DIABETES Flashcards
What is diabetes?
A group of metabolic diseases characterized by elevated blood glucose due to deficits in insulin secretion, insulin action, or both.
What are the types of diabetes?
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.
What are the risk factors for Type 1 Diabetes?
Family history of diabetes and exposure to certain viruses.
What are the risk factors for Type 2 Diabetes?
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.
How do insulin and glucagon regulate glucose after eating?
Glycogenesis occurs, storing glucose as glycogen, while processes like glycogenolysis, gluconeogenesis, and ketogenesis are suppressed.
What happens to glucose regulation during fasting?
Glycogenolysis breaks down glycogen into glucose, gluconeogenesis converts protein into glucose, and ketogenesis converts fats to fatty acids, leading to ketone production.
What are common symptoms of diabetes?
Hyperglycemia (blood glucose >250 mg/dL), polyuria, polydipsia, polyphagia, ketosis, fruity ‘acetone’ breath.
What are the symptoms of Type 1 Diabetes?
Abrupt onset, weight loss, dehydration, muscle wasting, abdominal pain, nausea/vomiting, mental status changes.
What are the symptoms of Type 2 Diabetes?
Gradual onset, detected in routine exams, symptoms like fatigue, nocturia, itchy skin, slow-healing wounds.
What is the diagnostic criterion for fasting plasma glucose?
> 126 mg/dL (NPO 8–12 hours prior).
What is the Oral Glucose Tolerance Test (OGTT) criterion?
Blood glucose >200 mg/dL 2 hours after the test.
What is the HbA1c criterion for diabetes diagnosis?
Average blood glucose over 120 days; diabetes diagnosed if ≥6.5%.
What are the goals of medical management for diabetes?
Regulate blood glucose through nutrition, physical activity, oral antidiabetic agents, or insulin therapy.
What are the dietary recommendations for diabetes?
Carbohydrates (50–60% of calories), protein (10–20% of calories), fats (≤30% of calories), minimize alcohol intake.
What are the types of insulin therapy?
Rapid-acting (e.g., lispro, aspart), short-acting (e.g., Regular insulin), intermediate-acting (e.g., NPH), long-acting (e.g., glargine).
What is the teaching point for insulin injection sites?
Rotate injection sites to prevent lipodystrophy; abdomen is the fastest absorption site.
What are the symptoms of hypoglycemia?
Mild: Hunger, shakiness, weakness. Moderate: Confusion, difficulty concentrating. Severe: Seizures, unconsciousness.
What is the management for mild hypoglycemia?
Administer juice or glucose tablets followed by protein/starch (e.g., cheese and crackers).
What causes Diabetic Ketoacidosis (DKA) in Type 1 DM?
Stress, infections, high blood sugar.
What are the symptoms of DKA?
Dehydration, ketotic breath, abdominal pain, Kussmaul breathing.
What is the management for DKA?
Rehydration with IV fluids, IV insulin to lower glucose, monitor potassium and blood glucose hourly.
What is Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS) in Type 2 DM?
Severe hyperglycemia without ketosis, blood glucose levels: 600–3000 mg/dL.
What are the symptoms of HHNS?
Severe dehydration, glycosuria, hypernatremia.
What is the management for HHNS?
Similar to DKA but with lower insulin dosages.
What are macrovascular complications of diabetes?
Cardiovascular disease (CAD, cerebrovascular disease) and peripheral vascular disease (PVD).
What are microvascular complications of diabetes?
Diabetic retinopathy, nephropathy, neuropathy.
What are the foot care recommendations for neuropathy?
Avoid restrictive shoes, inspect feet daily, never walk barefoot, cut toenails straight across.
What is the Dawn Phenomenon?
Morning hyperglycemia caused by growth hormone secretion. Treatment: Increase or adjust evening insulin.
What is the Somogyi Effect?
Morning hyperglycemia after nocturnal hypoglycemia. Treatment: Reduce evening insulin dose and provide bedtime snack.
What are the sick day rules for diabetes management?
Continue insulin/oral medications, eat small portions of carbohydrates frequently, stay hydrated, check blood glucose every 1–4 hours.
