Week 1 Diabetes Mellitus

Question 1

Primary Effect Insulin

Answer 1

lower blood glucose levels by facilitating entry of glucose into peripheral tissues

Question 2

Glucagon primary effect

Answer 2

Increase blood glucose to maintain normal levels and prevent hypoglycemia

Question 3

Insulin stimulates

Answer 3

glucose uptake
conversion of glucose to glycogen
fatty acid and triglyceride production

Question 4

Insulin inhibition

Answer 4

glucose breakdown
protein & fat breakdown

Question 5

Glucagon stimulates

Answer 5

glycogen breakdown
glucose synthesis
fat breakdown
ketone production

Question 6

Glucagon inhibits

Answer 6

glycogen synthesis

Question 7

Type I DM

Answer 7

Progressive destruction of insulin secretion (young age)

Question 8

Type II DM

Answer 8

Decreased sensitivity to circulating insulin (adult onset)

Question 9

Diabetes S&S

Answer 9

Polyuria
Polydipsia
Fatigue
Blurred vision
Weight loss

Question 10

Random blood glucose test

Answer 10

less than 200mg/dL

Question 11

Fasting blood glucose test

Answer 11

126mg/dL

Question 12

Hemoglobin A1C

Answer 12

4-6%

Question 13

there are various types

Answer 13

they all have various time

Question 14

Dx for type II DM

Answer 14

often undx until organ damage present
Peripheral neuropathy or claudication often presenting s/s
50% have HTN
annual foot, eye exam

Question 15

Type I DM Dx

Answer 15

kidneys, pancreas
polyuria/polydipsia
Diabetic ketoacidosis

Question 16

DM life expectancy

Answer 16

life expectancy is 7 to 10 years shorter for those with poorly controlled DM

Question 17

DM acute complications

Answer 17

Diabetic ketoacidosis
Hyperglycemia
hypoglycemia

Question 18

Is diabetic ketoacidosis a medical emergency?

Answer 18

yes, more common in type I

Question 19

Hyperglycemia acute complications

Answer 19

> 300mg/dl blood glucose
glucose in urine
dehydration
more common in type II

Question 20

Hypoglycemia acute complications

Answer 20

<70mg/dl blood glucose
activation of ANS
due to too much insulin, exercise, inadequate food

Question 21

Hypoglycemia s&s

Answer 21

Rapid onset
Headache
Fatigue
Hunger
Tachycardia
Sweating
Anxiety
Confusion

Question 22

Hyperglycemia s&s

Answer 22

Increased thirst
Frequent urination
Dry mouth
Nausea & vomiting
Shortness of breath

Question 23

Hypoglycemia Observations

Answer 23

Rapid onset
Appears nervous irritable
Difficulty focusing
Pallor, sweating, Shaky
Increasing HR

Question 24

What can PT do

Answer 24

sit pt down and give some kind of simple carb

Question 25

What should a PT know before exercising a pt with DM

Answer 25

you should know there normal glucose levels

Question 26

Peripheral Vascular Disease s&s

Answer 26

skin changes on legs and feet (thinning, shiny, or paleness)= “trophic changes”
weak pedal pulses in feet
wounds or ulcers on the legs and feet that won’t heal
reduced hair growth on legs
toes that turn blue
severe burning pain in toes
leg cramps
muscles that feel numb or heavy
arms and legs that are reddish blue
toenails that are thick and opaque
gangrene—tissue death caused by lack of blood flow

Question 27

Autonomic Dysfunction s&s

Answer 27

Impaired sweating
G-U dysfunction
Orthostatic hypotension
Decreased max HR & BP
Increased resting BP
Digestion problems

Question 28

what happens with high blood glucose

Answer 28

pancreas will release insulin
liver produces glycogen while cells take up glucose from blood

Question 29

What happens with low blood glucose

Answer 29

pancreas release glucagon
liver break down glycogen