Patient Centered Care

Question 1

Diabetes mellitus:

Answer 1

is a chronic multisystem disease characterized by hyperglycemia related to abnormal insulin production, impaired insulin utilizations or both. (7th leading cause of death in the U.S)

Question 2

Long term complications of diabetes includes:

Answer 2

adult blindness, end stage renal disease, and non traumatic lower limb amputations. It is also a major contributor to heart disease and stroke.

Question 3

More than half of adults with diabetes have

Answer 3

hypertension(HIGH Blood pressure)and high cholesterol levels

Question 4

The current theory’s of the cause of diabetes includes:

Answer 4

genetic, autoimmune, and environmental factors(viruses/obesity)

Question 5

Insulin is a hormone produced by

Answer 5

the B-cells in the islets of Langerhans of the pancreas.

Question 6

Insulin lowers blood glucose and facilitates a stable, normal glucose range of approximately

Answer 6

70-110 mg/dL

Question 7

Which type of Diabetes Mellitus is more common in young people?

Answer 7

Type 1

Question 8

90-95% of Diabetes is

Answer 8

Type 2

Question 9

Often times in type 2 diabetes there are

Answer 9

no symptoms

Question 10

Symptoms of type 2 diabetes include:

Answer 10

fatigue, ***recurrent infections, polyuria, polydipsia, and polyphagia

Question 11

Symptoms of type 1 diabetes include:

Answer 11

fatigue, WEIGHT LOSS WITHOUT TRYING, polyuria, polydipsia, and polyphagia

Question 12

Type 1 produces

Answer 12

none or minimal insulin

Question 13

What type of DM has vascular and neurologic complications?

Answer 13

Type 1

Question 14

Which type of diabetes requires nutrition therapy?

Answer 14

BOTH type 1 and type 2

Question 15

Glucagon, epinephrin, growth hormone, and cortisol work to oppose the effects insulin and increase blood glucose levels, they do this by:

Answer 15

stimulating glucose production and release by the LIVER and by decreasing the movement of glucose into the cells.

Question 16

Type 1 diabetes is

Answer 16

an autoimmune disorder in which the body develops antigens against insulin and/or the beta cells of the pancreas

Question 17

Human leukocyte antigens(HLAs) make some people predisposed to

Answer 17

type 1 diabetes

Question 18

classic symptoms of type 1 include:

Answer 18

it is Rapid, there is usually impending or actual ketoacidosis, excessive thirst, frequent urination, and excessive hunger

Question 19

Risk factors for type 2 diabetes are:

Answer 19

being overweight or obese, being older

Question 20

endogenous insulin is:

Answer 20

self made (in the body)

Question 21

exogenous insulin is:

Answer 21

insulin from an outside source

Question 22

Sometimes with type 1 diabetes patients experience a

Answer 22

honey moon period, or remission..usually occurs for 3-12 months after treatment is initiated.

Question 23

Type 2 diabetes is more prevalent in:

Answer 23

African americans, Asians, Hispanics, Native Hawaiians, other pacific Islanders, and Native Americans

Question 24

Type 2 diabetes is

Answer 24

insulant resistance, where secretions diminish overtime

Question 25

Metabolic abnormalities have a role in type 2 diabetes:

Answer 25

a. there is insulin resistance, tissues do not respond to insulin because receptors are insufficient, or unresponsive or both b. marked decrease of the ability of the pancreas to produce insulin(B cells become fatigued or when B-cell mass is lost c. Inappropriate glucose production by the liver d. altered production of hormones and cytokines by adipose tissue(adipokines)

Question 26

five components of metabolic syndrome:

Answer 26

1. elevated glucose levels 2. abdominal obesity 3. elevated BP 4. high levels of triglycerides, 5. decreased levels of high density lipoproteins(HDLs(Good cholesterol)

Question 27

the average person has type 2 diabetes for

Answer 27

6 1/2 years before they are diagnosed because the signs of hyperglycemia don't develop until 50-80% of beta cells are no longer secreting insulin!

Question 28

A1C is

Answer 28

glycosylated hemoglobin(used to diagnose Diabetes) at 6.5 it is diagnosed at 6.5%)

Question 29

Patients can be diagnosed with pre diabetes by doing a

Answer 29

2 hour oral glucose tolerance test | Normal level is 140-199

Question 30

pre diabetes is defined as:

Answer 30

impaired glucose tolerance or impaired fasting glucose

Question 31

people with pre diabetes should be monitored for:

Answer 31

symptoms such as fatigue, frequent infections, and slow healing wounds

Question 32

Women at high risk for gestational diabetes are:

Answer 32

obese, have a family history of diabetes, and are of advanced maternal age

Question 33

Women experiencing gestational diabetes have a

Answer 33

63% chance of developing type 2 diabetes within 16 years.

Question 34

Medical conditions that cause abnormal blood glucose levels:

Answer 34

``` cushing syndrome hyperthyroidism recurrent pancreatitis cystic fibrosis hemochromatosis parenteral nutrition ```

Question 35

3 commonly used medications that can induce diabetes in some people;

Answer 35

contraceptives, corticosteroids, thiazides, and atypical antipsychotics

Question 36

Diabetes caused by medical conditions or medications can

Answer 36

resolve when the underlying condition is treated or the medication is discontinued

Question 37

The osmotic effect of glucose produces the manifestations of

Answer 37

polydipsia and polyuria

Question 38

Polyphagia is a consequence of

Answer 38

cellular malnourishment when insulin deficiency prevents utilization of glucose for energy.

Question 39

In diabetes, weight loss may occur because the body cannot

Answer 39

get glucose and turns to other energy sources such as fat and protein

Question 40

In Diabetes, weakness and fatigue may occur because

Answer 40

the cells lack needed energy from glucose

Question 41

You should be concerned about the possibility of type 2 diabetes when:

Answer 41

your patient talks to you about recent visual changes and her recurrent vaginal yeast infections

Question 42

To diagnose diabetes:

Answer 42

often the doctor will order a COMPREHENSIVE METABOLIC PANEL (CMP) and look to see if there is an elevated blood glucose level that will trigger them to do an A1C (6.5% or higher is diagnostic of diabetes)

Question 43

Aa A1C of 6.5% means that:

Answer 43

6.5% of the total hemoglobin has glucose attached to it

Question 44

2 diseases that could influence the results of the A1C are

Answer 44

anemia and sickle cell anemia | these diseases affect red blood cells

Question 45

A1C goal for a patient with diabetes is

Answer 45

less than 7%

Question 46

Diabetes is

Answer 46

a chronic disease that is expensive and often requires major lifestyle changes. Maintaining blood glucose levels near normal is the goal.

Question 47

Rapid acting insulins:

Answer 47

Humolog | Novolog

Question 48

Short acting:

Answer 48

Humulin R, Novolin R

Question 49

Intermediate Acting

Answer 49

NPH (Humulin N, Novolin N)

Question 50

Long acting

Answer 50

Lantus | Lvemir

Question 51

Rapid acting insulin:

Answer 51

Onset:10-30 mins Peak:30-3 hr. Duration:3-5

Question 52

short acting insulin:

Answer 52

onset: 30-1 hr peak: 2-5 hours duration: 5-8 hours

Question 53

intermediate acting:

Answer 53

onset: 1.5-4 hours Peak: 4-12 Duration:12-18

Question 54

Long acting:

Answer 54

onset: .8-4 peak: Less pronounced or none duration: 16-24

Question 55

Which type of insulin most closely mimics natural insulin secretion?

Answer 55

basal bolus regimen

Question 56

Insulin preparations are clear solutions except:

Answer 56

NPH and protamine-containing insulin which are cloudy

Question 57

long acting insulins have less risk of hypoglycemia because they have

Answer 57

no pronounced peak

Question 58

Side effects of somogyi effect are

Answer 58

headache in morning, sweating and nightmares throughout the evening

Question 59

to prevent somogyi effect you would

Answer 59

decrease insulin

Question 60

dawn phenomenon is

Answer 60

an early-morning (usually between 2 a.m. and 8 a.m.) increase in blood sugar (glucose) relevant to people with diabetes. It is different from chronic Somogyi rebound in that dawn phenomenon is not associated with nocturnal hypoglycemia.

Question 61

treatment for somogyi effect is you give

Answer 61

less insulin in the evening

Question 62

treatment for dawn phenomenon is

Answer 62

an increase in insulin or an adjustment in administration time

Question 63

Afrezza is not recommended

Answer 63

in patients with asthma and can cause cough, throat pain and irritation

Question 64

Metformin works

Answer 64

to reduce glucose production by the liver(contraindicated in someone with a liver issue like drinking)

Question 65

MEtformin if administered before use of contrast die could

Answer 65

cause acute kidney injury which can induce lactic acidosis

Question 66

Glucotrol (a sulfonylurea):

Answer 66

increases insulin production by the pancreas

Question 67

Avandia is an insulin sensitizer that

Answer 67

won't cause hypoglycemia, but may increase risk for heart attack