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Endo > Pancreas And Diabetes > Flashcards

Pancreas And Diabetes Flashcards

1
Q

Pancreas exocrine gland function

A

Releases amylase and lipase

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2
Q

Pancreas endocrine function

A

Secretes insulin and glucagon

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3
Q

Alpha cells secrete

A

Glucagon

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4
Q

Beta cells secrete

A

Insulin

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5
Q

Delta cells secrete

A

Somatostatin

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6
Q

Glucagon

A

Stimulates the liver to turn glycogen into glucose

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7
Q

Ketoacidosis s/sx

A

Fruity breath, kussmaul respirations, polyuria, polydipsia, nausea/ vomiting

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8
Q

In type 2 diabetes which tissues and cells become insulin resistant

A

Liver, muscle, adipose tissue

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9
Q

Pre-diabetic fasting glucose level

A

100-125

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10
Q

Diabetic fasting blood glucose level

A

Greater than 126

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11
Q

Oral glucose tolerance test

A

Used when diabetes is suspected but can’t be definitively diagnosed by fasting plasma glucose test

Oral glucose drink given at least 75 g of glucose then glucose levels tested two hours later

Glucose levels less than 140 non-diabetic
140 to 199 prediabetic
Greater than 200 diabetes is indicated

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12
Q

Hemoglobin A1C test results

A

6.5% or higher diabetic
5.7- 6.4% pre-diabetic
Below 5.7% normal

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13
Q

Individuals with prediabetes usually develop type two diabetes

A

Within 10 years

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14
Q

Gestational diabetes

A

Tested at 24 to 28 weeks

At risk: obese, advanced maternal age, family history

Resolves 6 weeks postpartum

At risk for developing DMII in 5 to 10 years

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15
Q

Diabetes preprandial glucose

A

80-130

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16
Q

Diabetes postprandial glucose

A

Less than 180

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17
Q

Diabetes nutritional therapy

A

Minimum 130g carbs per day, use glycemic index

Limit saturated fats to less than 7% of total calories

Protein should make up 15-20% of total calories

Alcohol in moderation (alcohol can cause blood sugar to rise but excessive alcohol can cause hypoglycemia)

Can’t just cover calories with insulin

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18
Q

Diabetes and exercise

A

Get 150 per week, resistance 3x

Lowers insulin resistance and BG, weight loss, lowers triglycerides and LDL, raises HDL, improve BP and circulation

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19
Q

Glucose lowering effect of exercise

A

Up to 48 hours after exercise

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20
Q

Diabetics should not exercise if

A

BG exceeds 300 and if ketones are present in urine

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21
Q

Non insulin oral agents work on

A

Three defects of DMII:

  1. Insulin resistance
  2. Decreased insulin production
  3. Increased hepatic glucose production
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22
Q

Drug used to decrease glucose production by the liver and increased glucose uptake by the muscles

A

Metformin (Glucophage, Fortamet)

Class biguanide

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23
Q

Metformin labs

A

BUN, Crt, eGFR

Don’t administer if giving contrast dye

24
Q

Drugs given to stimulate the pancreas to secrete insulin, and increased insulin receptor sensitivity on tissues

A

Class: sulfonylureas
Glipizide (Glucotrol)
Glimerpiride (Amaryl)
Glyburide (Micronase)

25
Q

Sulfonylureas education

A

Monitor for hypoglycemia

Avoid alcohol

26
Q

Meal time insulins

A

Rapid acting

Short acting

27
Q

Rapid-acting insulin

A 
Insulin Lispro (Humalog)
Insulin aspart (Novolog)
28
Q

Rapid acting insulin onset

A

5-20 minutes

29
Q

Rapid acting insulin peak

A

30 minutes to 3 hours

30
Q

Rapid acting insulin duration

A

2-5 hours

31
Q

Short acting insulin

A

Regular insulin (Novolin R) (Humulin R)

32
Q

Short acting insulin onset

A

30 minutes

33
Q

Short acting insulin peak

A

2-5 hours

34
Q

Short acting insulin duration

A

5-8 hours

35
Q

Basal insulins “daily control”

A

Intermediate acting, long acting

36
Q

Intermediate acting insulin

A

NPH insulin (Novolin N) (Humulin N)

37
Q

Intermediate acting insulin onset

A

1-2 hours

38
Q

Intermediate acting insulin peak

A

6-12 hours

39
Q

Intermediate acting insulin duration

A

18-26 hours

40
Q

Long-acting insulin

A

Insulin glargine (Lantus)

41
Q

Long acting insulin onset

A

1-2 hours

42
Q

Long acting insulin peak

A

No peak

43
Q

Long acting insulin duration

A

Up to 24 hours

44
Q

Somogyi effect

A

Rebound hyperglycemia caused from hypoglycemia at night. Often happens when patients take insulin before bed.

45
Q

Dawn phenomenon

A

Early morning hyperglycemia caused by release of counter regulatory hormones such as cortisol GH etc., No insulin to counteract

46
Q

Symptoms of hyperglycemia

A

Polyuria, polydipsia, polyphagia, glucosuria, nocturia, ketonuria, kta, blurred vision, fatigue, lethargy, headache, abdominal pain, eventual coma

47
Q

Hypoglycemia

A

BG less than 70

48
Q

Drugs that mask hypoglycemia symptoms

A

Beta blockers

49
Q

Hypoglycemic episode give

A

15-20g fast acting simple sugar: 4-6 oz juice or soda if conscious
If unconscious: sub q or IM glucagon, IV dextrose

When BG reaches 70 give complex carbs

50
Q

Chronic hyperglycemia macrovascular complications

A

Cardiovascular disease

Cerebrovascular disease

51
Q

Chronic hyperglycemia microvascular complications

A

Eye and vision complications (retinopathy)
Diabetic neuropathy (nerve dysfunction, foot complications)
Diabetic nephropathy
Male ED

52
Q

Diabetic nephropathy

A

Damage to small blood vessels that supply the glomeruli

Patients should be screened annually for albuminuria (or albumin creatinine ratio)

Can be placed on ace inhibitor to prevent

53
Q

Sensory neuropathy

A

Most common

Affects hands and feet

54
Q

Autonomic neuropathy

A

Damage to nerves that manage every day body functions:

BP, HR, sweating, bowel and bladder emptying and digestion

55
Q

Drug prescribed for neuropathic pain control that decreases transmission of pain impulses to the spinal cord and brain

A

Tricyclic antidepressant (amitriptyline)

56
Q

Drug prescribed for neuropathic pain control that decreases the release of neurotransmitters that transmit pain (glutamate)

A

Antiseizure meds (gabapentin)

57
Q

DMII and steroids

A

May require more insulin, corticosteroids increase glucose levels

Endo (2 decks)

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