diabetes

Question 1

metabolic syndrome

Answer 1

will have: HTN,
Dyslipidemia
Hyperinsulinism
Centralized obesity
Glucose intolerance
Predisposition to T2DM
inc risk of CAD, stroke, PVD
apple shaped “elevated waist circumference

Question 2

type 1 diabetes

Answer 2

Autoimmune mechanisms are a major cause
absence of insulin
presenting sign: ketoacidiosis
eventually become dependent on exogenous insulin
three p’s - polydispia, polyuria, polyphagia
presenting sign; DKA

Question 3

type 2 diabetes

Answer 3

Cellular insulin resistance that develops overtime
Risk factors;
Sedentary behavior
Obesitynsensitivity of of body cells to insulin → pancreas attempts to compensate by secreting increasing amountsPancreas becomes exhausted and cannot compensate
peripheral neuropathy
three p’s

Question 4

diagnosis

Answer 4

oral glucose tolerance test > 200 mg/dL
glycated hemoglobin > 6.5
fasting glucose > 126 mg/dL
random plasma glucose >200 mg/dL
glucosuria
ketonuria
islet cell autoantibodies differentiate between the two
c peptide test: high: type 2
low: type 1

Question 5

diabetic ketoacidosis

Answer 5

ketone formation is a result of lipolysis which occurs in the absence of enogenrous insulin which is why DKA is associated w type 1
N/V/D, coma hyperosmoloarity paired a ICF fluid loss in the brain
3 P’s
criteria:
Blood glucose level: ≳250 mg/dL
Arterial pH: < 7.3
Serum bicarbonate: <18 mEq/L
Ketonuria and ketonemia
management: Fluid replacement counteracts dehydration and hyperosmolarity
IV insulin administered until blood glucose < 250 mg/dL
Subcutaneous insulin to keep levels between 150 and 200 mg/dLDo not overhydrate client, and blood glucose should be brought down gradually

Question 6

hyperomolar hyperglycemic syndrome

Answer 6

Glucose is not absorbed into the cells because of cellular insulin resistance
Hyperosmolarity causes a fluid shift out of the cells into the ECF
Cellular dehydration occurs
Glucosuric diuresis: excess glucose in the tubular fluid → pulls water into tubule → extra water excreted in urineClassification:
Blood glucose: >600 mg/dL
Arterial pH: mild acidosis : pH greater than 7.3
Serum bicarbonate: > 18 mEq/L
Blood osmolarity: > 320 mOsm/L
Urine and blood ketone: small
presentation: dehydration, rapid, thready pulse, abdominal distention
management: IV insulin until blood glucose is 300 md/dL