Module 9: Diabetes Acute and Chronic Complications Flashcards
Hypoglycemia is an acute or chronic dangerous situation?
It’s dangerous for those taking insulin or insulin secretagogue meds.
acute
_______ is the primary preferred energy source for the brain and erythrocytes.
Glucose
If BG drops, our _______ nervous system will usually give us the 1st physical signs of _________.
- shakiness
- sweating
- palpitations
- anxiety
- hunger
autonomic, hypoglycemia
Neuroglycopenic symptoms related to insufficient glucose to the __________.
- slow performance
- difficulty concentrating
- confusion & disorientation
- slurred speech
- irrational behavior
- extreme fatigue
- seizures
- unconsciousness
brain
If blood glucose < 70 mg/dL and pt is responsive, use the Rule of ____
15
The “Rule of 15” is used if blood glucose is < 70 mg/dL.
Step 1?
Step 2?
Step 1: Ingest 15g simple CHO
Step 2: Recheck blood glucose in 15 mins, if blood glucose is still < 70 mg/dL ingest another 15 g simple CHO then recheck 15 mins later
If blood glucose is < 70mg/dL and pt is unresponsive or unable to swallow, administer ________ and recheck _____ mins later.
glucagon, 15
Hyperglycemia can lead to diabetic __________ (DKA) which is also life threatening. But it is primarily seen in those with Type _____ DM.
ketoacidosis, 1
DKA is when inadequate _________ results in the body switching to burning ________ acids and producing acidic __________ _______.
insulin, fatty, ketone bodies
- Acetone-smelling breath
- Vomiting
- Dehydration
- Deep gasping breathing
- Confusion
- Coma
Are symptoms of what?
DKA
T/F: DKA is reversible.
T
___________ hyperosmolar state (HHS) is an acute complication of Type _____ DM.
Hyperglycemic, 2
T/F: HHS is usually present in older pts with T2DM.
T
HHS is characterized by hyperglycemia, hyperosmolarity, and dehydration without significant ______________.
ketoacidosis
The Somogyi Effect and Dawn Phenomenon BOTH present as ______ blood glucose first thing in the _____________. But have different causes.
high, morning
This is AKA “Rebound hyperglycemia” where blood glucose is VERY LOW in the early a.m. (~2-3 a.m.) due to INSUFFICIENT CHO prior to bed or TOO HIGH insulin/meds. What is it?
Somoygi Effect
In the Somogyi Effect, in response to the drop in blood glucose, the body releases ___________ (i.e. glucagon, GH, cortisol & catecholamines) overnight to help reverse the low blood sugar level, and lead to the rebound __________, but the blood glucose levels may be __________ than normal in the morning.
hormones, hyperglycemia, higher
What’s the tx for Somogyi Effect?
Small increase in CHO intake in p.m. or decrease med dosage
This is where blood glucose is normal - slightly elevated at ~ 2-3 a.m., but present with elevated fasting blood glucose first thing in the morning. This is due to some naturally produced hormones (i.e. GH, cortisol & catecholamines) while sleeping. What is it???
Dawn Phenomenon
In the Dawn Phenomenon, the naturally produced hormones will sleeping stimulate ____________ and ____________, which cause blood glucose to rise even higher in persons w/inadequate ____________.
glycogenolysis, gluconeogenesis, insulin
What is the tx for the Dawn Phenomenon?
Decrease CHO intake in p.m. (DO NOT ELIMINATE), OR, increase meds in p.m.
T/F: Exercising later in the day may have more of a glucose-lower effect in the night.
T
Macrovascular diseases (i.e. atherosclerosis/CVD, MI, CVA) are _______-term complications of DM.
long
T/F: Somebody who has poorly controlled DM is at a low risk for CVD.
F - higher risk
Microvascular diseases are _______-term complications of DM.
long
__________ is a microvascular disease caused by damage to the nephrons in the kidney which may lead to kidney failure, resulting from chronically high blood ____________.
Nephropathy, glucose
T/F: DM and HTN are the leading causes of end stage renal disease.
T
Chronically high blood glucose can damage the _____________ in the eye and may lead to ______________.
capillaries, retinopathy
Retinopathy is a frequent cause of new cases of ________________ in the U.S.
blindness
Neuropathy is a _______-term complication of DM.
long
Peripheral neuropathy often leads to decreased __________. So a person may not feel ________ like normal.
sensation, pain
Impaired circulation + peripheral neuropathy + poorly controlled DM can lead to foot ______ or poor _________ healing.
ulcers, wound
Autonomic nerve dysfunction is a ______-term complication of DM.
long
_____________ + poor circulation can lead to impotence, bladder & sexual dysfunction, gastroparesis, postural hypotension (drop in BP when someone stand up), cardiac denervation, hypoglycemic unawareness
Neuropathy
_____________ is delayed gastric emptying in the absence of any type of mechanical obstruction.
Gastroparesis
T/F: Diabetic gastroparesis is very rare.
F - very common
If blood glucose falls below normal after eating, this would be __________ (reactive) hypoglycemia.
postprandial
Someone has hypoglycemia of non-diabetic origin if they’re not ______ but have frequent episodes of _______________.
diabetic, hypoglycemia
