Question 1

Casual Plasma Glucose Test

Accepted Answer

For this test, blood can be drawn at any time, without regard to meals. Fasting is not required. Of note, the test can be performed in the office, using a finger-stick blood sample and the same type of test device employed by patients at home. A plasma glucose level that is 200 mg/dL or higher suggests diabetes. However, to make a definitive diagnosis, the patient must also display classic signs of diabetes: polyuria, polydipsia, and rapid weight loss. Ketonuria may also be present, but only if blood glucose is extremely high.

Question 2

Conventional insulin therapy

Accepted Answer

1 or 2 injections a day for Type 1 Diabetes

Question 3

C-Peptide (Connecting Peptide)

Accepted Answer

- -Is a peptide loop that runs from the A chain to the B chain. C-Peptide along with Proinsulin make up a precursor to Insulin. - -Measurement of plasma C-peptide levels offers a way to assess residual capacity for insulin synthesis. Since commercial insulin preparations lack C-peptide, and since endogenous C-peptide is only present as a by-product of insulin biosynthesis, the presence of C-peptide in the blood indicates the pancreas is still producing some insulin of its own.

Question 4

Diabetes Mellitus: Overview

Accepted Answer

-Disorder of carbohydrate metabolism >Deficiency of insulin >Resistance to action of insulin -Sustained hyperglycemia, polyuria, polydipsia, ketonuria, and weight loss

Question 5

Type 1 diabetes (T1DM)

Accepted Answer

>Often type 1 diabetes develops during childhood or adolescence, symptom onset is relatively abrupt >Primary defect is destruction of pancreatic beta cells due to autoimmune process

Question 6

Type 2 diabetes (T2DM)

Accepted Answer

>Most prevalent form of diabetes >Accounts for 90% to 95% of all cases of diabetes >Affects approximately 22 million Americans >Insulin resistance and impaired insulin secretion

Question 7

Gestational diabetes

Accepted Answer

>Appears in the mother during pregnancy and subsides rapidly after delivery >Managed in much the same manner as any other diabetic pregnancy

Question 8

Complications of Diabetes -Short Term

Accepted Answer

>Hyperglycemia >Ketoacidosis >Hypoglycemia

Question 9

Complications of Diabetes -Long Term Macrovascular vs Microvascular damage

Accepted Answer

``` -Macrovascular damage >Heart disease >Hypertension >Stroke >Hyperglycemia >Altered lipid metabolism ``` ``` -Microvascular damage >Retinopathy >Nephropathy >Sensory and motor neuropathy >Gastroparesis >Amputation secondary to infection (Glucose, Immune, Neuorpathy) >Erectile dysfunction ```

Question 10

Ways to Diagnose Diabetes

Accepted Answer

``` 1. Hemoglobin A1c Tests based on glucose: 2. Fasting plasma glucose (FPG) test 3. Casual plasma glucose test 4. Oral glucose tolerance test (OGTT) ```

Question 11

Prediabetes

Accepted Answer

>Impaired fasting plasma glucose between 100 mg/dL and 125 mg/dL >Impaired glucose tolerance test >Increased risk for developing type 2 diabetes >May reduce risk with diet changes and exercise and possibly with certain oral antidiabetic drugs

Question 12

Overview of Diabetes Treatment

Accepted Answer

>Primary goal is to prevent long-term complications >Tight control of blood glucose level is important >Controlling blood pressure and blood lipids also is important

Question 13

Treatment of Type 1 Diabetes

Accepted Answer

-Requires a comprehensive plan -Physical activity -Insulin replacement -Management of hypertension >An ACE inhibitor (for example, lisinopril) or an ARB (for example, losartan) can reduce the risk of diabetic nephropathy -Dyslipidemia >Statins (for example, atorvastatin)

Question 14

Treatment of Type 2 Diabetes

Accepted Answer

>Similar to type 1, requires comprehensive plan >Patient should be screened and treated for: -Hypertension, nephropathy, retinopathy, neuropathy, dyslipidemias >Glycemic control with: Modified diet and physical activity Drug therapY

Question 15

Tight Glycemic Control Important

Accepted Answer

``` TGC - levels within normal range around-the-clock Target goals: 1. A1C = <7.0% 2. Premeal plasma glucose = 70-130 mg/dL 3. Peak postmeal plasma glucos = <180 mg/dL -Beneficial for Young, Type-1 patients -Inappropriate for: >Long-standing type 2 diabetes >Advanced microvascular or macrovascular complications >Extensive comorbid conditions >History of severe hypoglycemia >Limited life expectancy ```

Question 16

Monitoring Treatment of Diabetes Klimeki said this won't be on the test but will probably see on NCLEX

Accepted Answer

-Self-monitoring of blood glucose (SMBG) >Common target values for blood glucose -70-130 mg/dL before meals -100-140 mg/dL at bedtime -Hemoglobin A1c >Also called glycosylated hemoglobin or glycated hemoglobin >Provides an index of average glucose levels over the prior 2 to 3 months >A1c goal of below 7% is good for most patients >Goal below 8% may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, or advanced microvascular or macrovascular complications

Question 17

Complication of Poor Glucose Control Diabetic Ketoacidosis

Accepted Answer

>Severe manifestation of insulin deficiency >Symptoms evolve quickly within hours or days >Most common complication in pediatric patients and leading cause of death >Characteristics: Hyperglycemia, Ketoacids, Hemoconcentration, Acidosis & Coma. >Treatment: Insulin, Bicarbonate, Fluids/Electrolytes.

Question 18

Fasting Plasma Glucose Test

Accepted Answer

To determine FPG levels, blood is drawn at least 8 hours after the last meal. In normoglycemic individuals, FPG levels are less than 100 mg/dL. If FPG glucose levels are 126 mg/dL or higher, diabetes is indicated.

Brainscape's Knowledge GenomeTM

Week 11 - Chapter 57 - Drugs for Diabetes Mellitus Flashcards

Brainscape's Knowledge Genome^TM