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Med Surg > 48 - Diabetes > Flashcards

48 - Diabetes Flashcards

(57 cards)

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1
Q

Norm blood glucose range

A

74-106 mh/dL

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2
Q

amount of insulin normally secreted daily

A

40-50 U
or
0.6 U/kg

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3
Q

____ + _____ STORE EXCESS GLUCOSE AS ______

A

liver + muscle cells stores glucose as GLYCOGEN

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4
Q

rise in plasma insulin after a meal causes

A
  • inhibition of gluconeogenesiis
  • enhances fat deposition
  • incr protein synth
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5
Q

fall in insulin level during normal overnight fasting causes

A
  • release of stored glucose fr liver

- release of protein fr muscle + fat

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6
Q

tissues that DO NOT directly depend on insuline for glucose transport but REQUIRE adequate glucose supply

A

brain, liver, blood cells

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7
Q

counterregulatory hormones effects

A

work AGAINST the effect of insulin;
incr blood gluc lvl by
-stim gluc production + release by liver
-decr mvmt of gluc into cells

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8
Q

counterregulatory hormones

A
  • glucagon
  • epinephrine
  • GH
  • cortisol
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9
Q

idiopathic diabetes

A

type 1 DM that is NOT autoimmune but genetic

-Rare

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10
Q

latent autoimmune diabetes in adults

[LADA]

A

slowly progressing autoimmune diabetes

-often mistaken for DM2

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11
Q

in DM1, patients require exogenous insulin or they will develop _____

A

DKA

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12
Q

in DM2, it is a combo of ___+___

A

inadequate insulin secretion + insulin resistance

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13
Q

presence of _____ is a major distinction bw type 1 + 2

A

endogenous insulin

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14
Q

insulin resistance

A

tissue DO NOT respond to action of insulin bc
1 receptors are unresponsive
2 insufficient number of receptors
3 both

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15
Q

in EARLY stages of insulin resistance, the pancreas responds to high bld.gluc by

A

producing greater amt of insulin

  • creates a temp state of hyperinsulin + hyperglycemia
  • pancreas can become fatigues fr overcompensation
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16
Q

metabolic syndrome 5 components

A 
1 incr gluc lvl
2 ab obesity
3 high BP
4 high triglycerides
5 decr lvl HDL
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17
Q

s/s of hyperglycemia occur when ____% of B cells are no longer secreting insulin

A

50-80%

-pt is usually diagnosed later bc onset is gradual, many ppl are diagnosed during routine lab testing

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18
Q

prediabetes

A
  • impaired gluc tolerance

- impaired fasting gluc

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19
Q

impaired gluc tolerance is diagnosed by

A

2 hr oral gluc tolerance test

140-199mg/dL = prediabetic

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20
Q

impaired fasting gluc is diagnosed by

A

fasting bld gluc levels

100-125mg/dL = prediabetic

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21
Q

person w prediabetes may not have s/s but ___ + ___ may already be occuring

A

long term damage to body especially heart + blood vessels may already be occuring

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22
Q

most women w gestational diabetes will have normal gluc levels w/in _____ postpartum

A

6 wks

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23
Q

conditions that may cause diabetes

Study These Flashcards
A 
1 Cushing syndrome
2 HYPERthyroidism
3 pancreatitis
4 cystic fibrosis
5 hemochromatosis
6 parenteral nutrition
24
Q

A1C diabetic level

25
fasting plasma gluc levels in diabetes
126mg/dL or greater | -no caloric intake for 8 hrs
26
2 hr plasma glucose level for diabetic range
200mg/dL or greater
27
random plasma gluc level for diabetic range
200mg/dL or greater w 3 Ps + unexplained wt loss
28
factors that can FALSELY ELEVATE VALUES
- low carb diet - acute illness - drugs like contraceptives or corticosteroids - restricted activity like bed rest - impaired GI absorption who recently took APAP
29
A1C
measurement of bld gluc levels over previous 2-3 months | -fasting is NOT needed
30
A1C goal range for diabetic patients
less than 7%
31
islet cell autoantibody testing
distinguishes bw type 1 DM vs other causes
32
DM2 may require exogenous insulin during periods of ___-
severe stress such as surgery or illness -or when DM2 has progressively gotten worse
33
exo insulin is derived fr
yeast or e.coli
34
basal bolus plan
- mimics endogenous insulin production | - combo of rapid/short acting + intermediate+long acting
35
___ prandial insulin is more like to cause HYPOglycemia
short acting bc of longer duration of action
36
avoid injectin insulin IM bc
rapid + unpredictable absorption | -could result in HYPO gluc
37
injection locations fr fastest to slowest
- ab - arm - thigh - butt
38
U100 meals
100 units in 1 mL
39
INSULIN needle lengths
6, 8, 12.7 mm
40
insulin gauge
28, 29, 30, 31
41
for patients w poort vision, ____ is a better option
pen bc they hear the clicks of the pen as the dose is selected
42
the infusion set is changed every _____
2-3 days + set at a new site
43
somogyi effect
hyperglycemia in AM - high dose of insulin causes decline in blood glucose levels at night - causes release of counterregulatory hormones - results in rebound hyperglycemia
44
dawn phenomenon
- hyperglycemia that is present upon awakening | - 2 counterreg hormones (cortisol + GH) are excreted in high amounts in AM
45
OA + non insulin injectibles | fixes
1 insulin resistance 2 decr insulin production 3 incr hepatic glucose production
46
alcohol inhibits ___
gluconeogenesis | breakdown of glycogen to glucose
47
exercise rec
150min/wk
48
exercise cautions
- if they exercise at PEAKS, they are at risk for HYPOglycemia - exercise 1 hr after a meal - check bld gluc before exercise
49
DKA is caused by
profound deficiency in insulin - characterized by HYPERglycemia, ketosis, acidosis, dehydration - may be seen in DM2 but mostly DM1
50
if DKA goes untreated....
pt will develop severe depletion of Na, K, Cl, Mg, Phosphate | -vomiting, renal failure, hypovolemic shock
51
DKA | s/s
- tachyardia, orthostatic hypotension, dehydration, dry mucus, fruity breath - Kussmaul resp (rapid deep to compensate)
52
DKA | ranges
bld gluc greater than 250mg/dL | blood pH less than 7.3
53
DKA | treatment
IV access 5-10% glucose when getting close to 250mg AVOID HYPOTONIC SOLN bc cerebral edema
54
HHS
pt who has enough insulin to prevent DKA but not enough to prevent severe HYPERGLYCEMIA -less common than DKA
55
HHS | common causes
pneumonia uti sepsis acute illness
56
HHS | lab valuses
blood gluc level greater than 600mg/dL - ketones are absent - hypokalemia is absent
57
___ is common rxn after glucagon injection
nausea | to prevent aspiration, turn to their side

Med Surg (18 decks)

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