Module 9: Diabetes Acute and Chronic Complications

Question 1

Hypoglycemia is an acute or chronic dangerous situation?

It’s dangerous for those taking insulin or insulin secretagogue meds.

Answer 1

acute

Question 2

_______ is the primary preferred energy source for the brain and erythrocytes.

Answer 2

Glucose

Question 3

If BG drops, our _______ nervous system will usually give us the 1st physical signs of _________.

• shakiness
• sweating
• palpitations
• anxiety
• hunger

Answer 3

autonomic, hypoglycemia

Question 4

Neuroglycopenic symptoms related to insufficient glucose to the __________.

• slow performance
• difficulty concentrating
• confusion & disorientation
• slurred speech
• irrational behavior
• extreme fatigue
• seizures
• unconsciousness

Answer 4

brain

Question 5

If blood glucose < 70 mg/dL and pt is responsive, use the Rule of ____

Answer 5

15

Question 6

The “Rule of 15” is used if blood glucose is < 70 mg/dL.

Step 1?
Step 2?

Answer 6

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

Question 7

If blood glucose is < 70mg/dL and pt is unresponsive or unable to swallow, administer ________ and recheck _____ mins later.

Answer 7

glucagon, 15

Question 8

Hyperglycemia can lead to diabetic __________ (DKA) which is also life threatening. But it is primarily seen in those with Type _____ DM.

Answer 8

ketoacidosis, 1

Question 9

DKA is when inadequate _________ results in the body switching to burning ________ acids and producing acidic __________ _______.

Answer 9

insulin, fatty, ketone bodies

Question 10

• Acetone-smelling breath
• Vomiting
• Dehydration
• Deep gasping breathing
• Confusion
• Coma

Are symptoms of what?

Answer 10

DKA

Question 11

T/F: DKA is reversible.

Answer 11

T

Question 12

___________ hyperosmolar state (HHS) is an acute complication of Type _____ DM.

Answer 12

Hyperglycemic, 2

Question 13

T/F: HHS is usually present in older pts with T2DM.

Answer 13

T

Question 14

HHS is characterized by hyperglycemia, hyperosmolarity, and dehydration without significant ______________.

Answer 14

ketoacidosis

Question 15

The Somogyi Effect and Dawn Phenomenon BOTH present as ______ blood glucose first thing in the _____________. But have different causes.

Answer 15

high, morning

Question 16

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?

Answer 16

Somoygi Effect

Question 17

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.

Answer 17

hormones, hyperglycemia, higher

Question 18

What’s the tx for Somogyi Effect?

Answer 18

Small increase in CHO intake in p.m. or decrease med dosage

Question 19

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???

Answer 19

Dawn Phenomenon

Question 20

In the Dawn Phenomenon, the naturally produced hormones will sleeping stimulate ____________ and ____________, which cause blood glucose to rise even higher in persons w/inadequate ____________.

Answer 20

glycogenolysis, gluconeogenesis, insulin

Question 21

What is the tx for the Dawn Phenomenon?

Answer 21

Decrease CHO intake in p.m. (DO NOT ELIMINATE), OR, increase meds in p.m.

Question 22

T/F: Exercising later in the day may have more of a glucose-lower effect in the night.

Answer 22

T

Question 23

Macrovascular diseases (i.e. atherosclerosis/CVD, MI, CVA) are _______-term complications of DM.

Answer 23

long

Question 24

T/F: Somebody who has poorly controlled DM is at a low risk for CVD.

Answer 24

F - higher risk

Question 25

Microvascular diseases are _______-term complications of DM.

Answer 25

long

Question 26

__________ is a microvascular disease caused by damage to the nephrons in the kidney which may lead to kidney failure, resulting from chronically high blood ____________.

Answer 26

Nephropathy, glucose

Question 27

T/F: DM and HTN are the leading causes of end stage renal disease.

Answer 27

T

Question 28

Chronically high blood glucose can damage the _____________ in the eye and may lead to ______________.

Answer 28

capillaries, retinopathy

Question 29

Retinopathy is a frequent cause of new cases of ________________ in the U.S.

Answer 29

blindness

Question 30

Neuropathy is a _______-term complication of DM.

Answer 30

long

Question 31

Peripheral neuropathy often leads to decreased __________. So a person may not feel ________ like normal.

Answer 31

sensation, pain

Question 32

Impaired circulation + peripheral neuropathy + poorly controlled DM can lead to foot ______ or poor _________ healing.

Answer 32

ulcers, wound

Question 33

Autonomic nerve dysfunction is a ______-term complication of DM.

Answer 33

long

Question 34

_____________ + poor circulation can lead to impotence, bladder & sexual dysfunction, gastroparesis, postural hypotension (drop in BP when someone stand up), cardiac denervation, hypoglycemic unawareness

Answer 34

Neuropathy

Question 35

_____________ is delayed gastric emptying in the absence of any type of mechanical obstruction.

Answer 35

Gastroparesis

Question 36

T/F: Diabetic gastroparesis is very rare.

Answer 36

F - very common

Question 37

If blood glucose falls below normal after eating, this would be __________ (reactive) hypoglycemia.

Answer 37

postprandial

Question 38

Someone has hypoglycemia of non-diabetic origin if they’re not ______ but have frequent episodes of _______________.

Answer 38

diabetic, hypoglycemia