0 is impaired fasting glucose; >7.0 is diabetes)
Give 75 grams of oral glucose in a liquid form
Measure blood glucose level again after 2 hours (<7.8 is normal; 7.9-11.0 impaired glucose tolerance; >11.0 diabetes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the abbreviation of glycated haemoglobin?

A

HbA1c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How long is the life span of haemoglobin in red cells?

A

120 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the normal glycated haemoglobin level?

A

<42 mmol/mol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the pre-diabetes glycated haemoglobin level?

A

42 to 47 mmol/mol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the diabetes glycated haemoglobin level?

A

> 48 mmol/mol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the aims of diabetes treatment?

A

Control symptoms
Prevent complications
Lead a normal life (no need to rely on measuring blood glucose or injecting insulin on a daily basis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is type 1 diabetes glucose control?

A

Always needs insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is type 2 diabetes glucose control?

A

Diet to lose weight/less carbs or sugar
Diet plus tablets/injected drugs
Diet plus insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What will happen to type 1 diabetic patients if they stop their insulin replacements?

A

Die rapidly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Will type 2 diabetic patients die rapidly if insulin replacement is stopped? Why?

A

No, they are not insulin-dependent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What raises blood glucose?

A

Food
Glucagon
Adrenaline
Cortisol
Growth hormone
Illness/stress (makes you eat more)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What lowers blood glucose?

A

Starvation
Insulin
Anti-diabetic drugs
Exercise
Illness/stress (makes you eat less/starve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What do oral hypoglycaemic drugs do?

A

Lower blood glucose levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the classes of oral hypoglycaemic drugs (and examples) that increase insulin secretion/act as insulin secretagogues?

A

Sulphonylureas eg gliclazide
DPP4 inhibitors eg sitagliptin, vildagliptin
GLP-1 binders eg exenatide, liraglutide (injected)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the classes of oral hypoglycaemic drugs (and examples) that increase the action of insulin/act as insulin sensitisers?

A

Biguanides (metformin)
Thiazolidinediones (glitazones eg pioglitazone)

36
Q

What class of oral hypoglycaemic drugs (and examples) have a mechanism of increasing glycosuria?

A

SGLT-2 inhibitors eg empagliflozin, campagliflozin

37
Q

How is insulin administered?

A

Injected subcutaneously

38
Q

What are some basic equipment that can be found on someone with insulin-dependent diabetes?

A

Vial of insulin + syringe
Insulin pen injector
Finger prick blood test kit
Glucose monitor

39
Q

What type of glucose monitor only gives readings when interrogated?

A

Flash glucose monitor

40
Q

What type of glucose monitor constantly transmits results to a device and gives warnings of high/low glucose?

A

Continuous glucose monitor

41
Q

How is insulin administered?

A

Subcutaneous injection

42
Q

What type of insulin is chemically modified, intermediate/long-acting, looks cloudy hence needs to shake the solution before drawing it up into syringe, is bound onto another molecule so it’s absorbed more slowly where its absorption activity peaks at ~4 hours and lasts for ~12 hours?

A

Isophane insulin

43
Q

When is the peak of the absorption of the short-acting soluble insulin eg Actrapid or Humulin S?

A

~ 1 hour

44
Q

How long does the short-acting soluble insulin last eg Actrapid or Humulin S?

A

~ 6 hours

45
Q

What are the different types of short-acting insulin? Give example brands.

A

Soluble - Actrapid, Humulin S
Insulin Aspart - Novorapid
Insulin Lispro - Humalog

46
Q

What are the different types of intermediate/long-acting insulin? Give example brands.

A

Isophane insulin - Insulatard, Humulin I
Insulin Glargine - Lantus
Insulin Detemir - Levemir

47
Q

What are the different types of biphasic insulin? Give example brands and concentrations.

A

Biphasic Isophane Insulin - Mixtard 30 (30% soluble; 70% isophane), Humulin M3 (30% soluble; 70% isophane)
Biphasic Insulin Aspart - NovoMix 30 (30% insulin aspart; 70% aspart protamine)
Biphasic Insulin Lispro - Humalog Mix25 (25% insulin lispro; 75% lispro protamine)

48
Q

When are biphasic insulins injected in a day according to the twice-daily soluble and isophane insulin regimen?

A

Morning before breakfast
Evening before dinner

49
Q

How does the basal-bolus insulin regimen work?

A

Injection of long-acting insulin once a day (timing does not matter as it lasts for 24 hours; usually given at night or first thing in the morning)
Injection of short-acting soluble insulin with each meal

50
Q

How is basal-bolus regimen better than twice-daily regimen?

A

Meal times can be more flexible

51
Q

Which regimen is the insulin pump usually preset to deliver?

A

Basal bolus regimen

52
Q

Do insulin pumps use short or long-acting insulin?

A

Short-acting insulin

53
Q

What are some acute diabetes complications?

A

Ketoacidosis (type 1 diabetes)
Hyperosmolar hyperglycaemic state (type 2 diabetes)
Hypoglycaemia

54
Q

What are some chronic diabetes complications?

A

Microvascular - retinopathy, neuropathy, nephropathy
Macrovascular - peripheral, coronary, cerebral
Foot problems (numb feet/amputations)

55
Q

How to manage mild and/or benign background diabetic retinopathy (where there are microaneurysms, which are formed on the arterials, bursting to cause microhaemorrhages which are benign and do not cause problems because they are out on the periphery of the vision)?

A

Monitoring

56
Q

How to prevent more advanced diabetic retinopathy where the blood vessels have actually burst and caused a severe haemorrhage that damages the central vision?

A

Laser photocoagulation

57
Q

What feet problems can a diabetic patient present?

A

Black toe(s)
Neuropathic foot ulcer(s)

58
Q

How to remove black toe?

A

Ray amputation
Falls off itself

59
Q

How to manage diabetic patients with neuropathy of the feet where they can’t feel their feet?

A

Good foot care/hygiene
Podiatrists pare down thick skin using scalpels (chiropody)
Pads in shoes to prevent rubbing (protection)
Form a habit of constantly checking feet to see if there are any damages that can’t be felt
Wear well-fitting footwear

60
Q

What is the condition called which is when there is a diabetic motor neuropathy affecting the hands causing wastage of hand muscles and stiffening of the fingers?

A

Diabetic cheiroarthropathy

61
Q

How to prevent long-term complications of diabetes?

A

Meticulous glucose control
Control of blood pressure
Avoidance/treatment of other risk factors eg smoking, hyperlipidaemia, obesity, inactivity
Early detection and management - screening

62
Q

What are the benefits of good glucose control whereby glycated haemoglobin is reduced by 11mmol/mol?

A

Reduce microvascular complications by 25%
Reduce amputations by 43%
Reduce heart failure by 16%
Reduce cataracts by 19%

63
Q

What would glucose control that is too tight increase the risk of?

A

Hypoglycaemia

64
Q

How to treat established diabetic retinopathy?

A

Laser photocoagulation
Careful monitoring

65
Q

How to treat established diabetic nephropathy?

A

ACE inhibition
Dialysis
Transplantation

66
Q

What are the treatment options for established diabetic peripheral vascular disease?

A

Bypass surgery
Angioplasty
Amputation

67
Q

What happens in hypoglycaemia?

A

Plasma glucose level is too low

68
Q

What are the causes of hypoglycaemia in diabetic patients?

A

Insulin
Oral hypoglycaemics

69
Q

What are the warning symptoms of hypoglycaemia (in response to increased adrenaline in the body)?

A

Tremor
Anxiety
Palpitations/tachycardia
Hunger
Dry mouth/Thirst

70
Q

What are the established symptoms of hypoglycaemia (neuroglycopenic; usually don’t get warning symptoms beforehand)?

A

Confusion/aggression
Slurred speech
Incoordination
Coma
Convulsions
Irreversible brain damage
Death

71
Q

What do the established symptoms of hypoglycaemia in diabetic patients mimic?

A

Drunkenness

72
Q

How to treat hypoglycaemia?

A

Establish diagnosis by measuring the blood glucose (definite hypoglycaemic range for a diabetic is <4; 4 is the floor)
If in doubt, treat anyway
Oral glucose (glucose tablets or drinks with sugar)
Buccal hypostop gel (glucose gel in a squeeze bottle)
Intramuscular glucagon 1mg (won’t work in patients with liver disease or severe starvation)
Intravenous glucose 20-30ml 50% (has to have a good large cannula that goes straight into the vein as it is a strong acid that can burn skin)

73
Q

What is the resuscitation protocol (ABCDEFG) when we see anyone in a state of collapse, confusion, or unconsciousness?

A

Airway, breathing, circulation, don’t ever forget glucose

74
Q

Why does glucagon come in dry powder form which needs to be mixed with a diluent in a vial and then drawn up into the syringe before intramuscular injection?

A

It has a poor shelf life in solution

75
Q

Where is the most convenient place to inject glucagon?

A

Large muscle of the outer thighs

76
Q

Which type of diabetes can diabetic ketoacidosis be presented in?

A

Type 1 diabetes

77
Q

What causes diabetic ketoacidosis in type 1 diabetic patients?

A

Omitting insulin (before getting diagnosed) or
intercurrent illness

78
Q

What does diabetic ketoacidosis (complete lack of insulin) cause?

A

Hyperglycaemia
Osmotic diuresis - leading to dehydration
Loss of Na in urine
Loss of intracellular K in urine
Accumulation of ketone bodies (soluble ketone acids that accumulate in the blood)

79
Q

How long does it take for the onset of clinical features of ketoacidosis?

A

Over 12 to 24 hours

80
Q

How to control pH of blood when acid builds up due to ketoacidosis?

A

Slow, deep breathing (Kussmaul respiration) to remove carbonic acid

81
Q

How to prevent diabetic ketoacidosis?

A

Never omit insulin in type 1 diabetes
If unwell and off food, still take insulin, monitor carefully and take liquid form carbohydrate
If unable to keep any food down, immediate admission for intravenous treatment
Education of patient and doctor and dentist

82
Q

What is the treatment given in the case of a medical emergency of diabetic ketoacidosis?

A

Intravenous insulin infusion
Intravenous rehydration and electrolyte replacement
Treat underlying causes such as infection or myocardial infarction
Secondary prevention (making sure patient understands how to prevent this from happening again)

83
Q

What is the newer term for hyperosmolar non-ketotic coma?

A

Hyperosmolar hyperglycaemic state (HHS)

84
Q

Although similar, how is the hyperosmolar hyperglycaemic state different from diabetic ketoacidosis?

A

Still have a bit of insulin so no build-up of ketoacids
Slower onset (over days)
Occurs in type 2 diabetes
Slower correction/rehydration

85
Q

How to manage diabetic patients during dental surgery (don’t usually require fasting)?

A

Check control and usual treatment/ways of monitoring
Check for relevant complications
List first in the morning to minimise disruption to their routine
FIngerprick check glucose before and after procedure, be prepared to treat hypoglycaemia
Give a mid-morning snack before leaving surgery
Remember that diabetes increases the risk of infections with any surgery (does not need prophylactic antibiotics)

86
Q

How to manage diabetic patients for short hospital procedures requiring fasting?

A

Omit morning insulin and breakfast
Get procedure done fast/first on the list
Give insulin treatment and breakfast immediately afterwards
Check if they are okay

87
Q

How to manage diabetic patients for major or longer hospital procedures?

A

Treat in hospital
Intravenous treatment with drip and insulin
GKI - glucose, potassium, insulin infusion
Monitor glucose hourly
Adjust insulin content of bag to maintain normal glucose levels between 6 and 12

Human Diseases (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions