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168.262 > Week five > Flashcards

Week five Flashcards

1
Q

What is the age of onset for DM1?

A

Most common in younger people by can occur at any age

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2
Q

What is the age of onset for DM2?

A

More usually age 35 years or older but can occur at any age. Incidence is increasing in children

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3
Q

What is the type of onset for DM1?

A

Abrupt but disease process may present for several years

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4
Q

What is the type of onset for DM2?

A

Insidious, may go undiagnosed for years

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5
Q

What is the prevalence of DM1?

A

5-15%

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6
Q

What is the prevalence of DM2?

A

85-95%

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7
Q

What are environmental factors of DM1?

A

Virus, toxins

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8
Q

What are environmental factors of DM2?

A

Obesity, lack of exercise

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9
Q

What is the primary defect of DM1?

A

Absent or minimal insulin production

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10
Q

What is the primary defect of DM2?

A

Insulin resistance, decreased insulin production over time, alterations in production of adipokines

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11
Q

What are islet cell antibodies in DM1?

A

Often present at onset

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12
Q

What are islet cell antibodies in DM2?

A

Absent

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13
Q

What is endogenous insulins for DM1?

A

Absent

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14
Q

What is endogenous insulins for DM2?

A

Initially increased in response to insulin resistance. Secretion diminishes over time

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15
Q

What is the nutritional status of a DM1 patient?

A

Thin, normal or obese

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16
Q

What is the nutritional status of a DM2 patient?

A

Obese or normal

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17
Q

What are symptoms of DM1?

A

Thirst, polyuria, polyphagia, fatigue, weight loss

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18
Q

What are symptoms of DM2?

A

Frequently none, fatigue, recurrent infections

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19
Q

How does ketosis occur with DM1?

A

Prone at onset or during insulin deficiency

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20
Q

How does ketosis occur with DM1?

A

Resistant except during infection or stress

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21
Q

What therapy is needed for both forms of DM?

A

Nutritional therapy

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22
Q

Is insulin required for DM1?

A

Yes, for all individuals

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23
Q

Is insulin required for DM2?

A

Required for some. Disease is progressive and insulin treatment may need to be added to treatment regimen

24
Q

What complications are common for both forms of DM?

A

Vascular and neurological complications

25
Q

What is presentation of DM1?

A

Polyuria, polydipsia, weight loss, fatigue, ketosis, hyperglycaemia, nausea, vomiting, blurry vision

26
Q

What are risk factors of DM1?

A
  • Genetic susceptibility
  • Autoimmunity
  • Environmental (exposure to viruses and triggers in diet)
27
Q

What are risk factors for DM2?

A
  • Genetics
  • Obese
  • Decreased physical activity
  • High fat diet
  • Age
  • Ethnicity
  • Hypertension
  • History of gestational diabetes
28
Q

What are long term complications of diabetes?

A
  • Stroke
  • Hypertension
  • Dermopathy
  • Artherosclosis
  • Nephropathy
  • Peripheral neuropathy
  • Neurogenic bladder
  • Infections
  • Erectile dysfunction
  • Islet cell losee
  • Gastroparesis
  • Coronary artery disease
  • Retinopathy
29
Q

How does hypertension occur in diabetes?

A

Hypertension progresses along with nephropathy

30
Q

What is dermopathy?

A

Small brown lesions on skin

31
Q

What is nephropathy?

A

Damage to kidneys from hyperglycaemia

32
Q

What is peripheral neuropathy?

A

Loss of peripheral sensation due to damage to the axons of the neurons

33
Q

What is neurogenic bladder?

A

Retention of urine in the bladder caused by diabetic neuropathy

34
Q

Why are diabetic patient at increased risk of infections?

A

Impairment of immune system due to hyperglycaemia

35
Q

Why does erectile dysfunction occur with diabetic patients?

A

Due to microvascular disease, peripheral and autonomic neuropathy

36
Q

What does peripheral vascular disease do?

A

Due to narrowed blood vessels there is decreased perfusion, decreasing wound healing

37
Q

What is gastroparesis?

A

Delayed emptying of stomach due to impaired neural control. This occurs since hyperglycaemic damages the axons of nerve cells

38
Q

What is coronary artery disease?

A

Damage to blood vessels causing buildup of plaque due to macro vascular complications

39
Q

What is diabetic retinopathy?

A

Damage to blood vessels in the eye from microvascular changes from hyperglycaemic

40
Q

What drugs address insulin resistance by increasing cellular uptake of glucose and/or improving cellular insulin sensitivity?

A
  • Biguanides (Metformin)
  • Sulfonylureas (Glipizide)
  • Thiazolidinediones (Actos)
41
Q

What drugs increased insulin production by stimulating beta cells or mediating factors that prevent beta cell response to glucose levels

A
  • Sulfonylureas (Glipizide)
  • Didpeptidyl Peptidase-4 Inhibitors (Sitagliptin)
  • Glucagon-like peptide 1 receptor agonists (exentide)
42
Q

What drugs decrease hepatic glucose production?

A
  • Biguanides (Metformin)
  • Sulfonylureas (Glipizide)
  • Didpeptidyl Peptidase-4 Inhibitors (Sitagliptin)
  • Glucagon-like peptide 1 receptor agonists (exentide)
43
Q

What drugs reduce blood glucose levels by delaying carbohydrate digestion?

A
  • Alpha-Glucosidase Inhibitor (Acarbose)

- Glucagon-like peptide 1 receptor agonists (exentide)

44
Q

What is the route, onset, peak and duration of Rapid Acting Insulin?

A
  • Route - subcutaneous
  • Onset - 30 minutes
  • Peak - 1-3 hours
  • Duration - 8 hours
45
Q

What is an example of Rapid Acting Insulin?

A

Aspart

46
Q

What is the route, onset, peak and duration of Short Acting Insulin?

A
  • Route - subcutaneous
  • Onset - 10-20 minutes
  • Peak - 1-3 hours
  • Duration - 3-5 hours
47
Q

What is an example of Short Acting Insulin?

A

Lipsro

48
Q

What is the route, onset, peak and duration of Intermediate Acting Insulin?

A
  • Route - subcutaneous
  • Onset - 1-1.5 hours
  • Peak - 4-12 hours
  • Duration - 12-24 hours
49
Q

What is an example of Intermediate Acting Insulin?

A

Isophane

50
Q

What is the route, onset, peak and duration of Long Acting Insulin called Detemir?

A
  • Route - subcutaneous
  • Onset - 1-2 hours
  • Peak - 3-4 hours
  • Duration - up to 24 hours
51
Q

What is the route, onset, peak and duration of Long Acting Insulin called Glargine?

A
  • Route - subcutaneous
  • Onset - 1-1.5 hours
  • Peak - no peak
  • Duration - 24 plus hours
52
Q

What causes hypoglycaemia?

A
  • Not enough food
  • Not enough carbohydrates
  • Missing or delaying meal
  • Introducing exercise without adjusting insulin level
  • Taking too much insulin
  • Excessive alcohol without carbohydrates
53
Q

How to manage hypoglycaemia?

A

1) Consume quick acting carbohydrate
2) Retest glucose level after 10 minutes and consume more if below 4.0mmol/L
3) Consume more substantial carbohydrate

54
Q

How to monitor diabetes?

A
  • Blood draws (HbA1c and lipid profile
  • Self blood glucose monitoring
  • Urine testing for microalbuminuria
  • Diabetic foot exams
  • Self-management skills
  • Weight and BMI
  • Healthy eating plan
  • Diabetic retinopathy screening
55
Q

What are the functional health patterns of diabetics?

A
  • Activity and exercise
  • Coping
  • Sexuality-reproductive pattern
56
Q

What are interventions for diabetes?

A
  • Education on disease process
  • Exercise
  • Medications
  • Diet
  • Monitoring

168.262 (6 decks)

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