Diabetes

Question 1

______ is made from the alpha cells (counterregulatory hormone)

Answer 1

glucagon

Question 2

____ is made by the beta cells

Answer 2

insulin

Question 3

insulin is not needed for the ______ or ______

Answer 3

brain or liver

Question 4

Destruction of beta cells by the immune system (80-90% of cells destroyed)

Answer 4

type 1 DM

Question 5

what are the 3 P’s?

Answer 5

o Polyuria
o Polydipsia
o Polyphagia

Question 6

Insulin is present but there is cellular resistance to it

Answer 6

type 2 DM

Question 7

what are risk factors for type 2 DM?

Answer 7

Obesity is a major risk factor
o Also, family history, HTN, sedentary lifestyle
o Metabolic syndrome

Question 8

what is metabolic syndrome?

Answer 8

 Elevated LDL’s
 Blood pressure

Question 9

The placenta blocks the action of the mother’s insulin

Answer 9

gestational diabetes

Question 10

in gestational diabetes, mother may need up to ____ the amount of insulin by the third trimester

Answer 10

3 times

Question 11

babies from mother with gestational DM are usually delievered by? why?

Answer 11

-by C-section due to the babies’ weight
-Baby puts on extra weight due to the extra sugar from the mom being given to the baby

Question 12

diabetes insipidus is caused by?

Answer 12

o Brain tumors
o Infections
o CBA’s
o Pituitary surgery
o Renal or organ failure
*ADH insufficiency (produced by the hypothalamus)
o Hypernatremia!

Question 13

Why do we change injection sites of insulin?

Answer 13

to prevent lipodystrophy
* Tissues become hardened
* Medication absorption is affected/hindered

Question 14

what are some rapid acting insulins?

Answer 14

• lispro (Humalog)
• aspart (Novolog)
• glulisine (Apridra)

Question 16

what is a short-acting insulin example?

Answer 16

• Regular (Humulin R, Novolin R)

Question 17

what is an intermediate acting insulin example?

Answer 17

• NPH (Humulin-N, Novolin N

Question 18

what are some long-acting insulin example?

Answer 18

• glargine (Lantus/Toujeo)
• detemir (Levemir)

Question 19

what is the Somogyi Effect

Answer 19

 hypoglycemia during late evening
 insulin causes counter-regulatory response
 hyperglycemia in early morning

Question 20

what is the Dawn Phenomenon

Answer 20

Abnormal early morning increase in blood glucose
Surge of hormones early morning as bedtime insulin is wearing off
Results in increased fasting glucose

Question 21

what are some other treatments for DM other than insulin and meds?

Answer 21

Stem cell treatments
Islet cell transplants
Gene therapy (beta cells with interleukin 10)
Pancreas transplants

Question 22

what is considered hypoglycemia?

Answer 22

<70

Question 23

what are s/sx of hypoglycemia?

Answer 23

 Confusion
 Irritability
 Diaphoresis
 Tremors
 Hunger
 Rapid pulse
 Hypotension
 Sweating
 Anxiety
 Weakness
 Visual disturbances

Question 24

some long term complications of hypoglycemia:

Answer 24

 Hypertension
 Hyperlipidemia
 Blindness
 End-stage kidney disease
 Amputations
 Neuropathy
 Macrovascular

Question 25

macrovascular complications from hypoglycemia?

Answer 25

* ATH * CAD * HTN * Stroke * PVD

Question 26

microvascular complications from hypoglycemia?

Answer 26

* Diabetic retinopathy * Diabetic nephropathy * Diabetic neuropathy o Foot ulcers/amputations * Mood alterations * Infection

Question 27

how many times a day should a patient check their blood sugar?

Answer 27

3-4 times

Question 28

what electrolyte imbalance would you exspect from a patient with HHNKS or DKA?

Answer 28

potassium

Question 29

what are ketones?

Answer 29

a by-product of fat metabolism -commonly seen in starvation

Question 30

what does insulin do?

Answer 30

promotes glucose transport from the bloodstream to the cell

Question 31

what are some conterregulatory hormones to insulin?

Answer 31

glucagon epinephrine growth hormone cortisol

Question 32

what insulins should not be mixed with othrs?

Answer 32

insulin glargine (lantus) insulin detemir (levemir)

Question 33

what BS level do the kidneys start to pour glucose out in the urine?

Answer 33

180

Question 34

what to do when a diabetic pt is going into surgery?

Answer 34

1. stop oral diabetic pills 2. stop sq insulin 3. dextrose may be needed (NPO)

Question 35

not DC of metformin can cause what?

Answer 35

lactic acidosis

Question 36

when a pt is unconscious how should you treat?

Answer 36

im injection of glucagon admin D50

Question 37

what causes HHNKS?

Answer 37

dehydration secondary to an illness in a type 2 diabetic

Question 38

what causes DKA?

Answer 38

lack of insulin and ketosis

Question 39

how do we treat HHNKS?

Answer 39

hydration insulin correct electrolyte imbalances

Question 40

how do we treat DKA?

Answer 40

airway managment fluid replacment insulin replacment elcetrolyte replacment sodium bicarb?

Question 41

what are the sick day guidelines?

Answer 41

-increase frequency of BS checks -check urine for ketones -drink plenty of fluids -watch for s/sx of dehydration