Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics: Diabetes & Womens Health > Diabetes week 1 > Flashcards

Diabetes week 1 Flashcards

1
Q

Risk factors for pre-diabetes (4 main ones)

A
  • family hx
  • sedentary lifestyle
  • overweight or obese
  • being non white (hispanic or native american)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Type 1 diabetes

A
  • insulin dependent
  • <20 years old
  • usually skinny
  • Islet autoantibodies present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Type 2 diabetes

A
  • initially non-insulin dependent
  • > 40 y/o
  • usually obese
  • more common in minorities
  • no autoantibodies present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

development of type 2 diabetes depends on:

A

-abnormal beta cell function & relative insulin deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Insulin resistance is when

A

there is a malfunction on the insulin receptor site and glucose spills over into the blood stream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the exercise prescription?

A

FITT

  • frequency : T1: daily T2: 3-5 days
  • Intensity: where they are seating and breathing heavily
  • time: T1: 20-30 min T2: 20-60mins
  • type: both aerobic and resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is hypoglycemia and what is it caused by?

A
  • BG < 70

- caused by food, exercise, medication or defect in glucagon secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hypoglycemia stage 1 signs and symptoms

A

-nervousness, anxiety, hunger, nausea, numbness/tingling, pallor, tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypoglycemia stage 2 signs and symotoms:

A

-sudden fatigue, weakness, dizziness, confusion, amnesia, seizures, coma death…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you treat hypoglycemian?

A

RULE OF 15!!

  • eat 15 gram carb load: orange juice, soda, candy
  • *then follow up with a more substantial snack (protein, carbs and fat)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Severe hypoglycemia treatment:

A

-Glucagon recombinant: 1 mg IV, IM, SQ or NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hyperglycemia signs and symptoms:

A
  • weakness, malaise, polyuria, weight loss, (develop over time)
  • high BG levels (>250)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hyperglycemia at home management:

A
  • monitor BG
  • insulin
  • rest, water 7 EXERCISE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hyperglycemia acute adverse effects:

A
  • diabetic ketoacidosis (DKA)

- hyperglycemic hyperosmolar state (HHS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Macro vascular complications

A
  • CAD –> leading cause of death in diabetics
  • PVD & PAD
  • cerebrovascular disease, hemorrhagic, ischemic strokes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ADA Blood pressure guidelines/ tx

A

ASCVD <15%: <140/90
ASCVD >15%: <130/80
Pregnancy: 120-160/80-105
-no drug of choice but use acei/arb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

AACE blood pressure guidelines/ tx:

A

BP goal < 130/80

-ACEi/ARB id drug of choice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ACC/AHA blood pressure guidelines/tx

A
  • BP <130/80
  • if CKD: acei
  • if HF: dont use non-DHP CCB
  • if black: use thiazide or CCB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ADA Aspirin therapy

A
  • primary p: maybe in pts with high CVD risk(high risk is using clinical judgement in age and about 50 years old)
  • secondary p: everyone!
20
Q

AACE aspirin therapy

A
  • primary p: when ASCVD score is > 10%

- secondary p: everyone!

21
Q

Obesity management

A
  • use diet and PE to achieve 5% weight loss
  • weight loss medication if BMI > 27
  • bariatric surgery if BMI > 35
22
Q

ADA & AACE vaccine reqs

A
  • flu- annually
  • pneumococcus: 19-64 (PPSV23) >65 (PCV 13 –> on year apart PPSV23)
  • hep B - all adults
23
Q

Microvascular complications of DM

A
  • retinopathy
  • nephropathy
  • neuropathy
24
Q

prevention of diabetic retinopathy

A
  • optimize glycemic control

- optimize blood pressure control

25
Q

Diabetic retinopathy TDM1

A
  • should have dilation of eyes within 5 years of diagnosis

- annual eye exam

26
Q

Diabetic retinopathy TDM2

A
  • should have dilation & exam of eyes at the time of diagnosis
  • annual eye exam
27
Q

Nephropathy risk factors

A
  • hyperglycemia
  • hypertension
  • proteinuria
  • dyslipidemia
28
Q

CKD treatment

A
  • optimize glucose control
  • optimize blood pressure
  • dietary protein intake should be ~.8g/kg per day
  • ***assess urinary albumin once a year
  • ACEi/ARB not primary prevention of CKD(they only help prevention when there’s albuminuria)
29
Q

Diabetic Peripheral Neuropathy

A
  • foot exams annually!

- risk factors: smokers, PAD, CKD, foot deformaties

30
Q

Prediabetes and its treatment

A

-FPG 100mg/dl to 125mg/dl
-A1C 5.7-6.4%
Treatment:
-7% loss of initial body weight
-inc moderate-intensity physical activity
-Metformin therapy should be considered, especially for those with BMI>35KG/m2

31
Q

Cholesterol management ADA Guideline

A

<40 ASCVD risk>20% high intensity
<40 ASCVD risk<20% no treatment require
>40 ASCVD risk>20% high intensity
>40 ASCVD risk<20% moderate intensity

32
Q

Cholesterol management ACC/AHA Guideline

A
  • DM go with moderate intensity statin
  • ASCVD risk>20% High intensity
  • ASCVD risk 7.5-20% Moderate intensity
33
Q

DCCT: T1DM

A

Intensive insulin therapy (stricter goals) reduces A1C and T1DM microvascular complications → EDIC

34
Q

UKPDS: T2DM

A

Intensive therapy (+metformin, SU) reduced microvascular events→ 10-year follow up: macrovascular; necessary to control BG, A1C, and BP

35
Q

ACCORD: T2DM

A

Super intensive therapy (A1C < 6.0%) led to higher risk of death, especially if AIC >8.5, Hx of neuropathy, Hx ASA use

36
Q

ADVANCE: T2DM

A

Corroborated with UKPDS 10-year follow-up with a decrease in micro- and macro- complications with intensive therapy

37
Q

VADT: T2DM

A

Lower threshold to start insulin therapy decreased major microvascular complications; severe hypoglycemia in last 90 days is strong predictor of mortality

38
Q

DM Lifestyle Management

A 
Medical nutrition therapy (MNT) for all
-Portion control and healthy food choices
-Plate method(most important for T2DM)
-Weight loss > 5%
- Individualized meal plans
-Alcohol consumption ↑ risk for hypoglycemia
● No more than 1 drink/day for women
● No more than 2 drinks/day for men
● Preferably drinking with food
-Physical Activity
-Smoking Cessation
39
Q

Special Populations: Pediatric T1DM

A

-FBG90-130mg/dl,PPG 90-150mg/dl,A1c<7.5%
● BP: treat if consistently > 130/80
● Cholesterol: treat if LDL consistently> 130mg/dL
● Microvascular monitoring once > 10y/o OR had DM for 5 years
● 60 minute aerobic exercise with strength training at least 3x/wk

40
Q

Special Populations: Pediatric T2DM

A

● Screening once > 10y/o AND BMI >85th percentile
● Aim for 7-10% weight loss
● 30-60 minutes of moderate vigorous physical activity 5x/wk with strength training for 3
● Goal A1C < 7% (6.5% reasonable if you can avoid hypoglycemia)

41
Q

Special Populations: Geriatric

A

Functional, cognitively intact older adults can use goals
developed for younger adults. Otherwise…
● A1C goals more lenient < 7.5%
● AVOID HYPOGLYCEMIA
● Routinely consider de-escalating regimens

42
Q

Sick Day Management

A

Sick day = infection, injury, surgery, trauma, invasive procedure,
major life stress
● Continue long-acting (basal) insulin as normal
● Use rapid-acting (bolus) insulin only if eating
● Continue PO medications EXCEPT: metformin, SGLT2i, GLP1-RA
○ D/C all PO medications if N/V/D
● Check OTC medications (sugar content)

43
Q

Sick Day Management counseling points

A
  • Test BG Q2H
  • T1DM: urine/blood ketones Q4H
  • Monitor Temp and hydration status
  • Track symptoms: N/V, thirst, urination
44
Q

Cystic Fibrosis-related DM (CFRD)

A

● Annually screen for CFRD in all CF patients > 10
○ Not recommended to use A1C
● Treat with insulin to attain individualized glycemic goals
● 5 years after diagnosis of CFRD, start annual monitoring for DM complications

45
Q

Gestational DM vs Pregnant DM Patient

A

● Insulin is preferred agent
○ Gestational DM: after delivery, consider starting metformin
● Strict targets
○ A1C in pregnancy < 6%
○ FBG < 95mg/dL
○ One hour postprandial < 140mg/dL or two hour postprandial < 120mg/dL

Therapeutics: Diabetes & Womens Health (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions