Diabetes and Amputations Flashcards
T or F: Glucose isn’t vital to your health
False; it is vital
Why is glucose important for your body?
It is the main source of energy for the cells that make up your muscles and tissues.
T or F: Glucose is your body’s main source of fuel.
True
T or F: Diabetes Mellitus refers to a a group of diseases that affect how your body uses glucose
True
Glucose is also known as?
blood sugar
T or F: A condition marked by a deficiency of or reduced sensitivity to insulin
True
Which type of diabetes is insulin dependent (IDDM)?
Type 1
Insulin dependent diabetes mellitus (IDDM) was formally known as?
juvenile onset diabetes
Which type of diabetes is non insulin dependent?
Type 2
Non insulin dependent diabetes mellitus (NIDDM) was formally known as?
adult onset diabetes
After what age does adult onset diabetes or NIDDM usually occur?
After age 40
Insulin is a hormone produced by what organ?
Pancreas
Insulin regulates what?
Glucose metabolism
T or F: Insulin is required for the cellular uptake of glucose which is required for energy
True
T or F: Without insulin the liver, muscles and fat tissue can still take up absorbed nutrients
False; Without insulin the liver, muscles and fat tissue CANNOT take up absorbed nutrients
T or F: Ketones are lethal in high concentrations
True
T or F: The body will use its own lipids as an energy source, this leads to ketones
True
What is Diabetic ketoacidosis?
A serious diabetes complication where the body produces excess blood acids (ketones)
T or F: Until the 1920’s diagnosis of diabetes was a death sentence
True
T or F: Diabetes doesn’t carry a significant risk for individuals to develop major disabling conditions
False; it carries a significant risk for individuals to develop major disabling conditions
Diabetes is the ____ most common reason for MD visits.
4th
What are the incidence and prevalence rates of diabetes?
Among US residents 65 and older, 10.9 million or 26.9 % had DM in 2010
•About 215, 000 people younger than 20 years had DM
•About 1.9 million people aged 20 years or older were newly diagnosed with diabetes in 2010 in the US
•Diabetes is the leading cause of kidney failure, non traumatic lower limb amputations, and new cases of blindness in the US
•Diabetes is a major cause of heart disease and stroke
•The seventh leading cause of death in the US
Diabetes is the leading cause of what three conditions?
- kidney failure
- nontraumatic lower limb amputations
- new cases of blindness
T or F: Diabetes is a major cause of heart disease and stroke
True
T or F: The seventh leading cause of death in the US
True
People who are usually thin have what type of diabetes?
Type 1
Ketoacidosis is common with what type of diabetes?
Type 1
Which type of diabetes has a gradual onset?
Type II
Which type of diabetes has a low prevalence?
Type I
Which type of diabetes can be due to physical inactivity?
Type II
Which type of diabetes is more common in African Americans, Native Hawaiians and Pacific Islanders?
Type II
T or F: The cause of type I diabetes is unknown.
True
T or F: There is a genetic predisposition for diabetes type I.
True
What are some environmentally based inciting events for type I?
–Acute illness –Virus –Diet –Environmental toxins –Physical /emotional stress
T or F: Type I diabetes is an autoimmune response produces antibodies against and destroys the pancreas cells that produce insulin. This leaves the person with little or no insulin. Instead of the glucose being transported into your cells, it builds up in your bloodstream
True
T or F: Type I diabetes begins as insulin resistance and disorder in which the cells do not use insulin properly. As the need for insulin arises the pancreas gradually looses its ability to produce it.
False; it’s type II
T or F: Family history of DM or prior history of gestational diabetes, older age, obesity and inactivity are possible causes for Type I diabetes.
False; it’s type II
What are some signs and symptoms of Type I Diabetes?
- Polyuria
- Polydispia
- Polyphagia
- Anorexia that results in a 10-30% weight loss
- Blurred vision
- Increased fatigue
- Decreased energy
- Chest pain and occasional difficulty breathing
- Nausea
- Muscle cramps
- Irritability
- Emotional liability
- Altered school and work behaviors
- Headaches
- Abdominal pain and discomfort
- Diarrhea or constipation
T or F: Anorexia can be a symptom of Type I diabetes.
True
T or F: Polyuria is a sign/symptom of Type I/II diabetes that results in a production of abnormally large volumes of dilute urine.
True
T or F: Polyphagia is a sign/symptom of Type I/II diabetes that results in excessive eating or appetite
True
What are some signs and symptoms of diabetes Type II?
- Polyuria
- Polydispia
- Polyphagia
- Unusual weight loss/ gain
- Extreme weakness and fatigue
- Irritability
- Frequent skin, gum, or bladder infections
- Cuts and bruises that are slow to heal
- Numbness or tingling on hands or feet
What are some signs and symptoms of diabetes Type II?
- Polyuria
- Polydispia
- Polyphagia
- Unusual weight loss/ gain
- Extreme weakness and fatigue
- Irritability
- Frequent skin, gum, or bladder infections
- Cuts and bruises that are slow to heal
- Numbness or tingling on hands or feet
T or F: During pregnancy the placenta produces hormones to sustain the pregnancy. These hormones make the cells more resistant to insulin.
True
T or F: As the placenta grows larger in the second and third trimesters, it secretes more of these hormones making it more difficult for insulin to work.
True
T or F: This results in the pancreas not being able to respond by producing enough extra insulin to overcome the resistance. When this happens too little glucose gets into the cells and too much remains in the blood. CDC reports that rate from 2 to 10 % of US pregnancies
True
What are some things you look for when diagnosing DM?
•Random plasma glucose of >200 mg/dl –regardless of last meal •Fasting glucose >126 mg/dl –No caloric intake for at least 8 hours •Two hour glucose > 200 mg/dl –Post load (meal) •Diagnosis can be confirmed if one of the above factors is sustained for several days
What are some complications associated with DM?
- Hypoglycemia
- Hyperglycemia
- Diabetic Retinopathy
- Diabetic Ketoacidosis (DKA)
- Diabetic Nephropathy
- Diabetic Neuropathy
What condition is known as too much insulin resulting in decreased blood glucose levels?
Hypoglycemia (
What are some symptoms of hypoglycemia?
Fatigue, headache, drowsiness, shallow breathing, nausea
What condition can lead to insulin shock?
Hypoglycemia (
What are some symptoms of insulin shock?
Seizure, accidental injury (fall), heart arrhythmia
T or F: Hypoglycemia may occur during exercise or ADL’s
True; •Consider increased consumption of carbohydrates
•Consider decreasing insulin dose (MD and Nurse)
What condition is known as too little insulin resulting in increased blood glucose levels?
Hyperglycemia
What are some symptoms of hyperglycemia?
Thirsty, heart burn, fast deep breathing, excessive urination, headache, blurred vision, nausea
What condition can lead to diabetic coma?
Hyperglycemia
What condition can occur about 15 years after onset?
Diabetic Retinopathy
T or F: >40 percent of DM patients have some stage of retinopathy
True
T or F: Blindness if not prevalent in DM
False; Blindness is 20 X more prevalent in those with DM
•Type I 10-15%
•Type II 5-8 %
Blindness is more prevalent in which type of diabetes?
Type I
Blindness is more prevalent in which type of diabetes?
Type I
What is an emergency state of metabolic imbalance that usually signals the onset of Type I DM?
Diabetic Ketoacidosis (DKA)
What condition occurs in patients with the disease because of illness, inappropriate reaction to insulin intake or missed injection?
Diabetic Ketoacidosis (DKA)
T or F: Patients who are sick should increase insulin and consume extra fluids
•Acetone smelling breath ‘fruity’ breath
True
What condition is characterized by systematic vascular changes in the kidneys that result with scarring reducing kidney functions?
Diabetic Nephropathy
Which type of DM is diabetic nephropathy most common in?
Type I
–25-30 % of those with type I
–15-20 % of these with type II
What condition is the leading cause of ESRD (End stage renal disease)?
Diabetic Nephropathy
Which condition is likely to develop HTN?
Diabetic Nephropathy
What does the treatment include for Diabetic Nephropathy?
Treatment includes dialysis (hemodialysis or peritoneal dialysis)
What is a micro vascular disease that effects peripheral nerves?
Diabetic Nephropathy
T or F: Exact link is not known between DM and Diabetic Neuropathy.
True
T or F: Diabetic Nephropathy affects 50% of individuals with DM
True
T or F: Damage due to Diabetic Nephropathy is typically more motor than sensory.
False; Damage is typically more sensory than motor
•Motor problems tend to include footdrop
T or F: Distal sensory impairment including pain is common
•Glove and stocking effect
•Decreased light touch and pinprick sensation
true
What are some symptoms of diabetic neuropathy?
•Numbness and tingling in hands and feet
•Variable loss of distal reflexes
•Intrinsic muscle wasting in the hands and feet
•Axonal losses (pain and sensory) and (position and touch)
–Have a higher rate of infection because of decreased sensation, decreased blood supply, hyperglycemic states promote pathogen growth, decreased immune response
•Can not reverse process
What is part of the medical management of DM Type I?
- No cure
- Oral medications or subcutaneous insulin injection
- Subcutaneous insulin infusion
- Immunosuppressiants
- Monitor blood glucose levels before each meal and bedtime
- Make lifestyle changes to facilitates insulin therapy and optimize health
- Nutritionally sound meals
- Balance between calorie intake and energy expenditure
- Frequent small snacks
- Regular exercise
- Vision compensation and training
What is part of the medical management of DM type II?
•Lifestyle changes and dietary control •Regular exercise •Oral glucose lowering agents •Insulin therapy •Blood glucose level monitoring –Breakfast, dinner and bedtime
What are some areas of occupation that are impacted because of DM?
•All areas may be impaired and degree of impairment depends on the progression of the disease •ADL’s- –Personal hygiene and grooming –Personal device care –Sexual activity •IADL’s –-Health management and maintenance –Meal preparation and cleanup –Medication routine •Performance Patterns –Habits, routine and roles
What are some overall treatment considerations for DM?
•Education and family support –Occupational profile •Therapeutic exercise •Medication management –habits, roles, and routines •Diabetic foot care –Injury to lower limb can lead to slow healing sores –Infections –Potential for amputations
T or F: Individuals with DM have the potential for amputations.
True
T or F: Injury to lower limb can lead to slow healing sores
True
What are some of the Do’s of diabetic foot care?
- Encourage podiatric exams
- Inspect feet daily for skin integrity
- Wash feet daily
- Dry feet between the toes
- Use cream and lotion
- Wear clean socks
- Cut nails and use emery board
- Non rubbing shoes/ inspect shoes
What are some of the Don’ts of diabetic foot care?
•Use heating pads, lamps etc on feet •Razor blades •Over the counter meds for corns and calluses •Crossing legs •Walk barefoot •Wear shoes without socks •Use hands to inspect shoes (if have neruopathy also)
