Diabetes

Question 0

Glucagon

Answer 0

1. Synthesized in the Liver**
2. Breaks down fats and muscles / not simple carbs
3. Helps maintain steady blood glucose when you have used all simple carbohydrates
   - GLUCAGON IS FOR WHEN GLUCOSE IS GONE

Question 1

Risk Factors after Liver Biopsy

Answer 1

1. Assess the lungs for: ** PRIORITIZE THE LUNG COLLAPSE
   - NOTHING - collapsed lung - silent lung
2. Bleeding
   - Clotting factors come from the liver so check for bleeding if there are liver issues

Question 2

Diabetes Type 1

Answer 2

1. Juvenile-onset diabetes
2. Results from autoimmune process that destroys beta cells of the pancreas
3. Leads to loss of insulin production

Question 3

Diabetes Type II

-Pathophysiology

Answer 3

1. Adult-onset diabetes

2. Insulin Resistance

Question 4

Diabetes Type II

-Risk factors

Answer 4

1. Age
2. Obesity
3. Family Hx

Question 5

Diabetes Type II

-Process

Answer 5

1. Increases insulin secretion to compensate for peripheral tissue resistance until system fails
2. If pancreas “burns out” then the type II diabetic will need insulin replacement just like a Type I diabetic

Question 6

Diabetes

-Definition

Answer 6

1. Starvation in the midst of plenty

Question 7

Hyperglycemia

-S/S

Answer 7

1. Weight loss
2. Polyphagia (excessive appetite)
3. Elevated blood glucose
4. Increase infections
5. Polydypsia
6. Polyuria

Question 8

Normal Fasting Plasma Glucose

Answer 8

1. < 126 mg/dL

Question 9

Normal Random plasma Glucose

Answer 9

1. <200 mg/dL

Question 10

Normal 2 hr Post-Glucose Tolerance test

Answer 10

1. Plasma glucose < 200 mg/dL

Question 11

HBA1C

Answer 11

1. Refers to the permanent attachment of glucose to hbg molecules and reflects the average plasma glucose exposure over the LIVE OF THE RBC

Question 12

Process of Inulin Production

Answer 12

1. Islets of langerhan (Beta cells) in the pancreas produce insulin in response to blood glucose levels.
   - Insulin is the bus that drives glucose into the cell

Question 13

Type 1 Diabetes

-Pathologic process

Answer 13

1. Autoimmune disease that causes immune system to attack beta cells in the pancreas.
   - Pt then loses insulin production capabilities

Question 14

Type 2 Diabetes

-Pathologic process

Answer 14

1. Insulin resistance
2. Beta cells and islets of langerhans are capable of producing insulin
3. Cells that are receiving the insulin are resistant

Question 15

Type 2 Diabetes

-What happens over time

Answer 15

1. Blood glucose increases because insulin cannot move it into the cell.
2. The pancreas then goes into overdrive and produces large amounts of insulin
3. After years, the pancreas and beta cells cannot compensate and insulin levels drop. Blood glucose levels then go well above normal

Question 16

Type 1 Diabetes Complications

-Diabetic Ketoacidosis (DKA) Causes

Answer 16

1. Caused by increase glucose demand from a stressor (infection)
   or
2. Pt stops taking insulin administration

Question 17

Type 1 Diabetes Complications

-Diabetic Ketoacidosis (DKA) Manifestations

Answer 17

1. Blood Glucose becomes VERY high
2. Cells shift to using proteins and lipids for energy because there is not enough insulin moving glucose into the cell
3. Breakdown of proteins and lipids causes Kitone bodies

Question 18

Insulin

-Na/K pump

Answer 18

1. Insulin is the regular of the sodium/potassium pump. If insulin is not present there is hypokalemia inside of the cell.
2. When insulin is restored, the serum potassium can drop very quickly to compensate for the intercellular hypokalemia

Question 19

Diabetes

-Long-term Effects

Answer 19

1. Due to hyperglycemia in the cell which causes damage to the endothelial and atherosclerosis

Question 20

Glycolysis

Answer 20

1. = ATP

2. Storage as: Glycogen (glycogenesis), fat and protein

Question 21

Hyperglycemia

-S/S

Answer 21

1. Weight loss
2. Polyphagia (excessive appetite)
3. Elevated Blood glucose
4. Increased infections
5. Polydypsia
6. Polyuria

Question 22

Hyperglycemia

-Diagnostics

Answer 22

1. Fasting plasma glucose greater than 126 mg/dL
2. Random plasma glucose greater than 200 mg/dL
   - w/ polyuria & polydipsia
3. 2 hour post glucose tolerance test with BG level greater than 200mg/dL

Question 23

Hyperglycemic Treatment

-For High Blood Sugar?

Answer 23

1. Reduce pt’s sugar intake

2. Metformin (decreases hepatic gluconeogenesis

Question 24

Hyperglycemic Treatment

-For increasing Insulin Secretion

Answer 24

1. Sulfonylyreas (glypizyde)

Question 25

Hyperglycemic Treatment

-For decreasing insulin Resistance

Answer 25

1. Thiazolidinediones

- Ex. Actos or avandia

Question 26

Hypoglycemia

-Adrenergic S/S

Answer 26

1. Diaphoresis
2. Weakness
3. Hunger
4. Headache
5. Anxiety

Question 27

Hypoglycemia

-Neuroglucopenic S/S

Answer 27

1. Confusion
2. Slurred speech
3. Coma & Seizure

Question 28

Hypoglycemia

-Causes

Answer 28

1. Excess insulin due to excessive diabetes treatment
2. Decreased glucagon
3. Decreased cortisol (adrenal insufficiency)
4. Decreased Growth Hormone
5. Liver failure of glycogen storage disease

Question 29

Somogyi Effect

Answer 29

1. Combination of hypoglycemia followed by rebound hyperglycemia

Question 30

Dawn Phenomenon

Answer 30

1. Early morning rise in blood glucose concentration w/ no hypoglycemia during the night

Question 31

Diabetic Retinopathy

Answer 31

1. Leading cause of blindness worldwide and in adults less than 60 years of age in the US
2. Seems to develop more rapidly in individuals with type 2 diabetes

Question 32

Diabetic Nephropathy

Answer 32

1. Most common cause of end-stage kidney disease

2. 1st manifestation of kidney dysfunction is microalbuminuria

Question 33

Diabetic Neuropathy

Answer 33

1. Most common cause of neuropathy in western world
   &
2. Most common complication of diabetes