DM I Flashcards
1. Define the following diseases/disorders to include the pathophysiology, epidemiology, risk factors (if any), clinical presentation, physical findings, diagnostic evaluation, differential diagnoses, and management plan. • Type 1 and Type 2 Diabetes Mellitus • Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) • Somogyi effect and dawn phenomenon • Hypoglycemia 2. Discuss the following medical complications to include treatment options associated with diabetes: • Retin
When is Type 1 DM typically diagnosed?
Children and Young Adults
What happens in Type 1 DM?
The body does not produce insulin
What is insulin used for? Why is it important?
Insulin is required in order for the body to properly use sugar (in the form of glucose)
Why is sugar important for the body?
Basic fuel for cells
What is the role of insulin with sugar?
Takes the sugar from the blood and carries it into the cells where it can be used to provide energy for functionality.
What happens when insulin binds to the insulin receptor on the cell membrane?
Unlocks the cell so glucose can pass into it.
Blood glucose will _____ after a meal
Rise
After a meal, what will your pancreas do to compensate for the rise in blood glucose
Pancreas will release more insulin
Blood glucose tends to _____ during the day
Fluctuate
Insulin is secreted from the pancreas from what cell?
Beta 1 Cell
In an islet smear, what will you see in a patient with DM I that you won’t see in normal patients?
Lymphocytic Infiltration
Type I DM is commonly an
Autoimmune Disease
Over time, what does the pathogenesis of DM I look like?
Interactions between genes imparting susceptibility and resistance. Beta Cells are normal
Variable insulitis B-cell sensitivity and injury occuring
Pre-diabetes (less Beta cells)
Overt Diabetes (80-90% of Beta Cell loss)
Untreated DM 1 can cause
- Muscle Atrophy because there will be NO glucose going to the muscles
- CVD (Stroke, MI, Loss of circulation)
- Blindness
- Kidney Disease
- Nerve Damage
- Amputation
- Diabetic Neuropathy
Treatment for DM 1
INSULIN therapy! So glucose can go into the cells
What is Diabetic Nephropathy?
Clinical Syndrome characterized by persistent albuminuria, HTN, RELENTLESS DECLIN IN GLOMERULAR FILTRATION RATE, and a high risk of CV morbidity or mortality.
This disease is a common cause of Diabetic Nephropathy
End Stage Renal Disease
How common is Diabetic Nephropathy in Diabetics?
20-30%
Action on Diabetic Nephropathy should occur before the development of
Albuminuria
What is important do monitor in a pt diagnosed with Diabetic Nephropathy?
Blood pressure! Because of the effects on the glomeruli
Diabetes can cause what in the eye?
RETINOPATHY
Non-proliferative:
1. Aneurysm
2. Hemorrhages
3. Hard exudates
4. Cotton Wool Spots
Proliferative:
5. Growth of the abnormal blood vessels
Visual changes with Diabetic Retinopathy:
Very blurry with spots of no vision (blacked out)
Neuropathy can be caused by diabetes in what areas of the body, most commonly?
Feet and HAnds
Heart and Circulation
Stomach, Bladder, and Sex Organs
Diabetes is the most common cause of ?
Peripheral neuropathy
Peripheral Neuropathy can cause
Foot Ulcers, which can lead to amputation
What is peripheral neuropathy?
Feet and Hands lose nerve senses
What is autonomic neuropathy?
Loss of nerve sensation in the ANS, such as in the heart or digestion
Autonomic Neuropathy can lead to
HRN, HR issues, Bladder Emptying issues, and Digestion issues
What is a HbA1C Test?
Test that measures the percentage of HbA1c in your body. Corresponds to an average blood glucose for the previous 3 months
What is HbA1C?
Glycosylated Hemoglobin
Keeping blood glucose in target range reduces:
Kidney Disease, Nerve Damage, and Eye Disease
Treatment for DM1
Insulin Pumps
Target percentage for Hb A1C
< 6.5%
Limiting factor for treatment of DM I
HYPOGLYCEMIA
Symptoms of Hypoglycemia
Headache
Sweating
Impaired Vision
Dizziness
Fast Heartbeat
Hunger
Shaking
Anxiety
Irritability
Weakness/Fatigue
Suspected Low Blood Sugar, what should you do?
Test your blood sugar to confirm, then drink 1/2 cup of juice or use 2-3 glucose tablets.
After 15 minutes, see if it has gone up past 80. If not, take another 15 mg or snack if meal is within the hour.
Hypoglycemic?
Eat or drink 15 grams of fast-acting low-fat carbohydrates right away