exam 4 (intro to diabetes) Flashcards
1
Q
Diabetes is a –
A
chronic multi-system disease related to abnormal or impaired insulin utilization
2
Q
what is diabetes characterized by?
A
Hyperglycemia resulting from lack of insulin or lack of insulins effect
3
Q
What causative factors is diabetes a combination of? -3
A
-genetic/hereditary
-autoimmune
-lifestyle
4
Q
What and where is insulin made of/in?
A
beta cells in the pancreas
5
Q
what do liver and muscle cells store?
A
excess glucose as glycogen
6
Q
what are two insulin dependent tissues?
A
skeletal muscle and apidose
7
Q
Insulin is required to _________ receptor sites in cells.
A
unlock
8
Q
what do receptor sites in cells allow for?
A
transport of glucose into cells to be used for energy
9
Q
where is glucagon released from?
A
alpha cells of the pancreas
10
Q
what are the three metabolic processes?
A
-glycolysis
-glycogenolysis
-gluconeogenesis
11
Q
what is insulin resistance?
A
When the body is making insulin, but the insulin the body is producing is not working to open the glucose channels.
12
Q
what is insulin insufficiency?
A
When the body is making some working insulin, but is not making enough for all of the cells.
13
Q
what is hypoglycemia?
A
low blood sugar; less than 70 mg/dL
14
Q
when does hypoglycemia occur?
A
When there is too much insulin in proportion to the amount of available glucose
15
Q
Production of what two things provides a defense against hypoglycemia?
A
-glucagon
-epinephrine
16
Q
untreated hypoglycemia can progress to-
A
loss of consciousness, seizures, coma, or death
17
Q
causes of hypoglycemia -5
A
-alcohol intake without food
-too little food
-too much diabetic medication
-too much exercise without enough food intake
-weightloss without change in medication
18
Q
three physiological consequences of hypoglycemia
A
-neurological symptoms
-hypoglycemia unawareness
-autonomic neuropathy
19
Q
three treatments of hypoglycemia
A
-rule of 15
-IV dextrose
-glucagon IM or sub-q
20
Q
factors affecting hypoglycemia -4
A
-overuse of SSi
-lack of dosage changes when dietary intake is changed
-overly vigorous treatment of hyperglycemia
-delayed meal after fast-acting insulin is used
21
Q
What is hyperglycemia?
A
high blood sugar; higher than 200 mg/dL
22
Q
when does hyperglycemia occur?
A
when there is not enough insulin working and too much glucose in the blood
23
Q
if hyperglycemia is untreated what can happen?
A
Diabetic Ketoacidosis or hyperosmolar hyperglycemia syndrome
24
Q
What can hyperglycemia lead to? -2
A
-coma
-death
25
causes of hyperglycemia -7
* Illness, infection
* Corticosteroids
* Too much food
* Not enough diabetic medication (insulin, oral) * Inactivity
* Emotional, physical stress * Poor absorption of insulin
26
Physiological Consequences of Hyperglycemia -4
* Toxic, inflammatory states
* Angiopathy
* Peripheral Neuropathy
* Fluid, Electrolyte, and Acid-Base Imbalance
27
Treatments of hyperglycemia -5
-continued db medication
-check glucose frequently
-check urine for ketones
-drink lots of fluids
-exercise
28
four factors affecting hyperglycemia
-changes in treatment regimen
-medications
-IV dextrose
-Overly vigorous treatment of hypoglycemia
29
what is glycosylated hemoglobin?
hemoglobin that glucose is bound by
30
What is a normal A1C?
less than 5.7
31
what is a prediabetes A1C?
5.7-6.5
32
what is a prediabetes A1C?
5.7-6.5
33
what is a diabetes A1C?
6.5 and higher
34
when can a fasting plasma glucose level be tested for?
at least 8 hrs after the last meal is eaten
35
normal FPG
less than 100
36
prediabetes FPG
100-125
37
diabetes FPG
126 and higher
38
What is an oral glucose tolerance test?
a two-hour test that checks the blood sugar before and two hours after a glucose drink is consumed
39
what does the OGTT show?
how well your body processes sugar
40
what is a normal OGTT
less than 140
41
what is a prediabetes OGTT
140-199
42
what is a diabetes OGTT
200 or higher
43
what kind of disease is type one diabetes
an autoimmune disease
44
what does type one diabetes result from?
beta cell destruction in the pancreas
45
_________ present for months to years before _________ symptoms
Autoantibodies, clinical
46
what does type one diabetes lead to?
Absolute insulin deficiency
47
what are three risk factors of type one diabetes?
-autoimmune
-viral
-medically induced
48
3 "p's" of type one diabetes
-polyuria
-polydipsia
-polyphagia
49
how do you diagnose type one diabetes? -4
-HA1C
-FPG
-OGTT
-random blood glucose plus symptoms of diabetes
50
what are some treatments of type one diabetes? -4
-administration of insulin
-tight glycemic control
-dietary modifications
-active lifestyle
51
What is type two diabetes caused by
insulin resistance or deficiency more common in adults
52
what kind of disease is type two diabetes?
progressive disease
53
what are three causes of type two diabetes?
-insulin resistance or deficiency
-pre-diabetes
-metabolic syndrome
54
what are some modifiable risk factors for type two diabetes? -5
-obese/fat distribution
-physical inactivity
-poor diet
-hypertension/high cholesterol
-smoking/alcohol
55
what are some non-modifiable risk factors of type two diabetes? -6
-family history
-race/ethnic background
-age
-pre-diabetic
-PCOS
-chronic glucorticoid
56
how can you diagnose type two diabetes? -4
-HA1C
-OGTT
-FPG
-random glucose checks with symptoms of diabetes
57
four treatments of type two diabetes
-insulin medications
-lifestyle changes
-tight glycemia control
-increase activity levels
58
three short-term complications of diabetes
-hypoglycemia
-hyperglycemia
-ketoacidosis
59
what are three microvascular long term complications
-retinopathy
-neuropathy
-nephropathy
60
what are three macrovascular long term complications
-cerebrovascular
-cardiovascular
-peripheral vascular
61
what are three other long term complications
-foot ulcerations
-amputations
-sexual disfunction
62
when and how is diabetic foot care done?
daily with mild soap and warm water, pat feet dry, moisturize but not in between toes
63
how should cuts be cared for on a diabetic patient's feet?
clean with warm water and mild soap, cover with a clean dressing
64
how should diabetics cut their toenails
evenly with round edges
65
five ways to prevent complications in diabetic patients
-pt education
-assess barriers to learning
-promote self-care
-teach in increments
-adjust regimen to meet needs
66
seven barriers to keeping diabetic pt's healthy
-degree of life changes and complexity of management plan
-cost of care
-access to medical treatment
-cultural factors
-lack of family support
-lack of knowledge
-fears
67
seven ways to increase adherence in diabetic patients
-encourage pt and family to take care of their health
-simplify regimen
-focus on the normal, not the differences
-teach the tools
-help the pt get supplies
-provide safe harbor
-provide adequate education
68
five points of nutrition therapy
-maintain blood glucose levels
-lipid profiles and BP levels
-prevent/slow the rate of chronic complications
-nutritional, personal,cultural and economic needs
-maintain the pleasure of eating
69
what are the three type one guidelines
-meal planning
-day-to-day consistency
-more flexible with rapid-acting insulin
70
what are the two type two guidelines
-emphasis on achieving glucose, lipid, and BP goals
-weight loss
71
Foods with a _____ _______ _______ raise glucose levels faster and higher than foods with a _____ __________ _______
high glycemic index, low glycemic index
72
what are three things to know about sugar-free foods
-does not mean carbohydrate-free
-often have higher saturated fat compared to the regular products
-important to look at food labels
73
what are three things to know about sugar alcohols
-found on most sugar-free foods
-include sorbitol, mannitol, xylitol, and isomalt
-eaten in large quantities can cause abdominal issues
74
when should diabetics check their blood sugar?
before meals and two hours after a meal
75
fixed insulin regimen
consistency
76
rapid-acting insulin
flexibility
77
what are a few things to keep into consideration when drinking alcohol as a diabetic -4
-limit to a moderate amount
-inhibits gluconeogenesis
-monitor blood glucose
-high in calories
78
what does the S stand for in S-I-C-K
sugar; check your blood sugar every 2-3 hrs or as necessary
79
what does the I stand for in S-I-C-K
insulin; always take your insulin
80
what does the C stand for in S-I-C-K
Carbs; drink lots of fluids
81
what does the K stand for in S-I-C-K
Ketones; check urine or blood for ketones every four hrs
82
What does exogenous insulin do?
restores the ability of cells to use glucose as an energy source, correcting hyperglycemia and many metabolic imbalances, by lowering plasma potassium levels
83
human insulin is-
identical to the insulin produced by the pancreas
84
human insulin analogs are-
modified forms of human insulin
85
If your diabetes is caused by a medication, what will happen when you stop taking that medication?
your diabetes will most likely go away
86
what does the exocrine function do in the pancreas?
produces enzymes for digestion
87
what function does creating insulin fall under in the pancreas?
endocrine
88
what is the islets of langerhans call composed of -3
-alpha cells
-beta cells
-exocrine cells
89
how much insulin does the average adult make in a day?
40-50 units
90
what stores and produces glucose?
the liver
91
what do the counterregulatory hormones do?
all work together to maintain normal glucose when under stress
92
what are the 4 counterregulatory hormones?
-cortisol
-growth hormone
-epinephrine
-glucogon
93
glycolysis definition
break down water and carbon dioxide to create energy
94
glycogenolysis definition
turns glycogen to glucose
95
glycogenolysis
produces glucose from non-carbohydrate source
96
what do the metabolic processes do?
produce glucose
97
what does "medically induced" risk factor in type one diabetes mean?
damage or removal of the pancreas
98
what does tight glycemic control mean?
a blood sugar of 80-130 before a meal and blood sugar of less than 180 two hours after meals
99
what does microvascular mean?
damage to small blood vessels
100
what does macrovascular mean?
damage to medium and large blood vessels
101
retinopathy definition
damage to the retina
102
nephropathy definition
damage to small blood vessels in the glomular space in the kidney
103
neuropathy definition
damage to feeling and or sensations
104
alcohol inhibits _______________
gluconeogenesis
105
what mimics physiological insulin secretion of a normal pancreas
basal-bolus insulin therapy
106
types of rapid-acting insulin
-aspart (Novolog)
-lispro (humalog
-glulisine (apidra)
107
types of short-acting insulin
regular insulin (humulin R, Novolin R)
108
type of intermediate-acting insulin
NPH (humulin, Novolin N)
109
long duration insulin types
-glargine (lantus)
-determir (Levemir)
110
what is important with rapid-acting insulin
must eat within 15 mins.
111
how do you administer U 100
only IV
112
how do you administer U 500
sub-q or IM, can not be given through IV
113
how does intermediate insulin look
cloudy suspension
114
which insulins can you mix
intermediate with short or rapid
115
when do you give long duration insulin
at the same time every day
116
how do you give long-duration insulin
sub-q
117
types of longer duration insulin
-glargine U-300 (toujeo)
-degludec (tresiba)
118
when and how do you give longer-duration insulin
injected once daily
