T2-Basic Overview of Diabetes

Question 1

What does the pancreas do?

Answer 1

Secretes insulin that allows it to get into the muscle cells

Question 2

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

Answer 2

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

Question 3

What diabetes occurs in 5% of the population?

Answer 3

Type 1

Question 4

What diabetes occurs in 95% of the population?

Answer 4

Type 2

Question 5

What diabetes usually occurs during childhood or adolescence?

Answer 5

Type 1

Question 6

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

Answer 6

Type 1

Question 7

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

Answer 7

Type 2

Question 8

Does Type 1 have abrupt or gradual onset?

Answer 8

Abrupt

Question 9

Does Type 2 have abrupt or gradual onset?

Answer 9

Gradual

Question 10

What is the etiology of type 1?

Answer 10

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

Question 11

What is the etiology of type 2?

Answer 11

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

Question 12

What are the insulin levels for type 1?

Answer 12

Insulin is reduced early in the disease and COMPLETELY absent later

Question 13

What are the insulin levels for type 2?

Answer 13

Insulin levels may be low

Question 14

What diabetes do the blood glucose levels fluctuate widely?

Answer 14

Type 1

Question 15

What diabetes do the blood glucose levels remain more stable?

Answer 15

Type 2

Question 16

What type of diabetes requires mandatory insulin replacement treatment?

Answer 16

Type 1

Question 17

What insulin can you take oral anti diabetics with?

Answer 17

Type 2

Question 18

What are the symptoms of type 1?

Answer 18

Polyuria, polydipsia, polyphagia, weight LOSS

Question 19

What are the symptoms of type 2?

Answer 19

May be asymptotic initially

Question 20

Which diabetes can lead to HHNS?

Answer 20

Type 2

Question 21

What can type 1 diabetes lead to?

Answer 21

Diabetic ketoacidosis

Question 22

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

Answer 22

Tachycardia
Palpations
Sweating
Nervousness

Question 23

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

Answer 23

Headache
Confusion
Drowsiness
Fatigue

Question 24

What do beta blockers do in diabetics?

Answer 24

Mask hypoglycemia

Question 25

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

Answer 25

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!

Question 26

How do we confirm diabetes?

Answer 26

Patient must have positive results on 2 separate days

Question 27

What are the 3 lab tests used for testing diabetes?

Answer 27

Fasting plasma glucose Casual plasma glucose Hgb A1c

Question 28

Explain the Fasting Plasma Glucose test.

Answer 28

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

Question 29

Explain the Casual Plasma Glucose test.

Answer 29

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)

Question 30

Describe the Hemoglobin A1c test.

Answer 30

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

Question 31

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

Answer 31

Hgb A1c

Question 32

What are the 3 main symptoms of diabetes?

Answer 32

Polyuria, polydipsia, polyphagia

Question 33

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

Answer 33

6-7

Question 34

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

Answer 34

Rapidly

Question 35

How is gestational diabetes managed?

Answer 35

The same way as a regular diabetic who is pregnant

Question 36

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

Answer 36

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

Question 37

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

Answer 37

Yes, Metformin

Question 38

What are the 3 aspects to diabetes management?

Answer 38

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

Question 39

What is the central characteristic for both DKA and HHNS?

Answer 39

Hyperglycemia brought on by insulin deficiency

Question 40

DKA or HHNS: | Hyperglycemia, production of ketoacids, hemoconcentration, acidosis, coma

Answer 40

DKA

Question 41

DKA or HHNS: | Seen more with type 1 and pediatric patients

Answer 41

DKA

Question 42

DKA or HHNS: | Occurs more with type 2 patients

Answer 42

HHNS

Question 43

DKA or HHNS: | Urine smells like rotten apples, breath smells sweet or like acetone

Answer 43

DKA

Question 44

DKA or HHNS: | No ketoacids developed

Answer 44

HHNS

Question 45

DKA or HHNS: | Metabolic changes occur slowly

Answer 45

HHNS

Question 46

DKA or HHNS: | Changes begin one to two months before signs and symptoms become apparent

Answer 46

HHNS

Question 47

DKA or HHNS: | pH less than 7.3

Answer 47

DKA

Question 48

DKA or HHNS: | Blood thickens and becomes "sluggish"

Answer 48

HHNS

Question 49

What happens in HHNS?

Answer 49

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

Question 50

What happens if the HHNS is left untreated?

Answer 50

Coma, seizures, and death

Question 51

What is the treatment for both DKA and HHNS?

Answer 51

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

Question 52

Treatment for DKA and HHNS | What is done first?

Answer 52

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

Question 53

Treatment for DKA and HHNS: | How should glucose levels be reduced, quickly or slowly?

Answer 53

SLOWLY (50 mg/dL/hr)