DM- T1DM

Question 1

T1DM

T1DM is caused by _ destruction of _ cells of the _ resulting in _

Answer 1

autoimmune destruction of Islet cells of pancreas resulting in absence of insulin

Question 2

T1DM

What often triggers an autoimmune response?

Answer 2

infection

Question 3

T1DM

When does T1DM typucally onset

Answer 3

childhood

Question 4

T1DM

What does the body depend on in T1DM

Answer 4

exogenous sources of insulin for survival

Question 5

T1DM

Recall- what is insulin

Answer 5

a hormone made by pancrease that facilitates uptake glucose by cells and stops fat breakdown

fat breakdown is what produces ketones

Question 6

T1DM

What happens to a T1 diabetic without insulin

2

Answer 6

8-16 hours ketosis develops
12-24 hours DKA

Question 7

T1DM

How does ketosis develop

2

Answer 7

Without insulin the liver breaks down fat into ketones and releases them

Without insulin the cells cannot uptake glucose leading to high glucose levels in blood

Question 8

T1DM

What do ketones cause

Answer 8

metabolic acidosis because ketones lower pH of blood

when met acid is compensated it is ketosis, if becomes severe it is DKA

Question 9

T1DM

What is DKA

Answer 9

Severe metabolic acidosis with high blood glucose levels due to high ketones from lack of insulin

Question 10

T1DM

How fast is the onset of T1DM

Answer 10

usually very fast, days-weeks

Question 11

T1DM

4 most common initial presenting signs

Answer 11

rapid significant weight loss
polydipsia
polyuiria
polyphagia

can also have fatigue, blurrred vision, some present in DKA

Question 12

T1DM

What is key in reducing end organ damage and morbidity/mortality?

Answer 12

tight glucose control

Question 13

T1DM

When ketones build up in blood where are they spilled to?

Answer 13

Urine

Question 14

T1DM

Who is best to initate and initially stabilize a patient starting insulin?

Answer 14

diabeted ed or endocrinologist

Question 15

T1DM

What two types of insulin are usually used once a patient is stable

Answer 15

basal dose long acting insulin
+
bolus doses of short/rapid acting insulin based on carb intake

Question 16

What are examples of basal (long acting) insulins

2

Answer 16

Insulin glargine (Lantus)
Insulin determir (Levemir)

Question 17

What are examples of short/rapid acting insulins

4

Answer 17

Lispro
aspart
glulisine
insulin regular

Question 18

What is premixed insulin

Answer 18

called NPH or analogues insulin
combo vial containing mix of short and long acting/intermediate insulin

another option based on what works best for patient

Question 19

What is the goal of insulin therapy

3

Answer 19

healthy blood glucose level
minimal highs and no lows
A1c 7 or less

Question 20

What provider usually follows diabetics

Answer 20

endocinology

Question 21

What are key teaching points for insulin dependent diabetics

2

Answer 21

• How carbs, exercise, and illness impact insulin requirements
• Emergency s/s hypoglycemia

Question 22

What are the common s/s of hypoglycemia

4

Answer 22

sweating
palpitations/shaking
confusion
loss of conciousness

Question 23

What is a low glucose level

Answer 23

<3

Question 24

What are two examples of tertiary prevention in T1DM

Answer 24

foot care
glucose monitoring

Question 25

What needs to be adjusted during exercise

Answer 25

either lower basal insulin or increase carbs

exercise can cause hypoglycemia

Question 26

How often should T1DM have an A1C check?

Answer 26

q3 months until stable and then q6 months

Question 27

How many times a day should insulin dependent diabetics check their BLG

Answer 27

QID