Type 1 & 2 Diabetes Flashcards

1
Q

What are some S&S of Hypoglycemia ?

A

BG< 70 mg/dL
- reduced cognition
- tremors
- diaphoresis
- weakness
- hunger
- HA
- irritability
- seizures

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2
Q

What are some S&S of Hyperglycemia ?

A

BG> 140 mg/dL
- polyuria
- polydipsia
- dehydration
- fatigue
- fruity odor to breath
- kussmaul breathing
- weight loss
- hunger
- poor wound healing

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3
Q

In Type 1 DM, why doesn’t their body produce insulin ?

A

destruction of beta cells caused by the autoimmune response
- beta cells produce insulin

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4
Q

What is stable glucose levels ?

A

70-140 mg/dL

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5
Q

When is insulin production at it’s lowest ?

A

at night
- because that’s when our body’s are at rest and we don’t eat

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6
Q

What does protein breakdown cause in the body ?

A

generates ketones which causes a drop in pH
- which causes metabolic acidosis
- body tries to get rid of some acidity via your mouth (causing fruity smell)

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7
Q

What A1C levels mean you are diabetic ?

A

greater then or equal to 6.5%
- A1C of < 5.7% normal

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8
Q

What are some macrovascular complications of DM ?

A
  • coronary arteries: MI
  • cerebral arteries: CVA (stroke)
  • peripheral vessels: PAD
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9
Q

What are some microvascular complications of DM ?

A
  • retinopathy: capillaries in eyes are damaged which causes blindness
  • neuropathy: bladder dysfunction, foot or leg amputation, poor wound healing
  • nephropathy: proteinuria, chronic renal failure
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10
Q

What is glucose goal for a Type 1 diabetic who is 13-19 yrs old ?

A

90-130

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11
Q

What is the glucose goal for a Type 1 diabetic who is 6-12 yrs old ?

A

90-180

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12
Q

What is the glucose goal for a Type 1 diabetic who is <6 yrs old ?

A

100-180

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13
Q

Why do we want the glucose levels of children to be higher ?

A

need fat and sugar for brain development

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14
Q

What are examples of Rapid-Acting Insulin ?

A
  • lispro (Humalog)
  • aspart (Novolog)
  • glulisine (apidra)
  • not for NPO or pt’s who are awake and alert (only if unconscious)
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15
Q

What are examples of Short-Acting insulin ?

A

Regular (Humulin R, Novolin R)
- only one that can be given IV

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16
Q

What are examples of Intermediate-Acting insulin ?

A

NPH (Humulin N, Novolin N)
- cloudy appearance

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17
Q

What are some examples of Long-Acting insulin ?

A
  • glargine (Lantus)
  • detemir (Levemir)
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18
Q

What is the onset, peak, and duration of Rapid-Acting insulin ?

A
  • onset: 15-30 mins
  • peak: 0.5-2.5 hrs
  • duration: 3-6 hrs
19
Q

What is the onset, peak, and duration of Short-Acting insulin ?

A
  • onset: 0.5-1 hr
  • peak: 1-5 hrs
  • duration: 6-10 hrs
20
Q

What is the onset, peak, and duration of Intermediate-Acting insulin ?

A
  • onset: 1-2 hrs
  • peak: 6-14 hrs
  • duration: 16-24 hrs
21
Q

What is the onset, peak, and duration of Long-Acting insulin ?

A
  • onset: 70 min
  • peak: none
  • duration: 18-24 hrs
22
Q

What is a Basal-Bolus regimen ?

A

closely mimics the body’s normal response and release of insulin
- basal is the maintenance insulin (intermediate or long-acting)
- bolus is what you give before eating to prepare for glucose release (rapid or short-acting)
- personalized to each pt

23
Q

Where do you get the fastest absorption of insulin ?

A

the abdomen
- then the arm, thigh, and buttock

24
Q

What happens if you insert insulin into a lump ?

A

lipodystrophy

25
What do insulin pumps do ?
deliver a basal rate of regular or rapid acting insulin - or program to deliver a bolus dose with each meal
26
What is the minimum total carbohydrate ?
130 g/day - 45-60 g/meals
27
How does exercise affect glucose levels ?
- always encourage exercise and never restrict - this enhances insulin absorption - it lowers glucose levels (eat a snack before exercising or exercise after a meal) - adjust insulin if needed - check glucose before, during and after activity
28
What is Somogyi Effect ?
hyperglycemia present upon waking - an overdose of insulin which causes hypoglycemic between 2-4 am - you go hypoglycemic at night and you body releases glucose and glucagon to correct it and causes you to wake up hyperglycemic
29
What is Dawn Phenomenon ?
hyperglycemia present upon waking - peaks in adolescence and young adulthood (maybe because of growth hormone) - growth hormone and cortisol is released at night and this causes your glucose to increase causing hyperglycemia
30
What are some S&S and Tx of Somogyi Effect ?
- S&S: HA, night sweats, nightmares - Tx: adjust insulin dose down or add bedtime snack
31
What is the Tx for Dawn Phenomenon ?
adjust timing of insulin or possible increase in insulin
32
How is the pancreas affected by Type 2 DM ?
- defective B-cell secretion of insulin - insulin resistance stimulates increased insulin secretion - eventual exhaustion of B-cell in many people
33
How is the liver affected by Type 2 DM ?
- excess glucose production - inappropriate regulation of glucose production
34
How is the Adipose Tissue affected by Type 2 DM ?
- decreased adiponectin and increased leptin - results in altered glucose and fat metabolism
35
How are the muscles affected by Type 2 DM ?
- defective insulin receptors - insulin resistance - decreased uptake of glucose by cells resulting in hyperglycemia
36
What A1C levels indicate someone with diabetes ?
> 6.5%
37
What A1C levels indicate someone who is pre-diabetic ?
5.7%-6.4%
38
What A1C levels indicate someone who is perfectly healthy ?
<5.6%
39
What determines the difference in someone who is Type 1 DM and Type 2 DM ?
islet cell autoantibodies - Type 1 DM is because of an autoimmune reason
40
How does Metformin/Biguanide affect the body ?
- reduces glucose production by liver - enhance insulin sensitivity at tissues - improve glucose transport into cells - can cause weight loss - beneficial against plasma lipids
41
How do Sulfonylureas affect the body ?
Glipizide and Glyburide - increases insulin production from pancreas (beta cells) - risk of hypoglycemia and weight gain
42
What does Meglitinides affect the body ?
increase insulin production from the pancreas
43
What does Thiazolidinediones affect the body ?
improve insulin sensitivity, so no hypoglycemia concerns - linked to cardiovascular problems, so rarely used
44
What is the difference between Ozempic and Wegovy ?
- Ozempic is a lower dose and was only studied in relation to control of glucose - Wegovy is a higher dose and was only studied in relation to weight loss