Diabetes Flashcards

1
Q

Type 1

A

Body developed antibodies against insulin and/or antibodies against cells that make insulin
-not enough insulin in the body

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2
Q

Type 2

A

Not enough insulin made or not used effectively

-3 Ps, weight gain or loss, prolonged healing

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3
Q

Somogyi Effect

A

Hypoglycemia in the morning

  • check glucose between 0200-0400
  • bedtime snack
  • reduce insulin dose
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4
Q

Dawn Phenomen

A

Hyperglycemia upon wakening

  • measure bedtime, nighttime, and morning glucose
  • increase insulin or change time when it’s given
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5
Q

What carb sources are good

A

Low fat dairy, legumes, grains, veggies, and fruit

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6
Q

Diet

A

Limit cholesterol <200

1 drink daily women, 2 men

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7
Q

Exercise

A
  • weight loss, decreases insulin resistance, balance cholesterol
  • improves circulation and BP
  • done 1 hr after meals
  • complication of hypoglycemia: measure before, during, and after exercise
  • if BG <100 eat a snack and recheck in 15 min
  • if BG >250 and ketone present, delay
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8
Q

If patient is sick with other illness, having surgery, under stress

A
  • check BG every four hr
  • type 1: check for ketones 3-4 hr
  • contact HCP if BG > 300 twice in a row or urine ketones are mod-high
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9
Q

DKA

A

Great loss of insulin

  • dry mucous membranes, hyperglycemia (>250), lethargy, dehydration
  • kussmaul respiration’s, sweet fruity breath
  • ABCs, IV, rehydrate, monitor BG and potassium (hypo)
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10
Q

HHS

A

Body has enough insulin to prevent DKA but not enough to prevent hyperglycemia (type 2)

  • impaired thirst sensation
  • BG of 600
  • ABCs, BG checks and IV insulin, F&E, cardiac monitoring
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11
Q

Hypoglycemia

A
  • rule of 15: 15g of carbs to get to 70
  • if doesn’t improve after 2-3 doses then call HCP
  • unconscious: 20-50 ml of 50% dextrose or 1 mg of glucagon
  • shakiness, palpitations, nervousness, diaphoresis
  • altered mental function: difficulty speaking, visual probs, stupor
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12
Q

Angiopathy

A
  • damage to blood vessels secondary to chronic hyperglycemia
  • leading diabetes related death
  • keep appointments for lab work
  • eye and foot exams
  • risk factor assessment
  • exercise stress testing
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13
Q

Macro vascular/Micro Angiopathy

A
  • maintain tight control of BG, BP, and weight
  • smoking cessation
  • macro: lead to CAD, stroke, PAD
  • micro: retinopathy, nephropathy, dermopathy (10-20 yrs after diagnosis)
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14
Q

Retinopathy

A
  • dilated eye exam annually
  • manage BG and HTN
  • laser photo coagulation therapy to treat retina
  • Virectomy treats hemorrhage and retinal detachment of macula
  • Illuven steroid
  • proliferative: more severe, nonproliferative: more common
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15
Q

Nephropathy

A
  • manage BP and BG
  • albumin to creatinine ratios annually
  • HTN: medications
  • leads to ESRD
  • albuminuria: ACE and Angiotensin antagonists
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16
Q

Why are diabetics at risk for complications related to their feet?

A

Higher risk of vascular damage and neuropathy

  • impact on skin and WBC= prolonged healing
  • smoking can increase risk
17
Q

When to self monitor

A
  • before meals
  • 2 hrs after meals
  • when hypoglycemia is suspected
  • during illness
  • before, during, after exercise
18
Q

Pancreas transplant

A

For type 1 diabetes with kidney transplant

  • eliminates need for exogenous insulin, SMBF, diet restrictions
  • long term complications may persist
  • life long immunosuppression
19
Q

Diabetes signs

A
  • malaise, fatigue
  • obesity, weight loss or gain
  • thirst, hunger, N/V
  • poor healing
  • frequent urination
20
Q

Lab values

A
  • high triglycerides, cholesterol, LDL, blood urea nitrogen, creatinine
  • low HDL
  • A1C >6.0%
  • fasting BG >126
  • OGTT >200
21
Q

What can untreated hypoglycemia progress to

A

Loss of consciousness
Seizures
Coma
Death

22
Q

Sensory neuropathy

A

Loss of protective sensation in lower extremities

-risk for amputation

23
Q

Autonomic neuropathy

A

Can affect nearly all body systems

  • gastroparesis: delayed gastric emptying
  • postural hypotension, resting tachycardia, painless myocardial infarction
  • disrupts sexual function
  • neurogenic bladder leads to urinary retention
24
Q

Diabetic dermopathy

A

Most common

-red brown, round or oval patches

25
Q

Ancathosis nigricans

A

Manifestation of insulin resistance

-velvety light brown to black skin

26
Q

Necrobiosis lipoidica diabeticorum

A

Red yellow lesions

27
Q

Priority intervention in ED, for DKA and HHS

A

IV fluids and insulin

28
Q

Why is there a risk for hypokalemia when DKA is treated?

A

Insulin can deplete potassium