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Adult Health I > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Type I Diabetes

A

No Insulin Production.
Caused by an Auto Immune Response
Cells break down protein, which causes Ketones= Acidosis.

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2
Q

Type II Diabetes

A

Pancreas does not produce enough insulin or produces insulin that does that work properly.

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3
Q

What is the Onset of Type I Diabetes?

A

Abruptly.

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4
Q

What are the signs and symptoms of Diabetes?

A

Polyuria, Polydipsia, Polyphagia.

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5
Q

What is the Onset of Type II Diabetes?

A

Gradually.

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6
Q

What is the treatment for Type I Diabetes?

A

Insulin injections.

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7
Q

What is the treatment for Type II Diabetes?

A

Diet & Exercise, Oral hypoglycemia agents such as metformin, insulin.

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8
Q

The complication of Type I Diabetes is called?

A

Diabetic Ketoacidosis (DKA)

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9
Q

The complication of Type II Diabetes is called?

A

Hyperosmolar Hyperglycemic State (HHS)

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10
Q

What is Diabetic Ketoacidosis?

A

Not enough insulin is produced which leads to a very high glucose level. Cells break down protein & fat into energy which can lead to Ketones build-up which is acidosis.

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11
Q

What is Hyperosmolar Hyperglycemic State?

A

No acidosis is present, just high amounts of glucose in the blood.

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12
Q

What is the treatment for Diabetic Ketoacidosis?

A

IV Insulin, Fluid replacement, Correction of electrolyte imbalances.

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13
Q

What is the treatment for Hyperosmolar Hyperglycemic State?

A

Fluid replacement, Insulin administration, correction of electrolyte imbalances.

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14
Q

What is the normal range for Glucose?

A

70-110 mg/dL

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15
Q

What are the symptoms of Hyperglycemia? (<200 mg/dL)

A

Polyuria
* Polydipsia
* Polyphagia
* Hot & dry skin
* Dry mouth (dehydration)
* Fruity breath
* Deep, rapid breaths (air hunger)
* Numbness & tingling
* Slow wound healing
* Vision changes

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16
Q

What are the symptoms of Hypoglycemia? (>60 mg/dL)

A

Cool & clammy skin
* Diaphoresis
* Palpitations
* Fatigue & weakness
* Confusion
* Headache
* Shakiness
* Inability to arouse from sleep

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17
Q

What does a diabetic diet consist of?

A

Complex carbohydrates, Fiber-rich foods,
Heart-healthy fish, Good fats,
Sugar-free fluids.

18
Q

Rapid Insulin

A

Lispro, Aspart, Glulisine
Onset: 5-30 minutes.
Peak: 30 minutes-3 hours
Duration: 3-5 hours

19
Q

Short-acting Insulin

A

Regular
Onset: 30-60 minutes
Peak: 2-4 hours
Duration: 5-7 hours

20
Q

Intermediate Acting Insulin

A

NPH
Onset: 1-2 hours
Peak: 4-12 hours
Duration: 18-24 hours

21
Q

Long Acting Insulin

A

DO NOT MIX WITH ANY OTHER INSULIN
Glargine
Detemir
Onset: 1-2 hours
Peak: None
Duration: 24 hours

22
Q

What are the risks of Type II Diabetes? (Metabolic Syndrome)

A

Low HDL Cholesterol
Insulin Resistance
Hypertension
Visceral Obesity
High Triglycerides

23
Q

What is insulin?

A

A hormone produced by b-cells in islets of Langerhans. Daily amount of insulin that is secreted by an adult is 40-50 Units.

24
Q

What is the function of insulin?

A

Metabolize, Store, Signal, Inhibit, Unlock.

25
Q

What is Gestational Diabetes?

A

Diabetes develops during pregnancy.

26
Q

What is the Somogyi Effect?

A

When a hypoglycemic period during the night causes a rebound hyperglycemic period in the morning. More common in Type I diabetes.

27
Q

What is the Dawn Phenomenon?

A

Takes place early in the morning. With the rise of the sun, a rise in the blood glucose concentration occurs with no hypoglycemia during the night.

28
Q

Inhaled Insulin (Afrezza)

A

Rapid-acting insulin administered at the beginning of each meal or within 20 minutes after starting a meal.
Used in combination with long-acting insulin in Type I.
Adverse Reactions: Hypoglycemia, cough, throat pain, irritation.
Not recommended for treatment of DKA, smokers, patients with asthma or COPD due to risk of bronchospasm.

29
Q

Biguanides

A

Metformin
Most effective 1st line treatment for Type 2.
Available in immediate-release, extended-release, and liquid forms.
ACTION: Reduces glucose production by the liver.
Enhances insulin sensitivity.
Improves glucose transport.
May cause weight loss. Used to prevent Type 2.

30
Q

Sulfonylureas

A

Glipizide, Glyburide, Glimepiride
ACTION: Increases insulin production from the pancreas. Hypoglycemia is a major side effect.

31
Q

Meglitinides

A

Repaglinide, Nateglinide
ACTION: Increases insulin production from the pancreas. Decreases risk of hypoglycemia.
Take 30 minutes just before each meal to mimic normal response to eating. DO NOT take if skipped a meal.

32
Q

α-Glucosidase Inhibitors

A

Acarbose, Miglitol
Starch blockers
ACTION: Slow down the absorption of carbohydrates in the small intestine.
Take with the first bite of each meal.
Check 2-hour postprandial glucose to determine effectiveness.

33
Q

Thiazolidinediones

A

Pioglitazone, Rosiglitazone
Insulin sensitizers
Most effective in those with insulin resistance
Improve insulin sensitivity, transport, and utilization at target tissues.

34
Q

Dipeptidyl Peptidase-4 (DDP-4) Inhibitors

A

Alogliptin, Sitagliptin, Saxagliptin, Linagliptin
Incretin hormones
Mechanism of action: Increases insulin synthesis and release from the pancreas and decreases hepatic glucose production when glucose levels are normal or elevated
ACTION: DDP-4 Inhibitors block the action of DDP-4.

35
Q

Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitors

A

Canagliflozin, Dapagliflozin, Empagliflozin
ACTION: Block reabsorption of glucose by the kidney
Mechanism of action: Increase urinary glucose excretion.

36
Q

Dopamine Receptor Agonist

A

Bromocriptine
ACTION: Increases dopamine receptor activity.
Patients with type 2 diabetes have low levels of dopamine that may interfere with the body’s ability to control blood glucose.
Improves glucose levels.

37
Q

Glucagon-Like-Peptide 1 Receptor Agonists

A

Inhibit gastric emptying
Decreases blood glucose
Decreases Glucagon secretion & Increases insulin release.

38
Q

Amylin Analogs

A

Pramlintide
Amylin is a hormone secreted by B-cells in response to food intake slowing gastric emptying, reducing postprandial glucagon secretion, and increasing satiety.
Administer subcutaneous in the thigh or abdomen before meals with at lease 250 calories.
Used with mealtime insulin but can’t mix together in the same syringe; i bolus insulin dose.
ADVERSE EFFECT: Watch for severe hypoglycemia 3 hours after injection.

39
Q

What is the importance of exercise?

A

Decreases insulin resistance
Contributes to weight loss
Decreases Triglycerides, LDL, BP
Increases HDL
FREQUENCY: 30 minutes, 5 days per week

40
Q

Macrovascular Complications

A

Disease of the large and medium-sized blood vessels. (Cerebrovascular Disease, Cardiovascular Disease, Peripheral Vascular Disease).
Women > Men

41
Q

Microvascular Complications

A

Capillaries and Arterioles
Thickening of Vessel Membrane
Etiology: Chronic Hyperglycemia
Retinopathy
Nephropathy
Neuropathy

Adult Health I (2 decks)

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