Test #2 Diabetes ARTICLES - Rude man

Question 1

What is diabetes mellitus?

Answer 1

a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin produced.

Question 2

Is insulin produced in the alpha or beta cells of the pancreas?

Answer 2

beta cells

Question 3

What percent of adults have type 1 diabetes?

Answer 3

< 10% (this is a disease that leads to the destruction of beta cells)

Question 4

There are two types of type 1 diabetes. What are they called?

Answer 4

rapidly progressive and slowly progressive. (rapid is common in children. slow usually occurs in adults and is sometimes referred to as latent autoimmune diabetes of the adult [LADA])

Question 5

What percentage of people who have diabetes, have type 2 diabetes?

Answer 5

90%

Question 6

In type 2 diabetes, do the beta cells produced insulin?

Answer 6

when the disease begins, yes. insulin is released into the blood stream but the body is unable to use the insulin effectively.

Question 7

What happens to insulin production when type 2 diabetes progresses?

Answer 7

insulin resistance leads to high blood glucose levels and the beta cells respond to these levels by producing more insulin in an effort to reduce the blood glucose level.

eventually, the beta cells become exhausted by the over-production of insulin and begin to fail.

the diabetes worsens as the ability of the pancreas to produce insulin is impaired.

Question 8

People with type 1 and type 2 diabetes have three common symptoms, known as the three P’s. What are the three P’s of diabetes?

Answer 8

Polyuria (increased urine output)

Polydipsia (increased thirst)

Polyphagia (increased appetite)

Question 9

In a 2010 study by Frisch, it was reported that peri-operative hyperglycemia not only increases length of stay in a hospital, but it is also associated with what other post-op complications? (5)

Answer 9

pneumonia

sepsis

UTIs

acute renal failure

acute myocardial infarction

Question 10

The body’s normal metabolic stress response results in the release of catabolic hormones, including epinephrine, norepinephrine, cortisol, glucagon, and growth hormone. What does this response do to the production of insulin?

Answer 10

it inhibits the secretion of insulin and also increases insulin resistance.

Question 11

Before an elective procedure, what glycated hemoglobin level (HbA1c) would you want to see to proceed?

Answer 11

< 8.5%

Question 12

What does the HbA1c tell you?

Answer 12

the average glucose concentration over the previous three months (normal: 4 - 5.7%)

Question 13

What is the insulin dose and timing on the day of surgery for someone taking insulin (lantus, levemir, insulatard, humulin I, insuman) once a day, in either the morning or evening?

Answer 13

they will take their usual dose at the regular time, but will need to check their blood glucose levels on admission as well as in the pre and post-operative period

Question 14

What is the insulin dose and timing on the day of surgery for someone taking two injections of mixed insulin per day (eg. novomix 30, humulin m3, humalog mix 25)?

Answer 14

they must halve their usual morning dose and take their usual insulin dose with their evening meal

Question 15

What is the insulin dose and timing on the day of surgery for someone taking a combination of long-acting peakless insulin once a day with short or rapid-acting insulin (basal or bolus regimen) with each meal?

Answer 15

they should continue taking long-acting insulin with no change in dose or timing, but omit short or rapid-acting insulin until they are able to eat again

Question 16

In regards to post-op pain, which medication has a reduced effect in the presence of hyperglycemia?

Answer 16

morphine

Question 17

How do you feel about this bee-tee?

Answer 17

I bet you like this bee-tee even more!