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CSON IM2 > exam 4 (intro to diabetes) > Flashcards

exam 4 (intro to diabetes) Flashcards

1
Q

Diabetes is a –

A

chronic multi-system disease related to abnormal or impaired insulin utilization

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2
Q

what is diabetes characterized by?

A

Hyperglycemia resulting from lack of insulin or lack of insulins effect

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3
Q

What causative factors is diabetes a combination of? -3

A

-genetic/hereditary
-autoimmune
-lifestyle

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4
Q

What and where is insulin made of/in?

A

beta cells in the pancreas

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5
Q

what do liver and muscle cells store?

A

excess glucose as glycogen

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6
Q

what are two insulin dependent tissues?

A

skeletal muscle and apidose

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7
Q

Insulin is required to _________ receptor sites in cells.

A

unlock

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8
Q

what do receptor sites in cells allow for?

A

transport of glucose into cells to be used for energy

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9
Q

where is glucagon released from?

A

alpha cells of the pancreas

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10
Q

what are the three metabolic processes?

A

-glycolysis
-glycogenolysis
-gluconeogenesis

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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.

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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.

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13
Q

what is hypoglycemia?

A

low blood sugar; less than 70 mg/dL

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14
Q

when does hypoglycemia occur?

A

When there is too much insulin in proportion to the amount of available glucose

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15
Q

Production of what two things provides a defense against hypoglycemia?

A

-glucagon
-epinephrine

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16
Q

untreated hypoglycemia can progress to-

A

loss of consciousness, seizures, coma, or death

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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

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18
Q

three physiological consequences of hypoglycemia

A

-neurological symptoms
-hypoglycemia unawareness
-autonomic neuropathy

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19
Q

three treatments of hypoglycemia

A

-rule of 15
-IV dextrose
-glucagon IM or sub-q

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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

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21
Q

What is hyperglycemia?

A

high blood sugar; higher than 200 mg/dL

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22
Q

when does hyperglycemia occur?

A

when there is not enough insulin working and too much glucose in the blood

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23
Q

if hyperglycemia is untreated what can happen?

A

Diabetic Ketoacidosis or hyperosmolar hyperglycemia syndrome

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24
Q

What can hyperglycemia lead to? -2

A

-coma
-death

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25
Q

causes of hyperglycemia -7

A
  • Illness, infection
  • Corticosteroids
  • Too much food
  • Not enough diabetic medication (insulin, oral) * Inactivity
  • Emotional, physical stress * Poor absorption of insulin
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26
Q

Physiological Consequences of Hyperglycemia -4

A
  • Toxic, inflammatory states
  • Angiopathy
  • Peripheral Neuropathy
  • Fluid, Electrolyte, and Acid-Base Imbalance
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27
Q

Treatments of hyperglycemia -5

A

-continued db medication
-check glucose frequently
-check urine for ketones
-drink lots of fluids
-exercise

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28
Q

four factors affecting hyperglycemia

A

-changes in treatment regimen
-medications
-IV dextrose
-Overly vigorous treatment of hypoglycemia

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29
Q

what is glycosylated hemoglobin?

A

hemoglobin that glucose is bound by

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30
Q

What is a normal A1C?

A

less than 5.7

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31
Q

what is a prediabetes A1C?

A

5.7-6.5

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32
Q

what is a prediabetes A1C?

A

5.7-6.5

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33
Q

what is a diabetes A1C?

A

6.5 and higher

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34
Q

when can a fasting plasma glucose level be tested for?

A

at least 8 hrs after the last meal is eaten

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35
Q

normal FPG

A

less than 100

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36
Q

prediabetes FPG

A

100-125

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37
Q

diabetes FPG

A

126 and higher

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38
Q

What is an oral glucose tolerance test?

A

a two-hour test that checks the blood sugar before and two hours after a glucose drink is consumed

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39
Q

what does the OGTT show?

A

how well your body processes sugar

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40
Q

what is a normal OGTT

A

less than 140

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41
Q

what is a prediabetes OGTT

A

140-199

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42
Q

what is a diabetes OGTT

A

200 or higher

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43
Q

what kind of disease is type one diabetes

A

an autoimmune disease

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44
Q

what does type one diabetes result from?

A

beta cell destruction in the pancreas

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45
Q

_________ present for months to years before _________ symptoms

A

Autoantibodies, clinical

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46
Q

what does type one diabetes lead to?

A

Absolute insulin deficiency

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47
Q

what are three risk factors of type one diabetes?

A

-autoimmune
-viral
-medically induced

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48
Q

3 “p’s” of type one diabetes

A

-polyuria
-polydipsia
-polyphagia

49
Q

how do you diagnose type one diabetes? -4

A

-HA1C
-FPG
-OGTT
-random blood glucose plus symptoms of diabetes

50
Q

what are some treatments of type one diabetes? -4

A

-administration of insulin
-tight glycemic control
-dietary modifications
-active lifestyle

51
Q

What is type two diabetes caused by

A

insulin resistance or deficiency more common in adults

52
Q

what kind of disease is type two diabetes?

A

progressive disease

53
Q

what are three causes of type two diabetes?

A

-insulin resistance or deficiency
-pre-diabetes
-metabolic syndrome

54
Q

what are some modifiable risk factors for type two diabetes? -5

A

-obese/fat distribution
-physical inactivity
-poor diet
-hypertension/high cholesterol
-smoking/alcohol

55
Q

what are some non-modifiable risk factors of type two diabetes? -6

A

-family history
-race/ethnic background
-age
-pre-diabetic
-PCOS
-chronic glucorticoid

56
Q

how can you diagnose type two diabetes? -4

A

-HA1C
-OGTT
-FPG
-random glucose checks with symptoms of diabetes

57
Q

four treatments of type two diabetes

A

-insulin medications
-lifestyle changes
-tight glycemia control
-increase activity levels

58
Q

three short-term complications of diabetes

A

-hypoglycemia
-hyperglycemia
-ketoacidosis

59
Q

what are three microvascular long term complications

A

-retinopathy
-neuropathy
-nephropathy

60
Q

what are three macrovascular long term complications

A

-cerebrovascular
-cardiovascular
-peripheral vascular

61
Q

what are three other long term complications

A

-foot ulcerations
-amputations
-sexual disfunction

62
Q

when and how is diabetic foot care done?

A

daily with mild soap and warm water, pat feet dry, moisturize but not in between toes

63
Q

how should cuts be cared for on a diabetic patient’s feet?

A

clean with warm water and mild soap, cover with a clean dressing

64
Q

how should diabetics cut their toenails

A

evenly with round edges

65
Q

five ways to prevent complications in diabetic patients

A

-pt education
-assess barriers to learning
-promote self-care
-teach in increments
-adjust regimen to meet needs

66
Q

seven barriers to keeping diabetic pt’s healthy

A

-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
Q

seven ways to increase adherence in diabetic patients

A

-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
Q

five points of nutrition therapy

A

-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
Q

what are the three type one guidelines

A

-meal planning
-day-to-day consistency
-more flexible with rapid-acting insulin

70
Q

what are the two type two guidelines

A

-emphasis on achieving glucose, lipid, and BP goals
-weight loss

71
Q

Foods with a _____ _______ _______ raise glucose levels faster and higher than foods with a _____ __________ _______

A

high glycemic index, low glycemic index

72
Q

what are three things to know about sugar-free foods

A

-does not mean carbohydrate-free
-often have higher saturated fat compared to the regular products
-important to look at food labels

73
Q

what are three things to know about sugar alcohols

A

-found on most sugar-free foods
-include sorbitol, mannitol, xylitol, and isomalt
-eaten in large quantities can cause abdominal issues

74
Q

when should diabetics check their blood sugar?

A

before meals and two hours after a meal

75
Q

fixed insulin regimen

A

consistency

76
Q

rapid-acting insulin

A

flexibility

77
Q

what are a few things to keep into consideration when drinking alcohol as a diabetic -4

A

-limit to a moderate amount
-inhibits gluconeogenesis
-monitor blood glucose
-high in calories

78
Q

what does the S stand for in S-I-C-K

A

sugar; check your blood sugar every 2-3 hrs or as necessary

79
Q

what does the I stand for in S-I-C-K

A

insulin; always take your insulin

80
Q

what does the C stand for in S-I-C-K

A

Carbs; drink lots of fluids

81
Q

what does the K stand for in S-I-C-K

A

Ketones; check urine or blood for ketones every four hrs

82
Q

What does exogenous insulin do?

A

restores the ability of cells to use glucose as an energy source, correcting hyperglycemia and many metabolic imbalances, by lowering plasma potassium levels

83
Q

human insulin is-

A

identical to the insulin produced by the pancreas

84
Q

human insulin analogs are-

A

modified forms of human insulin

85
Q

If your diabetes is caused by a medication, what will happen when you stop taking that medication?

A

your diabetes will most likely go away

86
Q

what does the exocrine function do in the pancreas?

A

produces enzymes for digestion

87
Q

what function does creating insulin fall under in the pancreas?

A

endocrine

88
Q

what is the islets of langerhans call composed of -3

A

-alpha cells
-beta cells
-exocrine cells

89
Q

how much insulin does the average adult make in a day?

A

40-50 units

90
Q

what stores and produces glucose?

A

the liver

91
Q

what do the counterregulatory hormones do?

A

all work together to maintain normal glucose when under stress

92
Q

what are the 4 counterregulatory hormones?

A

-cortisol
-growth hormone
-epinephrine
-glucogon

93
Q

glycolysis definition

A

break down water and carbon dioxide to create energy

94
Q

glycogenolysis definition

A

turns glycogen to glucose

95
Q

glycogenolysis

A

produces glucose from non-carbohydrate source

96
Q

what do the metabolic processes do?

A

produce glucose

97
Q

what does “medically induced” risk factor in type one diabetes mean?

A

damage or removal of the pancreas

98
Q

what does tight glycemic control mean?

A

a blood sugar of 80-130 before a meal and blood sugar of less than 180 two hours after meals

99
Q

what does microvascular mean?

A

damage to small blood vessels

100
Q

what does macrovascular mean?

A

damage to medium and large blood vessels

101
Q

retinopathy definition

A

damage to the retina

102
Q

nephropathy definition

A

damage to small blood vessels in the glomular space in the kidney

103
Q

neuropathy definition

A

damage to feeling and or sensations

104
Q

alcohol inhibits _______________

A

gluconeogenesis

105
Q

what mimics physiological insulin secretion of a normal pancreas

A

basal-bolus insulin therapy

106
Q

types of rapid-acting insulin

A

-aspart (Novolog)
-lispro (humalog
-glulisine (apidra)

107
Q

types of short-acting insulin

A

regular insulin (humulin R, Novolin R)

108
Q

type of intermediate-acting insulin

A

NPH (humulin, Novolin N)

109
Q

long duration insulin types

A

-glargine (lantus)
-determir (Levemir)

110
Q

what is important with rapid-acting insulin

A

must eat within 15 mins.

111
Q

how do you administer U 100

A

only IV

112
Q

how do you administer U 500

A

sub-q or IM, can not be given through IV

113
Q

how does intermediate insulin look

A

cloudy suspension

114
Q

which insulins can you mix

A

intermediate with short or rapid

115
Q

when do you give long duration insulin

A

at the same time every day

116
Q

how do you give long-duration insulin

A

sub-q

117
Q

types of longer duration insulin

A

-glargine U-300 (toujeo)
-degludec (tresiba)

118
Q

when and how do you give longer-duration insulin

A

injected once daily

CSON IM2 (7 decks)

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