Endocrine - Diabetes Flashcards
What does the pancreas release when sugar is high?
Insulin
Insulin allows glucose to enter the cell.
What does the pancreas release when sugar is low?
Glucagon
Glucagon causes the liver to release stored glucose.
What are the three consequences of insulin deficiency?
- Liver releases stored glucose
- Body breaks down muscle/protein and fat for energy
- Breakdown of fat releases ketones as a byproduct
What happens to beta cells in Type 1 diabetes?
They are destroyed
Beta cells are responsible for producing insulin.
What characterizes Type 2 diabetes?
Cells become resistant to insulin
They no longer utilize insulin properly.
What are the risk factors for Type 1 diabetes?
- Heredity
- Youth-onset
What are the risk factors for Type 2 diabetes?
- Adult-onset
- Obesity
- Sedentary lifestyle
- Hypertension
- Family history
- Certain ethnicities (Native Americans, African Americans, Hispanic Americans)
What are the three P’s associated with diabetes symptoms?
- Polyuria
- Polydipsia
- Polyphagia
What is diabetic ketoacidosis?
A condition that occurs only in Type 1 diabetes
It results from a buildup of ketones and is often triggered by a stressor.
What is the Dawn phenomenon?
Glucose rises due to overnight release of adrenal hormone
Glucose slowly rises throughout the night.
What is the Somogyi phenomenon?
Rebound hyperglycemia due to a drop in glucose levels overnight
It is usually due to evening insulin administration.
What are microvascular complications of uncontrolled hyperglycemia?
- Neuropathy
- Nephropathy
- Retinopathy
What are macrovascular complications of uncontrolled hyperglycemia?
- Peripheral arterial disease
- Myocardial infarctions
- Strokes
What fasting blood glucose level indicates diabetes?
Greater than or equal to 126 mg/dL
What does an Hgb A1C level of greater than or equal to 6.5% indicate?
Diabetes
It measures glucose control over a period of 3 months.
What is metabolic syndrome?
A risk profile for developing Type 2 diabetes and cardiovascular disease
It includes abdominal obesity, hyperglycemia, hypertension, and hyperlipidemia.
What is the mechanism of action of Biguanides like Metformin?
Decreases the amount of glucose released by the liver and increases cell sensitivity to insulin.
What are the contraindications for Biguanides?
Kidney disease
Monitor GFR and BUN & creatinine closely.
What do Sulfonylureas do?
Stimulate the pancreas to release insulin
They should be taken with or just before meals.
What is the effect of Thiazolidinediones (TZDs) like Pioglitazone?
Decreases glucose release by the liver and increases cell responsiveness to insulin
Contraindicated in patients with heart failure.
What are the types of insulin?
- Rapid (lispro, aspart)
- Short (regular)
- Intermediate (NPH)
- Long (glargine, detemir)
What should be done before administering rapid-acting insulin?
Ensure the patient has food in front of them.
What is the storage guideline for insulin?
Stored in the refrigerator when not in use
Insulins may stay at room temperature for 28 days when in use.
What are the symptoms of hypoglycemia?
- Sweating
- Tachycardia
- Heart palpitations
- Anxiety
- Tremors
- Blurred vision
- Altered level of consciousness
- Behavior changes
- Slurred speech
What should be administered if a patient is conscious and hypoglycemic?
Simple carbohydrates
What are the general nutrition guidelines for diabetics?
Carbs should come from fruit, vegetables, whole grains, legumes, and dairy
At least 25g of fiber is recommended.
What are the alcohol guidelines for diabetics?
- 2 drinks for men
- 1 drink for women daily
What is a key foot care guideline for diabetics?
Do not wear the same shoes two days in a row.
What should be monitored during exercise for diabetics?
Avoid extreme temperatures and ensure glucose levels are between 100-250 mg/dL.
What are the sick day rules for diabetics?
- Check glucose every 2-4 hours
- Continue insulin and/or diabetic meds
- Eat meals at regular times and stay hydrated
- Monitor urine for ketones
