Disbetes Unit 6

Question 1

Chronic complication - Microvascular

Answer 1

Retinopathy, nephropathy, neuropathy.

Question 2

Chronic complications- Macrovascular

Answer 2

CAD, CVA, MI, PVD (amputations)

Question 3

Etiology of Diabetes

Answer 3

Unknown
Autoimmune - Beta cells destroyed
Viral
Environmental 
Genetic
Obesity/inactivity = type 2
Non-immune = secondary to other disease type 1

Question 4

Extra cellular action of insulin

Answer 4

Fats into fatty acid and glycerol, CHO into simple sugars, proteins to amino acids

Question 5

Intracellular action of insulin

Answer 5

Insulin stimulates entry of amino acids into cell & enhances protein formation

Question 6

Glycogen metabolic action

Answer 6

Stimulates breakdown of protein & fat stores

Question 7

Hyperglycemia (metabolically)

Answer 7

Causes metabolism of protein and fats. Increases protein wasting & ketones- deposits of lipids in vascular walls

Question 8

Diagnostic fasting blood glucose ? Oral glucose tolerance test?
Hb A1C ?

Answer 8

FBG is = > 126mg/dl
OGTT => 200
A1C > 6.5%

Question 9

Hyperglycemia causes

Answer 9

Illness/infection
Too much food 
Too little medication
Inactivity 
Stress
Corticosteroids

Question 10

Hypoglycemia causes

Answer 10

Alcohol intake without food
Too little food
Too much medication 
Too much exercise
Weight loss without changing meds
Beta blockers masking symptoms

Question 11

Hyperglycemia signs & symptoms

Answer 11

3 P's 
Weakness fatigues
Blurred vision
Headache
N/V 
Abdom cramps 
Glycosuria
Progression to DKA

Question 12

Hypoglycemia signs & symptoms

Answer 12

Cold clammy 
Numbness in fingers, toes, mouth
Tachycardia 
Emotional changes
Headache
Nervousness, tremor
Unsteady gait
Slurred speech 
Coma

Question 13

Hypoglycemia Interventions

Answer 13

15-20 grams of simple carbs
Check and take again in 15 if not resolves
Carry CHO on you
If unresolved get medical attention

Question 14

Hyperglycemia Inteventions

Answer 14

Medical care if symptomatic
Check BS frequently
Drink fluids frequently
Take medication as prescribed

Question 15

Metabolic Syndrome?

Answer 15

Combination of symptoms - Any 3 out of 5

Waist >40 in men and >35 in in women
Triglicerides >150 mg/dl or on meds
HDL 130/85 or on meds
FBG >110

Question 16

Somogi Syndrome is?

Treat?

Answer 16

Hyperglycemic in the morning and Hypoglycemic (counter-regulatory hormones) at night
Treat: Decrease evening insulin dose, FS between 2-4 am.

Question 17

Dawn Phenomenon ?

Treat?

Answer 17

Hyperglycemia in the morning - hormones (GH & Cortisol)

Treat: Increase evening insulin dose

Question 18

Diabetic Ketoacidosis ?

Treat?

Answer 18

Blood sugar increases to 300-800 - Dehydration, HypoTN

Treat: Acute = O2 (Kussmaul breathing), protect airway, NS IV until urine output is >30ml/hr, regular insulin drip 2u/hr.
Recovery= Slow hydration with IV fluids, replace K, Mg, Phos, Na, Chl with lab monitoring

Question 19

Hyperosmolar Hyperglycemic Syndrome

Answer 19

Non-Ketonic
Patient produces enough insulin but not enough to prevent hyperglycemia
Hypotention due to osmotic Diresis
Dehydration & Tachy
Seizures & Cerebral Dehydration
Common with PNA, UTI, sepsis
TREAT: Control Blood sugar, hydrate

Question 20

Ultra Short Acting Insulin?

Onset, Peak, Dur?

Answer 20

Lispro (Humalog), Aspart (Novalog)
O= 5-15 min
P= 30-60 min
D=2-4 hr

Question 21

Short acting insulin?

Onset, Peak, Dur?

Answer 21

Regular (Humulin), R-Novolin
O= 30min-1hr
P= 2-3 hr
D= 4-6 hr

Question 22

Intermediate Acting?

Onset, Peak, Dur?

Answer 22

NPH Humulin N, Novolin
O = 2-4 hr
P = 4-12 hr
D = 16-20 hr

Question 23

Long Acting insulin?

Onset, Peak, Dur?

Answer 23

Glargine (Lantus), Detemir (Levemir)
O= 1 hr
P= continuous/no peak
D = 24 hr