Diabetes type I and type II Flashcards

1
Q

______ is a metabolic disorder or disease that is brought about by either the insufficient production of insulin or inadequate activity of insulin receptors.

A

Diabetes mellitus

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2
Q

The disease can be classified into what three different categories?

A

-type 1,
-type 2
-gestational diabetes.

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3
Q

Essentials of diagnosis for what issue?
(1) Polyuria / Polydipsia
(2) Weight loss
(3) Plasma glucose of 126 mg/dL or higher after an overnight fast, documented on more than one occasion.
(4) Ketonemia / ketonuria - inadequate insulin leads to inadequate glucose within muscle cells which promotes fat metabolism (the source of ketones).

A

Diabetes

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4
Q

definition of what type of diabetes?
Auto-immune antibodies (anti-pancreatic islet cells, anti-insulin, anti-
GAD65).
(a) Primarily occurs in children and adolescence through may develop in adults up to the age of 30.
(b) Patients with this type diabetes have partial or absolute deficiency of endogenous insulin production and require exogenous insulin for survival.

A

Type 1

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5
Q

Classic signs and symptoms of what issue

May include polyuria, polydipsia, fatigue, polyphagia, unexplained weight loss, poor wound healing, blurred vision, and a higher prevalence of certain infections, especially candidal vaginitis and balanitis, recurrent/severe urinary tract infections, recurrent skin infections, and malignant otitis externa.

A

diabetes

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6
Q

The presence of any symptoms of diabetes or infections should lead the Independent Duty Corpsman to check the patient’s what?

A

blood glucose level

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7
Q

Lab/imaging findings: Type 1 Diabetes
Urine screening:
1) A urine dipstick is a rapid screening that may point to a diagnosis of urinary tract infection (UTI), kidney disease, diabetes, or a urinary injury.
2) If test results are _______, other tests will be needed before a definite diagnosis can be made.
3) Glucosuria: The average renal threshold for glucose is approximately ____mg/dl (above this range glucose is usually typically detectible in urine).
4) Ketonemia, ketonuria, or both

A

2) abnormal
3) 150- 180mg/dL

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8
Q

Lab/imaging findings: Type 1 Diabetes
Blood testing procedures:
1) Plasma glucose of _____ mg/dL or higher after an overnight fast, documented on more than one occasion.
2) An oral Glucose Tolerance Test (GTT) is used if the fasting plasma glucose level is < ______ mg/dL in suspected cases (most commonly used to screen for gestational diabetes).
3) Presence of one or more autoantibodies such as; _______, _____ and ______.
4) Glycosylated Hemoglobin (Hemoglobin A1): ______ is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over time.

A

1) 126 mg/dL
2) 126 mg/dL
3) Anti-insulin, antiislet cell, and anti-glutamic acid decarboxylase (GAD65)
4) HbA1c

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9
Q

The advantages of using the HbA1c to diagnose diabetes are that there is no need to fast; and it provides an estimate of glucose control for the preceding _____ months

A

2-3 months

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10
Q

A fasting plasma glucose ≥ 126 mg/dL or HbA1c of 6.5% is diagnostic of
diabetes if what?

A

confirmed by repeat testing

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11
Q

Treatment Diabetes Type 1

A

Insulin therapy: Only medication that is effective in lowering blood glucose levels in type 1 diabetes.

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12
Q

Insulin is indicated for type 1 diabetes as well as for type 2 diabetes with what issues?

A

hyperglycemia not adequately controlled with diet alone or combined with other medications

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13
Q

Insulin is indicated for type 1 diabetes as well as for type 2 diabetes with what issues?

A

hyperglycemia not adequately controlled with diet alone or combined with other medications

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14
Q

Insulin is supplied in AMMAL in 10 ml bottles containing 100 un/ml, which is a (short or slow) acting insulin.

A

SHORT

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15
Q

Short Term Therapy Type 1
1) Treatment of type 1 DM requires a multidisciplinary approach by the
healthcare team (Physician, Nurse, and Dietitian).
2) Patients diagnosed with new-onset of type 1 DM require ________ therapy.
3) Immediate short term goal is to what?

A

2) lifelong insulin
3) control hyperglycemia, maintain serum electrolytes and hydration to avoid DKA episodes.

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16
Q

Disposition
(a) Type 1 Diabetes (controlled with insulin) requires a _______ for continued military service. Member is usually not worldwide assignable.
(b) Patients determined to have new onset diabetes (type 1 or 2) should be referred to _______ or _______ for further evaluation and management.

A

a) medical board
b) Internal Medicine or Endocrinology

17
Q

Diabetic neuropathies are the most common complications of diabetes affecting up to __% of older patients with type 2 diabetes.

A

50%

18
Q

Stocking-glove pattern of sensory deficit is a sign of what?

A

Peripheral neuropathy

19
Q

Heart Disease
1) Due to coronary atherosclerosis.
a) MI is______ times more common in DM patients.
b) Leading cause of death in Type ___ DM patients

A

a) 3 to 5
b) type 2

20
Q

Essentials of diagnosis for what issue?
(a) Insulin resistance due to inadequate activity of insulin receptors.
(b) Most patients are over 40 years of age and obese through is becoming more common in adolescence.
(c) Polyuria and polydipsia. Ketonurea and weight loss generally are uncommon at time of diagnosis. Candidal vaginitis in women may be an initial manifestation. Many patients have few or no symptoms.
(d) Plasma glucose of 126 mg/dL or higher after an overnight fast on more than one occasion.
(e) Random glucose of 200mg/dL or higher.
(f) Hemoglobin A1C of 6.5% or higher.
(g) Hypertension, dyslipidemia, and atherosclerosis are often associated.

A

Type 2 Diabetes

21
Q

Treatment type 2 diabetes
Stage 1

A

diet modification and weight reduction.
a) Diet (Recording food eaten)
b) Exercise (Incorporating regular exercise)

22
Q

Treatment type 2 diabetes
-stage 2

A

includes various oral antidiabetic medications.
a) Biguanides (Metformin/Glucophage) ***First line medication
b) Sulfonylurea’s
c) Meglitinide analogs
d) Dipeptidyl Peptidase derivative
e) Thiazolidinediones
f) α-Glucosidase Inhibitors
g) Glucagon-Like Peptide Receptors Agonist
h) Sodium-glucose cotransporter-2 (SGLT2 Inhibitor)

23
Q

Treatment: type 2 diabetes
Stage 3

A

insulin requirement
-due to inability to achieve adequate glucose control with oral medications

24
Q

What is the most important risk factor for type 2 diabetes?

A

Obesity