Week 10: Chp 44: Coordinating Care for the Patient with Diabetes Mellitus

Question 1

Circulating fasting blood glucose level range

Answer 1

65-99 mg/dL

Question 2

Two hormones primarily responsible for the homeostasis of blood glucose control is?

Answer 2

• insulin

- glucagon

Question 3

Where is insulin and glucagon located

Answer 3

the pancreas

Question 4

Where is insulin released from?

Answer 4

released from the beta cells of the pancreas

Question 5

Where is glucagon released from?

Answer 5

alpha cells of the pancreas

Question 6

The normal Process of Blood Glucose Control

Answer 6

1. glucose arrives in the blood stream
2. once in the bloodstream, the glucose is transported to target cells
3. in response to increased blood glucose levels, insulin is released from the pancreatic beta cells
4. at the target cells, insulin facilitates the transport of glucose across the cell membrane to the cell’s interior; insulin is the key to the cell, allowing glucose to cross the cell membrane to be metabolized
5. inside the cell, glucose is metabolized as fuel, releasing the energy necessary for normal cellular functioning
6. if blood glucose levels are too high, more insulin is secreted by the pancreas
7. When blood glucose is driven into the cells and metabolized, glucose levels fall in the blood as a result
8. If blood glucose levels fall too low, insulin release is suppressed, and glucose remains in the bloodstream instead of being driven into the cells
9. in addition, in response to falling blood glucose levels, the hormone glucagon is released from the pancreatic alpha cells. Glucagon stimulates the production and release of glucose from glycogen stores in the liver so that blood glucose levels rise to normal

Question 7

What happens if blood glucose levels fall to low?

Answer 7

insulin release is suppressed, and glucose remains in the bloodstream instead of being driven into the cells
-glucagon is then released to increase blood glucose

Question 8

What does Insulin do when blood glucose levels are high

Answer 8

more insulin is secreted by the pancreas, so it can transport the glucose to target cells for glucose to be metabolized as fuel

Question 9

What is the hallmark of diabetes mellitus?

Answer 9

hyperglycemia (blood glucose levels rise above normal)

Question 10

What happens when there is a disruption in the production of insulin (insulin deficiency) or when there are defects in the effective action of insulin at the cell membrane (insulin resistance)?

Answer 10

glucose cannot effectively cross cell membranes to enter the cell
-instead, glucose remains in the bloodstream, and blood glucose levels rise above normal (hyperglycemia)

Question 11

What is diabetes mellitus (DM)?

Answer 11

group of disorders characterized by elevated blood glucose levels and results from defects in insulin production, insulin action, or both

Question 12

Forms of Diabetes

Answer 12

• Type 1 Diabetes
• Type 2 Diabetes
• Gestational Diabetes

Question 13

Gestational Diabetes

Answer 13

defined as any degree of glucose intolerance with onset during pregnancy

• if the mothers blood glucose level is elevated above recommended targets, there is a risk of adverse outcomes to the mother, fetus, and infant
• women with a history of gestational diabetes have greatly increased the risk of developing type 2 diabetes

Question 14

Glucose Homeostasis

Answer 14

changes in blood glucose levels are regulated by insulin and glucagon release from the pancreas

• With increased blood glucose, insulin is released
• As blood glucose levels fall, glucagon is released to increase blood sugar

Question 15

Why is insulin Considered the key to the cell?

Answer 15

insulin facilitates transport of glucose across the cell membrane to the cells interior to be metabolized
(think of insulin as the key to open the cells door)

Question 16

why is glucagon important when blood glucose levels are low?

Answer 16

glucagon when released, initiates the liver to break down the stored glucose (glycogen) and releases it into the blood stream

Question 17

Diabetes Laboratory Testing: Values indicating DM

Answer 17

• Fasting blood glucose: > 126 mg/dL
• 2-hr post prandial (oral glucose tolerance test): > 200 mg/dL
• Random blood glucose level: > 200 mg/dL
• Hemoglobin A1c: > 6.5%