Diabetes

Question 1

diabetes definition

Answer 1

metabolic disease resulting from the breakdown in the ability to either produce or to utilize insulin resulting in hyperglycemia

Question 2

Type 1 diabetes

Answer 2

most common in adolescents
ketone development occurs

Question 3

s/s of type 1 diabetes

Answer 3

poyuria
polydipsia
polyphagia
weightloss

Question 4

labs/diagnostics of type 1 DM

Answer 4

serum fasting glucose( AT LEAST 8 hrs) > 126 or glycated hemoglobin (A1C) > 6.5

Question 5

Management of Type 1 DM

Answer 5

treatment if individualized

Basal insulin + meal time bolus of a rapid acting or short acting insulin

inslin pumps usually with this demographic

Question 6

Somogyi effect

Answer 6

nocturnal hypoglyecemia causes a surge of counter regulatory hormones which raises blood surgar

hypoglycemic @ 0300 but rebounds to a high glucose @ 0700

Question 7

Symogyi effect treatment

Answer 7

reduce bedtime dose of insulin

Question 8

Dawn Phenomenon

Answer 8

blood glucose becomes progressively increased throughout the night

Question 9

Dawn Phenomenon treatment

Answer 9

add or increase the bedtime dose of insulin

Question 10

Type 2 Diabetes is the

Answer 10

most common type of diabetes
circulating insulin exists enough to prevent ketoacidosis but is inadequate to meet patients insulin needs

Question 11

what is syndrome x?

Answer 11

obesity
hypertesion
abnormal lipid panel (low HDL’s, High Triglycerides)

Question 12

Metabolic syndrome

Answer 12

only need 3/5- to diagnose
1. waist circumfrance- 40 inch (101.6 cm) in men, >35 cm (88.9 cm) in women
2. BP 130/85
3. Triglycerides > 150
4. FBG- > 100
5. HDL < 40 in men, <50 in women

Question 13

S/S of Type 2 DM

Answer 13

gradual onset of hyperglycemia
polyuria
polydipsia
peripheral neuropathy
recurrent vaginitis (women)
chronic skin infections

Question 14

Labs/Diagnostsics of Type 2 BM

Answer 14

same as Type 1, except NO KETONES

Question 15

Managment of Type 2 DM

Answer 15

• diet/exercise
• Medications

Question 16

what medication is the standard of care for type 2 DM

Answer 16

Metformin

Question 17

Blackbox warning of metformin

Answer 17

Lactic acidosis

Question 18

presentation of lactic acidosis

Answer 18

muscle pain

Question 19

GLP-1 agonist black back warning

Answer 19

thyroid cancer
REMS program warning for pancreatitis

Question 20

SGLT2 inhibitor black box warnings

Answer 20

increased risk for foot and leg amputations

Question 21

Type 1 DM complication is known as

Answer 21

DKA

Question 22

DKA is a

Answer 22

intracellular dehydration that leads to elevated glucose levels

Question 23

s/s of DKA

Answer 23

• fruity breath
• Kussmaul’s breathing (HIGH)
• poluria
• weakness/fatigue

Question 24

labs/ diagnostic of DKA

Answer 24

hyperglycemia > 250/300
- ketonemia and or ketonuria
Hyperosmolality

Question 25

management of DKA

Answer 25

NS (1st hr) ….1/2 NS (>500 after 1st hour)… when glucose falls < 250 –> D51/2 NS

0.1 u/kg of Regular Insulin bolus + 0.1/kg/hr

bicarb gtt (44- 48 mEq in 900 ml 1/2 NS) for acidosis < 7.1

Question 26

formula for isulin drip

Answer 26

0.1 u/kg of Regular Insulin bolus + 0.1/kg/hr

Question 27

Type 2 DM complication is known as

Answer 27

Hyperosmlar Hyperglycemic state (HHS)

Question 28

HHS is caused by

Answer 28

severe intracellular dehydration WITHOUT Ketone production

patients cannot produce enough insulin to prevent hyperglycemia

Question 29

s/s of HHS

Answer 29

polyuria
weakness
change in LOC
Signs of dehydration

Question 30

labs /diagnostics of HHS

Answer 30

serum glucose > 600, usually > 1000
Elevated BUN/Cr
Elevated HA1c

Question 31

Treatment of HHS

Answer 31

NS (1st hr) ….1/2 NS (>500 after 1st hour)… when glucose falls < 230 –> D51/2 NS

0.1 u/kg of Regular Insulin bolus + 0.1/kg/hr