diabetes

Question 1

how many americans have diabetes

Answer 1

30 million

Question 2

how many americans dont know they have diabetes

Answer 2

1 in 4

Question 3

how many americans are pre diabetic

Answer 3

1 in 3 (90% dont know)

Question 4

prediabetes fasting glucose level

Answer 4

between 100-125 mg/dL

Question 5

pre diabetes glucose level after 75 g oral glucose challenge

Answer 5

140-199 mg/dL

Question 6

pre diabetes HbA1C

Answer 6

5.7-6.4

Question 7

assume that _____% of patients may display baseline dsyglycemia

Answer 7

more than 30%

Question 8

what can surgery do to pre diabetics

Answer 8

hyperglycemia (stress)

Question 9

diabetics have problems metabolizing….

Answer 9

carbs

proteins

lipids

Question 10

how does glucose enter a cell

Answer 10

insulin binds to alpha chains on cell membrane

beta chains are phosphorylated

intracellular tyrosine kinase activated

insulin receptor substrates are activated

synthesis of various substances including glucose transport protein

glucose transport protein binds to cell membrane, glucose can enter now

Question 11

normal blood sugar

Answer 11

75-100

Question 12

when normal glucose transport is inhibited, blood glucose levels…..

Answer 12

rise

Question 13

full blown diabetes HbA1c

Answer 13

more than 6.5

Question 14

controlled diabetes HbA1c

Answer 14

less than 7

Question 15

how many DM2 patients have no comorbidities

Answer 15

only 14%

Question 16

most common comorbities DM2 (5)

Answer 16

obesity

CV dz

HTN

dyslipidemia

kidney dz

Question 17

most common cause of mortality in diabetic pts

Answer 17

cardiovascular dz

Question 18

what CV condition is poorly tolerated by diabetic pts

Answer 18

tachycardia

10x increase risk of death if HR more than 105 for 5 min in post op period

Question 19

obesity has what other problem associated

Answer 19

OSA, GERD, airway management

Question 20

t/f: HTN has a greater effect on mortality than glycemic control

Answer 20

true

Question 21

insulin dependent diabetics with kidney disease at risk for hypo or hyper glycemia

Answer 21

hypo

Question 22

CKD pts with DM can’t do what

Answer 22

take oral medications like metformin

Question 23

a rapid reduction in HbA1c has what result

Answer 23

study showed increased mortality in drastic reduction in hyperglycemic levels

Question 24

SAMBA recommendation for safe BG level

Answer 24

less than 180

Question 25

intra-operative hyperglycemia can result in...(5)

Answer 25

dehydration ketoacidosis hyperosmolar hyperglycemic state delayed wound healing wound infection

Question 26

how often to check BG

Answer 26

at beginning of appt after two hours each subsequent hour at end of appt

Question 27

how does a diabetic get hypoglycemic

Answer 27

taking their meds skipping breakfast long dental appointments inability to eat after surgery

Question 28

signs and symptoms of hypoglycemia

Answer 28

confusion/combativeness weakness fatigue sweating palpitations

Question 29

ddx for hypoglycemia

Answer 29

stroke MI dementia drug OD/ under dose

Question 30

when do signs of hypoglycemia show up (what BG)

Answer 30

45-55

Question 31

what is red flag BG for hypoglycemia

Answer 31

70

Question 32

BG of less than 70 tx

Answer 32

give 15 g fast acting carb

Question 33

BG of less than 50 tx

Answer 33

give 30 mg fast acting carb

Question 34

examples of 15 g of carbs

Answer 34

1/2 cup apple juice or non diet pop small apple or orange 6 hard candies, 1 tablespoon jelly

Question 35

if you weigh 100 lbs 1 g of ingested glucose will raise BG by

Answer 35

5 mg/dL

Question 36

if you weigh 150 lbs 1 g of ingested glucose will raise BG by

Answer 36

4 mg/dL

Question 37

if you weigh 200 lbs 1 g of ingested glucose will raise BG by

Answer 37

3 mg/dL

Question 38

giving 50 mL of dextrose 50% IV will raise BG

Answer 38

75-125 mg/dL

Question 39

what do you do for unconscious hypoglycemic pt

Answer 39

if you have IV: 50 mL 50% dextrose no IV: 1 unit glucagon subcutaneously

Question 40

signs and symptoms of hyperglycemia

Answer 40

fatigue vision disturbances nausea excessive thirst polyuria

Question 41

tx for hyperglycemia

Answer 41

find out pts insulin routine, if you dont know assume 60 units

Question 42

the 1800 rule

Answer 42

divide patients daily insulin requirement into 1800 1 unit of rapid acting insulin will drop the BG by that many points

Question 43

aspart brand name

Answer 43

novolog

Question 44

lispro brand name

Answer 44

humalog

Question 45

glulisine brand name

Answer 45

apidra

Question 46

rapid acting insulins

Answer 46

aspart lispro glulisine