Short term complications of diabetes Flashcards
Question 1 of 7
Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box.
Dawn Phenomenon?
Growth hormone peaks in the evening Exogenous insulin is not primary cause Nocturnal hypoglycemia Normal to high blood glucose level between 2 and 4 a.m. Morning hypoglycemia Component of HHS
Growth hormone peaks in the evening
Exogenous insulin is not primary cause
Normal to high blood glucose level between 2 and 4 a.m.
In dawn phenomenon, peaking of growth hormone at night affects cell serum glucose. This results in morning hyperglycemia. Dawn phenomenon does not result in nocturnal hypoglycemia.
Question 2 of 7
Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box.
Somagyi Effect?
Morning hyperglycemia
Elevated blood glucose level between 2 and 4 a.m.
Nocturnal hypoglycemia
Increased risk with insulin therapy
Normal to high blood glucose levels between 2 and 4 a.m.
May result from nighttime peaking of insulin
Morning hyperglycemia
Nocturnal hypoglycemia
Increased risk with insulin therapy
May result from nighttime peaking of insulin
With the Somagyi effect, excessive insulin dosage or peaking of insulin at night causes hypoglycemia. The body activates several mechanisms to counteract the hypoglycemia (hepatic breakdown of glycogen, gluconeogenesis, and release of epinephrine, cortisol, and growth hormone). These mechanisms raise blood glucose, resulting in morning hyperglycemia.
Question 3 of 7
Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box.
Diabetic Ketoacidosis?
More common in type 1 than in type 2 diabetes Caused by a lack of insulin May result in “fruity” smelling breath Results from too much insulin Blood pH less than 7.3 Results from hypoglycemia Glucose available but body cannot use it Increased ketone formation
More common in type 1 than in type 2 diabetes Caused by a lack of insulin May result in “fruity” smelling breath Blood pH less than 7.3 Glucose available but body cannot use it Increased ketone formation
When someone with type 1 diabetes forgets to take insulin or does not take enough insulin, blood glucose rises. The body cannot use the glucose and perceives starvation and begins lipolysis, which leads to ketone formation.
As ketones accumulate in the blood, the blood becomes acidic, leading to clinical manifestations, including breath that smells fruity, Kussmaul respirations, signs of dehydration, and nausea and vomiting.
Question 4 of 7
Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box.
Hyperosmolar Hyperglycemia Syndrome?
More common in type 1 than in type 2 diabetes
Presence of insulin limits lipolysis and ketone formation
Elevated blood glucose greater than or equal to 600 mg/dL
Low risk for dehydration
Blood osmolarity greater than or equal to 320 mOsm/L
Extremely acidic pH (less than 7.2)
Infection is precipitating factor
Presence of insulin limits lipolysis and ketone formation
Elevated blood glucose greater than or equal to 600 mg/dL
Blood osmolarity greater than or equal to 320 mOsm/L
Infection is precipitating factor
HHS is a major short-term complication of type 2 diabetes. The body produces insulin, but the cells are resistant to insulin. Hyperglycemia results. At the same time, cells are not absorbing glucose and sense starvation. However, endogenous insulin counteracts lipolysis, limiting ketone formation. Additionally, elevated serum glucose results in increased osmotic pressure. Clinical manifestations include dehydration, tachycardia, confusion, polydipsia, polyuria, and hypotension. Precipitating factors include infection and noncompliance with diet or medication.
Question 5 of 7
Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box.
Hypoglycemia?
Only occurs in individuals with type 1 diabetes
May result from excess insulin
Inhibits the release of epinephrine and glucagon
Activates the sympathetic nervous system
Can occur in type 1 and type 2 diabetes
Treatments include glucose tablets and/or fruit juice
May result from excess insulin
Activates the sympathetic nervous system
Can occur in type 1 and type 2 diabetes
Treatments include glucose tablets and/or fruit juice
Hypoglycemia can occur in type 1 or type 2 diabetes. Factors such as too much insulin, poor timing of insulin, too little food intake, illness, physical activity and stressors can cause blood glucose levels to decline.
The body responds by releasing epinephrine, glucagon, and cortisol and activating the sympathetic nervous system. This response causes the signs and symptoms of hypoglycemia, such as sweating, dizziness, confusion, hunger, and heart palpitations. To manage hypoglycemia, some form of glucose is needed (e.g., glucose tablets, fruit juice, regular soft drink, hard candy).
Question 6 of 7
Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box.
Primary signs of diabetes mellitus Polyuria Blood glucose less than 70 mg/dL Polyphagia Polydipsia Hyperglycemia Reduced caloric intake
Polyuria
Polyphagia
Polydipsia
Hyperglycemia
The three polys—polyphagia, polydipsia, and polyuria—are common presenting signs of diabetes mellitus. Blood glucose less than 70 mg/dL is indicative of hypoglycemia. Diabetes mellitus is a condition of hyperglycemia.
Question 7 of 7
Can you differentiate the short-term complications of diabetes mellitus? For each complication, drag and drop the statements that apply to the complication to the box.
Treatment of short-term complications of diabetes mellitus
IV insulin treatment in both DKA and HHS
Candy or other high-sugar substances provided
Wait and see approach
Potassium supplementation in DKA treatment
Fluid replacement in both DKA and HS
IV mannitol solution for both DKA and HHS
IV insulin treatment in both DKA and HHS
Potassium supplementation in DKA treatment
Fluid replacement in both DKA and HS
In both DKA and HHS, blood glucose levels are highly elevated. IV insulin is given to reduce blood glucose. Fluid replacement is needed in both DKA and HHS. Both DKA and HHS are medical emergencies. Cellular dehydration is often present, so IV mannitol should not be given as this pulls water from the intracellular fluid. As DKA and HHS are hyperglycemic conditions, candy should not be provided.
Question 1 of 5
Which of the following are signs and symptoms of hypoglycemia? Select all that apply.
Sweating Heart palpitations Hunger Confusion Dizziness
Sweating Heart palpitations Hunger Confusion Dizziness
Question 2 of 5
The Somogyi effect results in morning __________________ following nocturnal _______________.
hypoglycemia, hypoglycemia
hyperglycemia, hyperglycemia
hypoglycemia, hyperglycemia
hyperglycemia, hypoglycemia
hyperglycemia, hypoglycemia
Question 3 of 5
Which of the following “poly’s” are related to hyperglycemia? Select all that apply.
polyuria polycythemia polymyalgia polydipsia polyphagia
polyuria
polydipsia
polyphagia
Question 4 of 5
A patient arrives with the diagnosis of diabetic ketoacidosis. Which of the following are associated with diabetic ketoacidosis? Select all that apply
More common in type 2 diabetes Fruity-smelling breath Elevated serum ketones Kussmaul’s respirations Decreased blood pH
Fruity-smelling breath
Elevated serum ketones
Kussmaul’s respirations
Decreased blood pH
Question 5 of 5
Which sign or symptom would you expect patients with hyperosmolar hyperglycemic syndrome to display?
Decreased serum osmolarity
Dehydration
Decreased urination
Extremely low blood glucose levels
Dehydration
