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DH 2 > Part I Diabetes- Endocrine and Metabolic conditions > Flashcards

Part I Diabetes- Endocrine and Metabolic conditions Flashcards

1
Q

What is the endocrine system?

A
  • endorcine glands, hormones, cell changes
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2
Q

What does the endocrine system helps to regulate ?

A
  • Cellular metabolism
  • Growth and development of the body
  • Reproduction function
  • Blood sugar levels
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3
Q

What is diabetes mellitus ?

A
  • Group of metabolic diseases characterized by high blood glucose and the inability to produce and or use insulin
  • Affects all ages and genders
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4
Q

What does poorly controlled and untreated diabetes leads to?

A
  • vascular disease
  • Retinopathy- blindness
  • Nephropathy- Kidney ESRD (End Stage-Renal Disease)
    *Metabolic complication
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5
Q

How is diabetes mellitus relevance to dentistry?

A
  • Bidirectional relationship with oral heath
  • Diabetes weakens immune system
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6
Q

What occurs to the body when diabetes weakens immune system?

A
  • Hyperglycemia: increase blood glucose -> saliva and sugar-> Caries and Periodontal disease
  • Ketoacidosis-> lack insulin-> thirst, frequent urination, nausea, fruity breath, confusion
  • Vascular wall disease -> prevent blood from circulating -> decreased ability to fight infection and poor wound healing
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7
Q

What are the four types of Diabetes?

A
  • Type I
  • Type II
  • Gestational diabetes
  • Other specific types
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8
Q

What is Type I diabetes?

A
  • occurs in childhood or adolescence
  • insulin deficiency caused by destruction of pancreatic beta cells
  • Genetic condition and autoimmune mediated
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9
Q

What is Type II diabetes?

A
  • Adult onset
  • Insulin resistance and deficiency due to defects in insulin receptors
  • Obesity, unhealthy lifestyle and poor die care
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10
Q

What is Gestational diabetes ?

A
  • Abnormal glucose tolerance first appearing or detected during pregnancy
  • Obesity is a risk factors: causes increase size in baby and risk for miscarriage
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11
Q

Define other specific types of diabetes?

A

Comes from the defect in beta cell functiona nd other diseases and infections ( cancer,thyroid disease and inflammation)

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12
Q

What are the signs and symptoms of Type I?

A
  • Onset <40
  • Polydipsia: Thirst
  • Polyuria: Urination
  • Polyphagia: Hunger
  • Weight loss
  • Loss of strength
  • Malaise
  • Irritability
  • Drowsiness
  • Bed wetting
  • Blurred vision
  • Ketoacidosis, which presents as:
    Vomiting
    Abdominal pain
    Nausea
    Tachypnea
    Paralysis
    Loss of consciousness
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13
Q

What are the signs and symptoms of Type-II?

A
  • one set over the age of 40
  • Associated with obesity
  • Other symptoms like TYPE I
  • Blurred or decreased vision
  • Paresthesia (numbness and tingling)
  • Dry flushed skin
  • Loss of sensation
  • Impotence (frequent urination and erectile disfunction)
  • Vulvar pruritus
  • Postural hypotension
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14
Q

What is type 1 vs type 2?

A

Type 1:
* Cannot be prevented or cured
* The body does not create enough insuline
* Causes are unknown but genetics may play a role
* Requires insuin injections for life

Type 2:
* Can be prevented through lifestyle modification
* The body does not creare enough insuline or develops resistance
* Causes include genetics, aging inactivity, obesity and more
* Requires insulin as needed injected or oral

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15
Q

What are the similarities between type 1 and type 2?

A
  • Can cause other serious health problems and complications
  • Requires a healthy lifestyle and medical supervision
  • Symptoms include thirst, frequent urination and blurry vision
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16
Q

What is the previous name for type 1 diabetes?

A
  • Insulin-dependent diabetes mellitus (IDDM)
  • Juvenile Diabetes
  • Childhood diabetes
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17
Q

What is the pervious name for type II diabetes?

A
  • Non-insulin dependent
  • Adult oneset diabetes
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18
Q

What are the percentages when it comes to type I and type II diabetes?

A

Type I: 5-10%
Type II: 90%

19
Q

What are the different insullin production?

A

Type I: non or very little
Type II: too little or too ineffective

20
Q

What are the different age of diagnosis for diabetes?

A

Type I: ages 0-40
Type II: 40 plus

21
Q

What are the different treatment for Type I and Type II

A

Type I: healthy eating, increased physical activity, blood sugar checks, insulin injections

Type II: healthy eating, increased physical activity, blood sugar checks, insulin injections or oral medication (may be needed),

22
Q

Diabetes diagnosis is made based on?

A

Level of blood glucose upon random sampling, after fasting or after a glucose tolerance test

23
Q

Diabetes test uses the?

A

glycosylated hemoglobin- this shows a average level of control over 2-3 months

24
Q

When is testing for diabetes recommended?

A

Recommended based on age and risk facotrs for the disease.
Ages 45 or older should get tested every 3 years

25
Q

What is the goal of medical management for Type 1 ?

A
  • Goal is to mimic physiologic insulin secretion
26
Q

What is insulin shock?

A
  • not enough calories plus normal insulin dose= excess insulin
  • Hypoglycemia reffered to as insulin shock
27
Q

What are the symptoms of insulin shock?

A
  • Hunger
  • Weakness
  • Trembling
  • Tachycardia
  • Pallor
  • Sweating
  • Progession = incoherent, uncooperative, beligerent, lack judgement and disorientation
  • Severe stage= unconsciousness and possible tonic or clonic muscle movement, sweating, palllor, rapid pulse, hypotension and hypothermia
28
Q

What is the medical management for Type-II ?

A
  • Begins with lifestyle modifications- diet, weightloss, reduction in risk facotrs for CVD
  • Oral glucose lowering agents may be used alone or in conjunction with insulin therapy
  • As condition progress therapeutic needs change
29
Q

What is the goal of medical management for type II?

A

Manage gylcemic control, treat associated conditions and manage complications

30
Q

ON TEST

What are the Glucose lowering agents ?

A
  • Meltformin (biguanides)
  • Glipizide and Glyburide
  • Glinides
  • Victoza, Ozempic
  • Farxiga and Jardiance
31
Q

What is the Dental Management for Diabetes?

A
  • Evaluate for cardinal signs and symptoms
  • If no diagnosis and symptoms are present, dismiss and refere to MD
  • Well controlled patient, recieve treatment as indicated
  • suspect DM if patient presents with headache, dry mouth, irritability, repeated skin infections, blurred vision, parethesia, progessive periodontal disease, abscessess, loss of sensation (Dismiss and refer to MD for testing)
  • Diagnosed, fasting blood glucose level is 126 or more (dismiss and refer to MD)
32
Q

If a patient is insulin dependent, what follow up questions should you ask?

A

Ask how much they use and how often they inject themselves.

33
Q

When do you dismiss a patient?

A
  • current or previous complications
  • irregular monitoring
  • if they cannot provide latest blood glucose level and latest HbA1c levels
  • How often do they see physican if more than 6 months dismiss them
  • If Pt has not taken meds as prescribed do not treat
34
Q

What does Meltformin (biguanides) do?

A

Reduces glucose production in the LIVER and causes a slight increase in the bodys ability to use glucose for energy.

35
Q

What does Glipizide and Glyburide (Insulin Secretagogues/Sulfonylureas) do?

A

Stimulate insulin production by interacting woth a componenet of a BETA CELL, should be taken with meal

36
Q

What does Glinides do?

A

Work similary to sulfonylureas, but they work faster and for a shorter time

37
Q

What does Victoza, Ozempic (incretins) do?

A
  • Amplify the amount of insulin created when glucose is present
38
Q

What does Farxiga and Jardiance (co-transporter 2 inhibitors) do?

A

INHIBIT GLUCOSE REABSOPRTION, lowers renal threshold for glucose and increases glucose excreted in the urine

39
Q

What questions helps to prevent a medical emergency for patients with diabetes?

A
  • Have you eaten today
  • What time
  • What did you eat
  • Tell PT to know if they are experincing insulin reaction during appt.
40
Q

Why are these question asked?

A
  • If the patient took insulin or meds but did not eat, this puts then at risk for** hypoglycemia**
40
Q

What are some Dental management, when it comes to medications?

A
  • NSAIDS can enhance the effects of sulfonylureas
  • Insulin dependent/uncontrolled may require **antibiotic premedication **
  • Anesthesia: Epinephrine possibly raises blood glucose level- use with caution due to other conditions like CVD.
41
Q

What are some oral manifestation for patient who has poorly controlled diabetes?

A
  • Xerostomia
  • Infections ( viral, fungal and bacterial)
  • Poor wound healing
  • Increased caries
  • Gingivitis
  • Periodontal disease
  • Abscesses
  • Burning mouth
42
Q

Controlled oral health can help with diabetes true/false?

A

True

DH 2 (21 decks)

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