Test 4 Flashcards
What is type 1 diabetes?
Type 1 diabetes is an auto immune disorder that causes destruction of the B cells in the pancreas resulting in an absolute insulin deficiency. Patients require a lifelong insulin replacement therapy to maintain their metabolism.
What age range is type 1 diabetes more common in? What physical characteristics do type 1 diabetics exude ?
Type 1 diabetics are usually adolescents and children with only about 13% of diabetics being older adults. Type 1 diabetics typically appear as thin or normal weight individuals.
What is type 2 diabetes?
Type 2 diabetes is also known as adult onset diabetes (though it is beginning to be seen more in children as well) and is caused by the B cells being unable to produce enough insulin or the insulin receptors being unable to receive insulin.
What age range is type 2 diabetes seen in? What physical characteristics do type 2 diabetics exude?
Type 2 diabetes is typically found in adults. More recently, type 2 has been seen in children more due to childhood obesity. Many type 2 diabetics will have an excess of fat around the stomach area.
What environmental factor can cause the activation of type 1 diabetes?
Illness can activate type 1 diabetes in people which carry the genetic disposition.
What is DKA and what are the signs and symptoms? How is it treated?
DKA is also known as diabetic ketoacidosis. DKA is an event that results from an insulin deficiency that is indicative of type 1 diabetes. The combination of hyperglycemia, ketosis, and acidosis lead to dehydration. Symptoms include fruity smelling breath, abdominal pain, vomiting, poor skin turgor, tachycardia, and hypotension. Fluid resuscitation and insulin therapy are used to correct this state.
What is HHNS? How is HHNS treated?
HHNS is hyperosmolar hyperglycemic nonketotic syndrome. This is characterized by hyperglycemia, hyperosmolality, and dehydration WITHOUT acidosis. HHNS is more common in the elderly and presents with glucose levels greater than 600 mg/dL. The treatment is focused around correction of dehydration and lowering of blood glucose with insulin.
Hyperglycemia
Hyperglycemia results from insufficient insulin production or secretion, excessive counterregulatory hormone secretion, or from deficient hormone signaling, that as a result gives the body a high glucose level.
Hypoglycemia
Hypoglycemia is a state of low glucose levels and typically occurs as a result of insufficient nutritional intake, adverse reaction to medications, excessive exercise, and/or as a consequence of disease states.
How does angiopathy relate to diabetes?
People that have long-standing hyperglycemia are at risk of developing angiopathy (damage to blood vessels) due to the fact that high glucose levels impair adequate oxygenation to the tissues.
How does diabetes lead to peripheral neuropathy and what are some consequences.
Hyperglycemia is toxic to nerves, resulting in nerve damage and leading to peripheral neuropathy which can cause a burning sensation or numbness in lower extremities. After sensation has been lost in the feet, the risk for foot ulcers and foot lesions greatly increases.
What are normal blood glucose levels in the fasting state?
70-99 mg/dL
What are normal blood glucose levels in the 2-hour postprandial state?
100-140 mg/dL
What is a normal A1c level? What A1c level would be indicative of prediabetes? What A1c would a diabetic have?
A normal A1c level will be 5.6. A person with prediabetes would have an A1c level of 5.7 to 6.4. A diabetic would have an A1c level of 6.5 or above.
When should Metformin not be given to a patient?
Metformin should not be taken 24-48 hours before and surgical procedure or dye.
What is Gabapentin used to treat in diabetics?
Gabapentin is used to treat peripheral neuropathy in diabetics
What are specific side effects of Insulin?
Hypoglycemia, initial weight gain, anxiety or depression, rashes, bumps or swelling at injection sites.
What are signs and symptoms of hypoglycemia? What would the blood glucose be of a person with hypoglycemia?
Reduced cognition, tremors, diaphoresis, weakness, hunger, headache, irritability, and seizures. The BG of a person with hypoglycemia would be less than 70 mg/dL.
What are signs and symptoms of hyperglycemia? What would the blood glucose be of a person with hyperglycemia?
Polyuria, polydipsia, dehydration, fatigue, fruity odor to breath, kussmaul breathing, weight loss, hunger, and poor wound healing. A person that is hyperglycemic would have a BG of greater than 140 mg/dL.
What is GDM?
GDM is gestational diabetes mellitus which is a hyperglycemic condition associated with pregnancy. Placental hormones increase insulin resistance, especially as pregnancy progresses, and postprandial hyperglycemia is the common presentation. Risk factors include obesity, past history of GDM, age older than 25 years, and family history of type 2 diabetes.
What is cushing’s syndrome?
Cushing’s syndrome is a rare disorder resulting in excessive corticosteroid secretion leading to hyperglycemia.
What is PCOS?
PCOS is polycystic ovary syndrome which is the most common type of disorder in women of reproductive age. it is characterized by infrequent menses and signs of higher than normal androgen levels. Infertility is common due to lack or regular menses due to anovulation. Women with PCOS are very insulin resistant, and approximately 40% of women with PCOS are obese or overweight will have diabetes or prediabetes before the age of 40 years; therefore, diabetes prevention efforts in these women are crucial.
What are some optimal 15 gram carbohydrates for treatment of hypoglycemia?
1/2 cup regular soda or juice 1 cup of milk 1/2 ampule of dextrose 50% (D50) 1 mg of glucagon 3-4 glucose tablets 1 tablespoon honey 4-6 pieces hard candy 15 jelly beans
What is euglycemia?
Euglycemia is when the blood sugar of an individual is at normal levels.
What is a risk factor for infants after birth?
Infants have a risk for hypoglycemia after birth if they are large or small for gestational age as well as if they are premature. Neonatal hypoglycemia is also more prevalent in infants whos mother had diabetes during pregnancy. This is caused by the infant producing insulin in response to high glucose levels in the womb.
What types of medications can effect glucose regulation?
Insulin Oral hypoglycemic agents Corticosteroids Estrogen ACE inhibitors Beta blockers Potassium-depleting diuretics Bronchodilators Antipsychotics Many antibiotics
