DIABETES

Question 1

What is diabetes?

Answer 1

A group of metabolic diseases characterized by elevated blood glucose due to deficits in insulin secretion, insulin action, or both.

Question 2

What are the types of diabetes?

Answer 2

Type 1: Pancreas does not produce insulin.
Type 2: Pancreas produces insulin, but the body cannot use it effectively.
Gestational Diabetes: Occurs during pregnancy.
Secondary Diabetes: Caused by other medical conditions or medications (e.g., prednisone).
Prediabetes: Elevated glucose levels not yet meeting diagnostic criteria for diabetes.

Question 3

What are the risk factors for Type 1 Diabetes?

Answer 3

Family history of diabetes and exposure to certain viruses.

Question 4

What are the risk factors for Type 2 Diabetes?

Answer 4

Obesity, physical inactivity, high triglycerides (>250 mg/dL), race/ethnicity, advanced age, previous impaired glucose tolerance or gestational diabetes, history of delivering a baby >9 pounds, family history of diabetes, and hypertension.

Question 5

How do insulin and glucagon regulate glucose after eating?

Answer 5

Glycogenesis occurs, storing glucose as glycogen, while processes like glycogenolysis, gluconeogenesis, and ketogenesis are suppressed.

Question 6

What happens to glucose regulation during fasting?

Answer 6

Glycogenolysis breaks down glycogen into glucose, gluconeogenesis converts protein into glucose, and ketogenesis converts fats to fatty acids, leading to ketone production.

Question 7

What are common symptoms of diabetes?

Answer 7

Hyperglycemia (blood glucose >250 mg/dL), polyuria, polydipsia, polyphagia, ketosis, fruity ‘acetone’ breath.

Question 8

What are the symptoms of Type 1 Diabetes?

Answer 8

Abrupt onset, weight loss, dehydration, muscle wasting, abdominal pain, nausea/vomiting, mental status changes.

Question 9

What are the symptoms of Type 2 Diabetes?

Answer 9

Gradual onset, detected in routine exams, symptoms like fatigue, nocturia, itchy skin, slow-healing wounds.

Question 10

What is the diagnostic criterion for fasting plasma glucose?

Answer 10

> 126 mg/dL (NPO 8–12 hours prior).

Question 11

What is the Oral Glucose Tolerance Test (OGTT) criterion?

Answer 11

Blood glucose >200 mg/dL 2 hours after the test.

Question 12

What is the HbA1c criterion for diabetes diagnosis?

Answer 12

Average blood glucose over 120 days; diabetes diagnosed if ≥6.5%.

Question 13

What are the goals of medical management for diabetes?

Answer 13

Regulate blood glucose through nutrition, physical activity, oral antidiabetic agents, or insulin therapy.

Question 14

What are the dietary recommendations for diabetes?

Answer 14

Carbohydrates (50–60% of calories), protein (10–20% of calories), fats (≤30% of calories), minimize alcohol intake.

Question 15

What are the types of insulin therapy?

Answer 15

Rapid-acting (e.g., lispro, aspart), short-acting (e.g., Regular insulin), intermediate-acting (e.g., NPH), long-acting (e.g., glargine).

Question 16

What is the teaching point for insulin injection sites?

Answer 16

Rotate injection sites to prevent lipodystrophy; abdomen is the fastest absorption site.

Question 17

What are the symptoms of hypoglycemia?

Answer 17

Mild: Hunger, shakiness, weakness. Moderate: Confusion, difficulty concentrating. Severe: Seizures, unconsciousness.

Question 18

What is the management for mild hypoglycemia?

Answer 18

Administer juice or glucose tablets followed by protein/starch (e.g., cheese and crackers).

Question 19

What causes Diabetic Ketoacidosis (DKA) in Type 1 DM?

Answer 19

Stress, infections, high blood sugar.

Question 20

What are the symptoms of DKA?

Answer 20

Dehydration, ketotic breath, abdominal pain, Kussmaul breathing.

Question 21

What is the management for DKA?

Answer 21

Rehydration with IV fluids, IV insulin to lower glucose, monitor potassium and blood glucose hourly.

Question 22

What is Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS) in Type 2 DM?

Answer 22

Severe hyperglycemia without ketosis, blood glucose levels: 600–3000 mg/dL.

Question 23

What are the symptoms of HHNS?

Answer 23

Severe dehydration, glycosuria, hypernatremia.

Question 24

What is the management for HHNS?

Answer 24

Similar to DKA but with lower insulin dosages.

Question 25

What are macrovascular complications of diabetes?

Answer 25

Cardiovascular disease (CAD, cerebrovascular disease) and peripheral vascular disease (PVD).

Question 26

What are microvascular complications of diabetes?

Answer 26

Diabetic retinopathy, nephropathy, neuropathy.

Question 27

What are the foot care recommendations for neuropathy?

Answer 27

Avoid restrictive shoes, inspect feet daily, never walk barefoot, cut toenails straight across.

Question 28

What is the Dawn Phenomenon?

Answer 28

Morning hyperglycemia caused by growth hormone secretion. Treatment: Increase or adjust evening insulin.

Question 29

What is the Somogyi Effect?

Answer 29

Morning hyperglycemia after nocturnal hypoglycemia. Treatment: Reduce evening insulin dose and provide bedtime snack.

Question 30

What are the sick day rules for diabetes management?

Answer 30

Continue insulin/oral medications, eat small portions of carbohydrates frequently, stay hydrated, check blood glucose every 1–4 hours.