Diabetes Melitius

Question 1

Glucose

Answer 1

major source of energy

Question 2

Glycogenolysis

Answer 2

breakdown of stored glycogen to glucose

Question 3

Glycogenesis

Answer 3

glycogen formation (stored in fat)

Question 4

Gluconeogenesis

Answer 4

formation of glucose from stored fat and proteins

Question 5

What is T1DM risk factors and s/s?

Answer 5

Absolute lack of insulin production, autoimmune destruction of pancreatic beta cells/insulin, scant/no insulin, can be due to viral infections; injectable insulin replacement required.
Common: children; 5% of patients are diagnosed
RF: GENETICS, age, obesity
s/s: polydipsia, polyuria, polyphagia, vision changes, glucosuria, ketonuria, heavy labored breathing

Question 6

What is T2DM risk factiors and s/s?

Answer 6

relative lack of insulin production (pancreas can’t produce enough insulin resistance), decreased pancreatic insulin production, commonly seen in 90% of diagnosed patients
RF: OBESITY, lifestyle, increasing age, lack of physical activity, ethnicity, gestational diabetes (pregnancy/ birth)
s/s: polydipsia, polyuria, polyphagia, gradual SILENT onset, prolonged wound healing, recurrent infections

Question 7

What is metabolic syndrome?

Answer 7

predisposition to T2DM
s/s: hyperinsulinism, centralized body weight “apple shape”, glucose intolerance, diabetic ketoacidosis, increases risk of stroke and CVD

Question 8

Acute complications

Answer 8

Hypoglycemia: <70, decreased BS
EMERGENCY SITUATION in both T1DM T2DM
s/s: headache, sweaty, shaking, grumpy, dizzy, confused, hungry

Hyperglycemic Diabetic ketoacidosis: only in T1DM

Hyperglycemic Hyperosmolar Syndrome: T2DM

Question 9

What is DKA (Diabetic Ketoacidosis/Diabetic coma)?

Answer 9

starts w/ hyperglycemia, burning of fatty acids for energy, and the production of ketones.
<250mg/dL
s/s: deep respiration (Kussmaul), decreased responsiveness, acetone breath (ketones), lethargy,

Question 10

What is Hyperglycemia Hyperosmolar Non-Kenotic Coma?

Answer 10

happens in T2DM occurs in older clients, may be missed, insidious onset
hyperglycemia = severe cellular dehydration = polyuria = hypovolemia

Question 11

What are the complications of uncontrolled diabetes?

Answer 11

Microvascular: retinopathy (vision/blindness), endothelia damage, neuropathy (nerve damage), nephropathy (kidney damage)

Macrovascular: CAD, MI, CVA (stroke), brain, hearty, extremities, occlusive disorders, no sensation in foot

Question 12

What are the complications of untreated metabolic syndrome?

Answer 12

T2DM, cardiovascular disease (CVD), stroke, kidney disease, and NAFLD

Question 13

What are the chronic complications of DM?

Answer 13

Brain (CV, atherosclerosis)
Eyes (cataract, retinal, microaneurysm, blindness)
Heart (MI, dysthymias)
Kidneys (failure, infection)
Nephropathy (impotence, infertility, urinary problems, loss of sensation)
Peripheral vascular disease (arterial, venous ulcers, delayed healing, gangrene)

Question 14

What are the long-term complications of DM?

Answer 14

arteriosclerosis (MI)
peripheral angiopathy (lack of circulation = ischemia limb)
diabetic retinopathy (lack of circulation in lower extremities, burning/tingling)
autonomic neuropathy (lack of SNS stimulation in hypoglycemia)
diabetic neuropathy (kidney failure)
poor wound healing (gangrene)
immunosuppression (infection)

Question 15

What is diabetes meletus?

Answer 15

high blood sugar

Question 16

What is fasting blood glucose and what is the normal level?

Answer 16

FBS: most accurate test for diagnosis of DM
Normal level: 70-100 mg/dL

Question 17

What is hypoglycemia?

Answer 17

blood glucose that is less than 70 mg/dL

Question 18

What is hemoglobin A1C?

Answer 18

tells the blood sugar levels of over the past 3
months
needs to have a number higher that 6.5 to be considered diabetic