DM summary

Question 1

DM is the ___ to regulate ___ leading to inadequate metabolism of ____

Answer 1

inability
glucose
macronutrients

Question 2

____ is impaired ___ ____ glucose and ____ _____ ____

Answer 2

pre- DM
fasting plasma
impaired glucose tolerance

Question 3

in type __ there is absolute of significant deficient of ____. there is ____ ____ _____ of ___ cells in the _____

Answer 3

1
insulin
cell mediated immunodestruction
beta 
pancreas

Question 4

patients with type 1 will experience h___, ____ and _____

Answer 4

hyperglycemia
hyperketonemia
ketoacidosis

Question 5

3 Ps

Answer 5

polydipsia
polyuria
polyphagia

Question 6

a patient with __ _ will experience the 3Ps; w____, b___ _____, f___, p____ and ___ ____

Answer 6

type 1
weight loss 
blurred vision
fatigue
paresthesias 
skin infections

Question 7

cause of hyperglycemia

Answer 7

• too much food, too little insulin or dm pills

- illness or stress

Question 8

onset of ___ is slow, and may lead to a medical emergency if not treated

Answer 8

hyperglycemia

Question 9

to dx type 1 DM, a ___ and ___ exam is needed; ___ and ____ blood ___ levels; and ___

Answer 9

history and physical
fasting and random
glucose
hbgA1c

Question 10

treatment of type 1

Answer 10

• carb (nutrient) intake
• exercise
• INSULIN REPLACEMENT THERAPY

Question 11

In type __ there is insulin ___ and a ____ in adequate ___ ____

Answer 11

2
resistance
reduction
insulin secretion

Question 12

those with type _ are often ___

Answer 12

2

asymptomatic

Question 13

pt with type _ may present with ___, visual ___, n__, ___, ____, recurrent ___, and _____

Answer 13

2
fatigue
changes 
neuropathy
CAD
PAD
infections 
neuropathy

Question 14

treatment of type 2 involves

___ ___ through ___ and ___ and ___ _____ agents

Answer 14

weight control through diet and exercise

oral glycemic agents

Question 15

goal of type 2

Answer 15

maintain optimal blood glucose levels

Question 16

dm A1C value

Answer 16

6.5 + %

Question 17

pre- dm A1C value

Answer 17

5.7-6.4%

Question 18

normal A1C lab

Answer 18

5%

Question 19

FPG value

DM

Answer 19

126 +

Question 20

FPG value

pre- dm

Answer 20

100-125

Question 21

FPG value

normal

Answer 21

99 or below

Question 22

OGTT value

dm

Answer 22

200+

Question 23

OGTT value

pre-dm

Answer 23

140-199

Question 24

OGTT value

normal

Answer 24

139 or below

Question 25

causes of hypoglycemia

Answer 25

- over-production/ over- administration of insulin - inadequate food intake - exercise - infection - several anti-hyperglycemia meds for T2DM

Question 26

hypoglycemia lab value

Answer 26

blood glucose between 45-60 mg/dl

Question 27

complications of hypoglycemia

Answer 27

seizures coma death

Question 28

clinical presentation of hypoglycemia

Answer 28

``` pallor tremor tachycardia palpatations headache diaphoresis confusion, poor judgement ```

Question 29

manifestations of HHS

Answer 29

- blood sugar >600 - low volume secondary to dehydration * note: insulin still available

Question 30

manifestations of DKA

Answer 30

``` fruity breath kussmals breathing tachycardia and hypotension altered LOC N&V, abdominal pain ```

Question 31

in ___ ___ the bedtime glucose is normal. there is a ____ ____ as result of insulin induced _____

Answer 31

smoggy effect rebound hyperglycemia hypoglycemia

Question 32

in ___ ___ hypoglycemia occurs at night, which triggers ___, ____ (only T2DM) ____, and __ __

Answer 32

``` somogyi effect catecholamine glucagon (only T2DM) cortisol growth hormone ```

Question 33

patient with an acute complication of __ ___ will have ____ in the morning often leading to the over- administration of ___ ____

Answer 33

somogyi effect hyperglycemia evening insulin

Question 34

to treat somogyi effect ___ _____ ____

Answer 34

decrease bedtime insulin

Question 35

patient with ___ ___ will have a bedtime glucose ___ than waking levels

Answer 35

dawn phenomenon

Question 36

___ released in the ___ morning lead to ___ glucose levels in ___

Answer 36

hormones early higher am

Question 37

in ___ ___ glucose levels rise steadily throughout the night. it is NOT triggered by ____

Answer 37

dawn phenomenon | hypoglycemia

Question 38

to treat dawn phenomena, limit ____ ___ and/or increase _____ ____ ___ or _____

Answer 38

evening snacks | pm oral glycemics or insulin

Question 39

chronic MACROvascular complications of dm

Answer 39

CAD PAD stroke

Question 40

chronic microvascular complications of DM

Answer 40

diabetic retinopathy | diabetic nephropathy

Question 41

other chronic complications of dm

Answer 41

diabetic neuropathies slow wound healing increased infection risk and reduced response

Question 42

infections in dm are ___ and often ___ ___. infection of ___ and ___ due to ____ and neurological impairement

Answer 42

``` common more severe feet legs vascular ```

Question 43

common infections of DM

Answer 43

fungal- candida, vaginal and or oral UTI dental caries cataracts gingivitis and periodontitis

Question 44

pregnancy and DM

Answer 44

- complications for both mom and fetus - spontaneous abortions - infants are larger weight and size; hypoglycemia first hours after birth