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Nursing 337 > Diabetes > Flashcards

Diabetes Flashcards

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1
Q

Define diabetes

A

a chronic multisystem disease related to abnormal insulin production, impaired insulin utilization or both

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2
Q

diabetes is the leading cause of what diseases

A

end-stage kidney disease and nontraumatic lower limb amputations

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3
Q

what are the current theories about the causes of diabetes

A

single or combination of genetic, autoimmune, and environmental factors

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4
Q

where is insulin produced

A

in the Beta cells in the islets of langerhans of the pancrease

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5
Q

what is the stable normal blood glucose level

A

70-120 mg/dL

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6
Q

what is the average amount of insulin secreted by the pancreas

A

40-50 units

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7
Q

what does the rise in insulin after a meal stimulate

A

storage of glucose as glycogen in liver and muscle, inhibits glucogenenesis, enhances fat deposition of adipose tissue and increases protein synthesis

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8
Q

what does the fall of insulin level during normal overnight fasting facilitate in?

A

release of stored glucose from the liver, protein from muscle and fat from adipose tissue

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9
Q

what tissues are considered insulin-dependent

A

insulin dependent tissues are skeletal muscle tissue and adipose tissue

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10
Q

what are the counterregulatory hormones

A

glucagon, epinephrine, growth hormone, and cortisol

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11
Q

What is the etiology and pathophysiology of Type 1 DM

A

it is an immune mediated disease caused by autoimmune destruction of pancreatic beta cells
leading to absence of insulin production

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12
Q

what is the prediposition to type 1 diabetes

A

it is related to Human leukocyte antigens,

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13
Q

how do HLA contribute to type 1 DM

A

when exposed to a viral infection HLA destroy pancreatic beta cells either directly or through an autoimmune response

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14
Q

what is idiopathic diabetes

A

a form of type 1 DM that is strongly inherited not related to autoimmunity

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15
Q

what is latent autoimmune diabetes in adults (LADA)

A

a slowly progressing autoimmune form of type 1 DM usually occurs in people who are over the age of 35 and who are not obese

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16
Q

what is the onset of type 1 DM

A

the islet cell autoantibodies responsible for beta cell destruction are present for months to years before the onset of symptoms

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17
Q

what are the key manifestations of type 1 dm

A

polyphagia, polydipsia, polyuria

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18
Q

without insulin from an outside source what will happen to a type 1 DM

A

patient will develop diabetic ketoacidosis (DKA) a life-threatening condition resulting in metabolic acidosis

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19
Q

what is the most prevalent type of diabetes?

A

type 2 DM

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20
Q

what are risk factors for developing type 2 DM

A

overweight/obese
older age
family history

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21
Q

what is the etiology and pathophysiology of type 2 DM

A

the pancreas produces some endogenous insulin but the insulin produced is either insufficient for the needs of the body or is poorly used by the tissues or both.

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22
Q

what are the major metabolic abnormalities that have a role in the development of type 2 diabetes

A
  1. ) insulin resistance- body does not respond to the action of insulin because receptors are unresponsive or insufficient number
  2. ) decrease in the pancreas’s ability to produce insulin, as the beta cells become fatigued from the compensatory overproduction of insulin when beta cell mass is lost
  3. ) inappropriate glucose production by the liver
  4. ) alltered production of hormones and cytokines by adipose tissue
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23
Q

what is the onset of type 2 DM

A

usually gradual

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24
Q

what is prediabetes

A

individuals that are at increased risk of development of type 2 diabetes

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25
Q

how is preediabetes diagnosed

A

an impired glucose tolerance (140-199) or impaired fasting glucose (100-125 mg/dL)

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26
Q

how do people with prediabetes reduce their risk of developing type 2 DM

A

maintaining a health weight, exercising regularly, and eating a healthy diet

27
Q

what is gestational diabetes

A

diabetes that develops during pregnancy and occurs in about 2-10% of pregnancies

28
Q

women with gestational diabetes are at risk for

A

cesarean delivery, perinatal death, birth injury, and neonatal complications

29
Q

who is at risk for gestational diabetes

A

women who are obese, advanced maternal age, family history of diabetes

30
Q

when are women screened for gestational diabetes

A

at 24-28 weeks using a 2 hour oral glucose test

31
Q

what are some disease or treatments that cause diabetes

A

cushing syndrome, hyperthyroidism, recurrent pancreatitis, cystic fibrosis, hemachromatosis, parenteral nurtrition.

32
Q

What is diabetes?

A

a chronic multisystem disease related to abnormal insulin production, impaired insulin utilization or both

33
Q

what are the classes of diabetes?

A

Type 1
Type 2
Gestational
other specific types

34
Q

What is the etiology of diabetes

A

combination of causative factors including

  • genetics
  • autoimmune
  • environmental
35
Q

where is insulin produced

A

by beta-cells in the islets of langerhans in the pancreas

36
Q

when is insulin normally released

A

released continuously into bloodstream in small increments with larger amounts released after food

37
Q

what is the normal glucose range

A

70-120mg/dL

38
Q

what are the normal functions of insulin (5)

A

promote glucose transport in skeletal muscle and adipose tissue

  • storage of glucose as glycogen
  • inhibits gluconeogenesis
  • enhance fat deposition
  • increase protein synthesis
39
Q

What are the counterregulatory hormones (4)

A

Glucagon
epinephrine
growth hormone
cortisol

40
Q

what are the functions of counterregulatory hormones

A

oppose effects of insulin
stimulate glucose production by liver
decreased movement of glucose into cell
help maintain normal blood glucose levels

41
Q

what is the onset of type 1 DM

A

younger- less than 40

42
Q

what is the etiology of type 1 DM

A
  • autoimmune destruction of beta cells
  • total absence of insulin
  • genetic predisposition and viral exposure
    • HLA-DR3 and HLA- DR4
  • idiopathic diabetes
  • latent autoimmune diabetes in adults (LADA)
43
Q

what is the manifestations of the development of type 1 DM

A

develop when pancreas can no longer produce insulin- rapid onset of ketoacidosis

44
Q

what is the most prevalent form of DM

A

type 2

45
Q

what are some risk factors of type 2 DM

A

overweight
obesity
advancing age
family history

46
Q

what is the etiology of type 2 DM

A

pancreas continues to produce some endogenous insulin

insulin is insufficient or poorly utilized

47
Q

what are the four major metabolic abnormalities associated with type 2 DM

A
  1. ) insulin resistance
  2. ) decreased insulin production by pancreas
  3. ) inappropriate hepatic glucose production
  4. ) altered production of hormones and cytokines by adipose tissue
48
Q

what are the metabolic syndromes that increase the risk for developing type 2 DM

A
  • elevated glucose levels
  • abdominal obesity
  • elevated BP
  • high levels of triglycerides
  • decreased levels of HDLs
49
Q

what is the onset of type 2 DM

A

gradual onset

hyperglycemia may go many years without being detected

50
Q

what is prediabetes

A

individuals that exhibit some symptoms of type 2 DM and are at greater risk for developing type 2 DM

51
Q

what are the tests to determine if someone is prediabetic

A

Impaired Glucose Intolerance- oral glucose tolerance test and
impaired fasting glucose

52
Q

what are some important teachings for prediabetes

A
  • undergo screening
  • mange risk factors
  • monitor for symptoms of diabetes
  • Maintain healthy weight, exercise, healthy diet
53
Q

what is gestational diabetes

A

diabetes that occurs during pregnancy

54
Q

what are some increased risks from gestational diabetes

A

increased risk of need for cesarean delivery

perinatal complications

55
Q

when do you screen for gestational diabetes

A

high risk pt at first visit

others at 24-28 weeks

56
Q

what are the clinical manifestations of type 1 diabetes

A 
classical symptoms 
- polyuria
- polydipsia
- polyphagia
wt loss
weakness
fatigue
57
Q

clinical manifestations of type 2 diabetes

A 
nonspecific symptoms
polyuria
polydipsia
polyphagia
fatigue
recurrent infection
recurrent fungal infection
prolonged wound healing
visual changes
58
Q

what are the diagnostic studies of diabetes

A

hemoglobin A1C
Fasting plasma glucose
two-hour plasma glucose level during OGTT
Classic symptoms of hyperglycemia with random plasma glucose level

59
Q

what level indicates diabetes with hemoglobin A1C

A

6.5% or higher

60
Q

what level indicates diabetes with fasting plasma glucose level

A

126 mg/dL

61
Q

what level indicates diabetes with two-hour plasma glucose levels during OGTT

A

200 mg/dL

62
Q

what level indicates diabetes with random plasma glucose level

A

200 mg/dL

63
Q

what are the goals of diabetes management

A 
Goals of diabetes management
Decrease symptoms
Promote well-being
Prevent acute complications
Delay onset and progression of long-term complications

Nursing 337 (9 decks)

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