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Melissa's Pharm 2 > T2-Basic Overview of Diabetes > Flashcards

T2-Basic Overview of Diabetes Flashcards

1
Q

What does the pancreas do?

A

Secretes insulin that allows it to get into the muscle cells

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2
Q

What happens if there is too much sugar in the blood?

A

Causes a person to be more prone to infections and the blood is thick and syrupy which can cause problems with flow

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3
Q

What diabetes occurs in 5% of the population?

A

Type 1

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4
Q

What diabetes occurs in 95% of the population?

A

Type 2

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5
Q

What diabetes usually occurs during childhood or adolescence?

A

Type 1

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6
Q

What type of diabetes has a family history that is usually negative?

A

Type 1

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7
Q

What type of diabetes has an age of onset that is usually over 40 years old?

A

Type 2

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8
Q

Does Type 1 have abrupt or gradual onset?

A

Abrupt

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9
Q

Does Type 2 have abrupt or gradual onset?

A

Gradual

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10
Q

What is the etiology of type 1?

A

Pancreatic beat cell destruction due to autoimmune disease (the patients immune system inappropriately wages war against its own beta cells)

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11
Q

What is the etiology of type 2?

A

Unknown- but strong familial association, suggesting heredity is a risk factor

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12
Q

What are the insulin levels for type 1?

A

Insulin is reduced early in the disease and COMPLETELY absent later

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13
Q

What are the insulin levels for type 2?

A

Insulin levels may be low

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14
Q

What diabetes do the blood glucose levels fluctuate widely?

A

Type 1

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15
Q

What diabetes do the blood glucose levels remain more stable?

A

Type 2

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16
Q

What type of diabetes requires mandatory insulin replacement treatment?

A

Type 1

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17
Q

What insulin can you take oral anti diabetics with?

A

Type 2

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18
Q

What are the symptoms of type 1?

A

Polyuria, polydipsia, polyphagia, weight LOSS

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19
Q

What are the symptoms of type 2?

A

May be asymptotic initially

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20
Q

Which diabetes can lead to HHNS?

A

Type 2

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21
Q

What can type 1 diabetes lead to?

A

Diabetic ketoacidosis

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22
Q

What are the fight or flight responses (SNS activation) of hypoglycemia?

A

Tachycardia
Palpations
Sweating
Nervousness

23
Q

Hypoglycemia causes decreased levels of glucose to the CNS. What are the symptoms here?

A

Headache
Confusion
Drowsiness
Fatigue

24
Q

What do beta blockers do in diabetics?

A

Mask hypoglycemia

25
Q

What does it mean when we say beta blockers mask hypoglycemia?

A

BB block the adrenergic nervous system which has epi and norepi (fight or flight)..Must teach patients who are diabetic and taking a beta blocker that the need to look for signs of decreased glucose in the CNS (headache, drowsiness, confusion, fatigue), not the typical ones we would see with fight or flight response!

26
Q

How do we confirm diabetes?

A

Patient must have positive results on 2 separate days

27
Q

What are the 3 lab tests used for testing diabetes?

A

Fasting plasma glucose
Casual plasma glucose
Hgb A1c

28
Q

Explain the Fasting Plasma Glucose test.

A

Blood drawn at least 8 hours after a meal
A normal FPG is less than 100 mg/dL
If you have diabetes, your level is greater than 126 mg/dL

29
Q

Explain the Casual Plasma Glucose test.

A

This test can be drawn at ANY TIME, without regard to meals

  • If you are diabetic, the level will be greater than 200 mg/dL
  • To make a definitive diagnosis, the patient must have greater than 200 mg/dL levels PLUS show classic signs of diabetes (polyuria, polydipsia, polyphagia and rapid weight loss)
30
Q

Describe the Hemoglobin A1c test.

A
  • Reflects average blood glucose levels over the previous 2-3 months
  • Greater than 6.5% indicates diabetes
31
Q

What is the most reliable measure for assessing diabetes control over the preceding 3 month period?

A

Hgb A1c

32
Q

What are the 3 main symptoms of diabetes?

A

Polyuria, polydipsia, polyphagia

33
Q

If a patient is pregnant and has diabetes, how many times should they monitor their levels each day?

A

6-7

34
Q

If a women has gestational diabetes, how soon after birth does the diabetes subside?

A

Rapidly

35
Q

How is gestational diabetes managed?

A

The same way as a regular diabetic who is pregnant

36
Q

If you have type 2 diabetes in pregnancy, what is the best form of treatment?

A

INSULIN. Discontinue your oral med and switch to insulin. You can resume your oral med after delivery.

37
Q

Is there any oral drug that is acceptable to take for type 2 diabetes in pregnancy?

A

Yes, Metformin

38
Q

What are the 3 aspects to diabetes management?

A

Diet and physical activity (reduces diabetes by 60%)
Oral (non-insulin meds)
Insulin

39
Q

What is the central characteristic for both DKA and HHNS?

A

Hyperglycemia brought on by insulin deficiency

40
Q

DKA or HHNS:

Hyperglycemia, production of ketoacids, hemoconcentration, acidosis, coma

A

DKA

41
Q

DKA or HHNS:

Seen more with type 1 and pediatric patients

A

DKA

42
Q

DKA or HHNS:

Occurs more with type 2 patients

A

HHNS

43
Q

DKA or HHNS:

Urine smells like rotten apples, breath smells sweet or like acetone

A

DKA

44
Q

DKA or HHNS:

No ketoacids developed

A

HHNS

45
Q

DKA or HHNS:

Metabolic changes occur slowly

A

HHNS

46
Q

DKA or HHNS:

Changes begin one to two months before signs and symptoms become apparent

A

HHNS

47
Q

DKA or HHNS:

pH less than 7.3

A

DKA

48
Q

DKA or HHNS:

Blood thickens and becomes “sluggish”

A

HHNS

49
Q

What happens in HHNS?

A
  1. Large amount of glucose is excreted by the urine, as well as lots of water (because water follows sugar)
  2. That leads to dehydration and loss of blood volume
  3. That increases the blood concentration of electrolytes and non-electrolytes (glucose)
  4. Loss of blood volume increases hematocrit so blood thickens and becomes sluggish
50
Q

What happens if the HHNS is left untreated?

A

Coma, seizures, and death

51
Q

What is the treatment for both DKA and HHNS?

A

Correct hyperglycemia (and acidosis for DKA), replace lost water and sodium, and normalize potassium balance

52
Q

Treatment for DKA and HHNS

What is done first?

A

Begin treatment with IV fluids and electrolytes, followed asap with insulin

53
Q

Treatment for DKA and HHNS:

How should glucose levels be reduced, quickly or slowly?

A

SLOWLY (50 mg/dL/hr)

Melissa's Pharm 2 (32 decks)

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