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FS HN 461 > Diabetes-Exam 2 > Flashcards

Diabetes-Exam 2 Flashcards

1
Q

DM definition

A

group of metabolic diseases characterized by hyperglycemia from insulin secretion/action or both

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2
Q

Type 1 diabetes

A

hyperglycemia as a result of beta-cell destruction and no insulin production

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3
Q

Type 2 diabetes

A

hyperglycemia as a result of insufficient insulin production or an indulin resistance

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4
Q

Macrosomia

A

term used to describe babies that their mothers were diagnose with gestational diabetes; higer risk for diabetes in the future

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5
Q

Type 1 DM cause

A

autoimmune disease of the destruction of beta-cells of the pancreas; why this happens in unknown; may be viral and genetic

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6
Q

Type 2 DM cause

A

Genetic predisposition; no real cause; risk factors incluse older age, obesity, and physical inactivity

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7
Q

Insulin

A

hormose secreted by the b-cells of the islet of langerhaans of the pancreas

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8
Q

Insulin-anabolic or catabolic?

A

anabolic

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9
Q

Insulins job as an anabolic hormone

A

Decrase BG, BFA, BAA, and increase muscle protein

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10
Q

What hormone opposes insulin

A

glucagon

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11
Q

Is glucagon catabolic or anabolic?

A

catabolic

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12
Q

Glucagons key metabolic function

A

lipolysis
glycogenolysis
gluconeogenesis

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13
Q

Pro-insulin

A

Precursor to insulin-A,B,C peptides

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14
Q

Insulin

A

Made from pro-insulin- A and B peptides (C is cleaved)

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15
Q

Will DM1 have high or low c-peptide

A

Low

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16
Q

Glucose intake by insulin cascase

A

insulin binds–>translocation of GLUT–>influx of glucose–>glycogen synthesis–>glycolysis–>fatty acid synthesis

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17
Q

How many different GLUT proteins are there

A

4

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18
Q

Cellular insulin effects

A 
Increase glycogen synthesis
Increase FA synthesis
Increase esterficiation of FA
Increased AA uptake
Increase K uptake
Ineease HCl secretion for digestion
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19
Q

Anti-catabolic roles of insulin

A

Inhibit proteolysis, lipolysis, gluconeogensis, glycogenolysis

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20
Q

Normal blood glucose

A

<100mg/dL

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21
Q

Glucose conversion

A

0.0555*mg/dL=mmol/L

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22
Q

Diagnostic criteria for DM

A

FBG>126mg/dL
2-h PG during OGTT >200mg/dL
A1C>6.5%
Random plasma glc >200md/dL

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23
Q

Stage 1 DM stage

A

autoimmunity
normoglycemia
presymptomatic

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24
Q

Stage 1 DM diagnostic criteria

A

Autoantibodies

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25
Q

Stage 2 DM stage

A

autoimmunity
dysglycemia
presymptomatic

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26
Q

STage 2 DM diagnostic criteria

A

autoantibodies
FBG 100-125mg/dL
2hPG during OGTT 140-199mg/dL
A1C 5.7-6.4%

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27
Q

Stage 3 DM stage

A

hyperglycemia

symptomatic

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28
Q

Stage 3 DM diagnostic criteria

A

clinical symptoms

diabetes by standard criteria

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29
Q

Pre-DM criteria

A

FBG 100-125mg/dL
2hPG during OGTT 140-199mg/dL
A1C 5.7-6.4%

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30
Q

non-insulin dependent tissues

A

kidneys, eyes, nerves, RBC

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31
Q

Renal threshold

A

250 mg/dL

32
Q

Urine ketones in DM1, DM2 or both?

A

DM1 only

33
Q

When are urine ketones present?

A

when BG consistenty >300 mg/dL

34
Q

What happens to Na+ with high glucose?

A

Decrease 1.6mEq/L for each 100mg/dL above normal

35
Q

Diabetic ketoacidosis DM1, DM2 or both

A

DM1 only

36
Q

What is diabetic ketoacidosis?

A

fat is converted to ketones for energy and when in large numbers can be life thretening

37
Q

Symptoms of diabetic ketoacidosis

A

polyuria, polydipsia, hyperventilation, dehydration, fruity breath

38
Q

Hyperglycemic hyperosmolar non-ketotic syndrome (HHNS) DM1, DM2 or both?

A

DM2 only

39
Q

What is HHNS?

A

super high blood glucose leading to dehydration

40
Q

HHNS symptoms

A

loss of conciousness or mental state

41
Q

Hypoglycemia DM1, DM2 or both

A

both

42
Q

What causes hypoglycemia

A

mismatched insulin and carbs

inconsistent meal patterns

43
Q

Hypoglycemia treatment plan

A

15/15-15gCHO and recheck in 15mins

44
Q

Are chronic complicatins the same for DM1 and DM2?

A

yes

45
Q

Macrovascular complications

A

cardiovascular-low LDL and high TG
Stroke
HTN

46
Q

Nephropathy affects what tissue

A

Kidney

47
Q

Nephropathy problems

A

Damage to glomerulus of kidney–> leads to chronic kidney failure

48
Q

Retinopathy affects what tissue

A

eye

49
Q

Retinopathy problems

A

blindness

50
Q

Neuropathy affects what tissue

A

nervous system

51
Q

Neuropathy problems

A

autonomic and cardiac nervous system problems

leads to many amputations

52
Q

Diabetes control and complications trial results

A

more intensive therapy and lifestyle changes led to better management of diabetes

53
Q

Diabetes prevention program results

A

lifestyle is most effective in managing diabates

54
Q

Glucotrack

A

earlobe monitor instead of pricking finger for insulin

55
Q

Basal insulin

A

insulin that works the and background and provides the needs for the day

56
Q

Bolus insulin

A

the insulin needed for each meal

57
Q

ADA reccomendations fo A1C

A

<7%

58
Q

How do you reccomend an A1C goal for a patient

A

needs to be personal depending on their needs

59
Q

Old insulin protocol

A

NPH and Regulat (70/30)

60
Q

New gold standard of insulin

A

Lantus and Humalog

61
Q

Insulin needs for t1DM

A

0.5-1 unit/kg (50% basal 50% bolus)

62
Q

Somogyi effect cause

A

patient was hypoglycemic and liver made glucose–> no insulin to cover glucose overnight–>hyperlycemia

63
Q

Somogyi effect cure

A

decrease insulin

have bedtime snack

64
Q

Dawn phenomenon cause

A

hormones cause a glucose increase in the am

65
Q

Dawn phenomenon cure

A

limit CHO at bedtime

increase insulin or use one that peaks later

66
Q

what should you do before changing insulin amounts

A

check many times in the middle of the night

67
Q

MNT goals BG

A

BG in closest to normal range as safely as possible (<100mg/dL)
A1C <7%

68
Q

MNT goals lipids

A

profile that reduces macrovascular complications (normal blood lipids)

69
Q

MNT goals BP

A

in normal range as safely as possible <140/90

70
Q

Protein MNT

A

15-20% or 1-1.5g/kg

protein rich carbs cannot be used to treat hypoglycemia

71
Q

Fat MNT

A

20-35% and general population reccomendations

72
Q

Alcohol MNT

A

limit as much as possible

73
Q

Sodium MNT

A

<1500mg is reccomended

74
Q

Micronutrient MNT

A

check b12 in metformin users

75
Q

diabulemia

A

not providing enough insulin to cover the carbohydrates resulting in weight loss from mobilized fat stores

FS HN 461 (8 decks)

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