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Hospital Dentistry - ABGD Oral Boards > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is the most common endocrine disorder?

A

Diabetes Mellitus

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2
Q

How does Diabetes Mellitus manifest?

A

Manifested by Hyperglycemia

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3
Q

What is the #1 cause of End Stage Renal Disease?

A

Diabetes Mellitus

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4
Q

What is the difference between Type I and Type II diabetes?

A
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5
Q

What is Gestational Diabetes?

A
  • Reported 2-10% of pregnancies
  • 35-60% risk for developing DMII in 10-20 years
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6
Q

What is FPG?

What are normal, pre-diabetic, and diabetic values?

A
  • Fasting Plasma Glucose
  • Normal: < 100 mg/dl
  • Pre-Diabetes: 100-125 mg/dl
  • Diabetes > 126 mg/dl
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7
Q

What OGTT stand for?

What are the Normal, Pre-Diabetes, and Diabetic lab values?

A
  • Oral Glucose Tolerance Test
  • Normal: < 140 mg/dl
  • Pre-Diabetes: 140-199 mg/dl
  • Diabetes: > 200 mg/dl
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8
Q

What are HbA1c lab values for Normal, Pre-Diabetes, and Diabetes?

A
  • Normal: < 5.7%
  • Pre-Diabetes: 5.7 - 6.4 %
  • Diabetes: > 6.5 %
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9
Q

Describe the Pathogenesis of Type I DM…

A
  • Environmental insult triggers autoimmune reaction
  • Microbial, chemical, dietary
  • Cell mediated destruction of Beta Cells
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10
Q

Describe the Honeymoon Phase of DM Type I…

A
  • Recovery of beta cell function after start of insulin therapy
  • Exogeneous insulin requirements drop
  • Insulin secretion will eventually fail
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11
Q

What is the Pathogenesis of Type 2 DM?

A
  • Insulin resistance
  • Results in decreased intracellular glucose transporter activity
  • Beta cell compensation
  • Beta cells gradually fail to compensate for increasing insulin resistance
  • Impaired glucose tolerance
  • Fasting hyperglycemia
  • Eventual beta cell failure
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12
Q

How does one self monitor DM?

A
  • Blood glucose
  • Urine glucose
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13
Q

What does HbA1c stand for?

A

Glycosylated Hemoglobin

Reflects long term control

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14
Q

Describe a rapid-acting Insulin…

A
  • Aspart
  • Lispro
  • Onset 15 minutes
  • Peak 30 minutes
  • Duration: 4-5 hours
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15
Q

Describe a short acting insulin…

A
  • Insulin (Regular)
  • Onset: 30-60 minutes
  • Peak: 50-120 minutes
  • Duration: 5-8 hours
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16
Q

Describe a Intermediate acting Insulin…

A
  • NPH
  • Onset: 1-3 hours
  • Peak: 8 hours
  • Duration: 20 hours
17
Q

Describe a Long Acting Insulin…

A
  • Glargine
  • Onset: 1 hour
  • Peak: N/A
  • Duration: 24 hours
18
Q

What is an Insulin Pump?

A
  • Uses portable infusion pump connected to an indwelling subcutaneous catheter
  • Shown to have significant advantages over multiple daily injections
  • Reduces glycemic variability, clinical hypoglycemia
19
Q

What are GLP-1 and GIP?

A
  • Incretin Mimetics
  • Mimics naturally occurring gut hormones
  • Promotes insulin relase
  • Inhibits glucagon release
  • Gila monster saliva
20
Q

What kind of drug is Metformin?

A
  • Anti-hyperglycemic agent
  • Decreased HGP (hepatic glucose production)
  • Decreased IR (insulin resistance)
  • Decreased glucose adsorption
21
Q

What kind of drug is Arcarbose?

A
  • Oral Anti-diabetic agent
  • Glucosidase Inhibitors
  • Delays digestion of carbs and adsorption of glucose
22
Q

What kind of drug is Rosiglitazone?

A
  • Oral anti-diabetic agent
  • Decreased Insulin Resistance (IR)
  • Decreased Hepatic Glucose Production (HGP)
  • Increased glucose disposal
23
Q

What kind of drug is Januvia?

A
  • Inhibits enzymatic breakdown of GLP-1 and GIP
24
Q

What do Oral Antidiabetic Agents like Sulfonyureas do?

What are 2 examples?

A
  • Glyburide
  • Glipizide
  • Increased pancreatic insulin secretion (chronically)
25
Q

What is an example of an oral antidiabetic agent that acts acutley?

A
  • Meglitinides
  • Increased pancreatic insulin secretion (acutley)
26
Q

When should you see a Diabetic patient as a dentist?

A
  • Minimize stress: short, midmorning appointments
  • High insulin activity in afternoon
  • Increased risk of hypoglycemia
27
Q

How should a dentist instruct a diabetic patient to eat prior to a dental appointment?

A
  • Patient should take all usualy meds
  • Continue usual diet
  • Normal procedure dietary intake
28
Q

If a diabetic pt needs to NPO, how do you manage a clinical encounter?

A
  • May need to alter insulin regimen
  • NPO causes…
  • Increased physiologic and psychologic stress
  • Increased release of epi and corticosteroids
  • Induces hyperglycemia
29
Q

What should you consider if a patient has a HgA1c > 8%?

A
  • Consider antibiotics (High blood sugar is perfect food for microbes)
  • Pre-op/post-op finger stick
  • Follow-up
  • Consult physician
30
Q

What are signs and symptoms of Hypoglycemia (Initial State)?

A
  • Initial State:
  • Weakness
  • Trembling
  • Hunger
  • Sweating
  • Tachycardia
  • Anxiety
  • Confusion
31
Q

What are the signs and symptoms of a patient experiencing a Moderate State of Hypoglycemia?

A
  • Combative
  • Incoherent
32
Q

What are the signs and symptoms of someone in a severe state of Hypoglycemia?

A
  • Unconsciousness
  • Hypotension
  • Hypothermia
33
Q

How do you treat Hypoglycemia?

A
  • GLUCOSE, GLUCOSE, GLUCOSE
  • Soda (not diet), fruit juice
  • Do not force oral administration, aspiration risk
  • IV glucose
  • Glucagon auto injector
  • Cake frosting under tongue
  • When in doubt, give glucose

Hospital Dentistry - ABGD Oral Boards (10 decks)

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