Chapter 15 - Diabetes Mellitus

Question 1

What is Diabetes Mellitus?

Answer 1

Relative or complete lack of insulin secretion by beta cells
OR
defects of insulin receptors

Question 2

Diabetes Mellitus results in what?

Answer 2

disturbances of carbohydrate, protein, and lipid metabolism, and in elevated blood glucose levels

Question 3

In Diabetes Mellitus, __________ and ____________ damage results in disability and premature death?

Answer 3

Macrovascular and Microvascular

Question 4

Macrovascular complications?

Answer 4

• coronary artery disease
• peripheral vascular disease
• cerebrovascular disease

Question 5

Microvascular complications?

Answer 5

• nephropathy
• retinopathy
• neuropathy
• impaired healing leading to gangrene and amputation

Question 6

Autonomic effects of Diabetes Mellitus?

Answer 6

• orthostatic hypotension
• gastroparesis
• neurogenic bladder
• impotence

Question 7

Classifications of Diabetes Mellitus?

Answer 7

Type 1 (T1DM) : 5% to 10% of patients
Type 2 (T2DM) : more than 90% of patients

Question 8

Symptoms of Type 1 Diabetes Mellitus?

Answer 8

• polydipsia
• polyuria
• polyphasic
• weight loss

Question 9

Type 1 Diabetes Mellitus is caused by what?

Answer 9

destruction of pancreatic beta cells

• Autoimmune disorder
• Idiopathic diabetes

Question 10

Symptoms of Diabetes Mellitus?

Answer 10

• gradual onset of polyuria and polydipsia
• easily fatigues
• frequent infections (especially UTIs)
• May have condition for many years before complications lead to diagnosis

Question 11

What is Type 2 Diabetes Mellitus caused by?

Answer 11

Insulin resistance - failure of cells to respond to insulin
OR
- defects in insulin secretion

Question 12

Type 2 Diabetes Mellitus Risk Factors?

Answer 12

• family history
• obesity
• gestational diabetes

Question 13

________ produces an insulin-resistant state; causes cells to produce excess insulin

Answer 13

Obesity

Question 14

What is A1C called?

Answer 14

Glycosylated hemoglobin

Question 15

What does A1C reflect?

Answer 15

Reflects blood glucose control for 100 to 120 days

Question 16

What is used for Type 2 Diabetes Mellitus when diet and physical activity do not control hyperglycemia?

Answer 16

Oral glucose-lowering medications

Question 17

Type 1 Diabetes Mellitus requires what type of insulin?

Answer 17

exogenous insulin
(to maintain blood glucose level WNL)

Question 18

Some patients with T2DM require _________ to optimize glucose control?

Answer 18

Insulin

Question 19

what is the goal of Insulin use?

Answer 19

To maintain the glucose level as close to physiologic normal as possible.

Question 20

What are benefits of Exercise?

Answer 20

• lowers blood glucose levels
• assists in maintaining normal lipid levels
• Increases circulation

Question 21

People with diabetes should not exercise when?

Answer 21

When insulin is at its peak

Question 22

When is exercise ideal for people with Diabetes?

Answer 22

Exercise when blood glucose level is 100 to 200mg/dLl

(30 to 60 minutes after meals)

Question 23

When should exercise be avoided in individuals with diabetes?

Answer 23

When blood glucose level is greater than 250mg/dL and when ketones are in the urine

Question 24

Causes of Hypoglycemia?

Answer 24

• too much insulin
• skipping meals
• too much exercise without food replacement

Question 25

When do symptoms of Hypoglycemia occur?

Answer 25

Occur when blood glucose level falls below 50mg/dL

Question 26

Symptoms of Hypoglycemia?

Answer 26

- Hunger - Erratic behavior - Confusion - Trembling/shaking - Cool, Clammy, Pale skin

Question 27

Hypoglycemia--> Food to raise blood sugar quickly?

Answer 27

- 5 to 6 pieces of hard candy - 4oz of fruit juice or regular soda (not diet) - 1Tbsp of sugar, jelly, or honey - 3 glucose tablets (available without a prescription at most pharmacies)

Question 28

What effect does an illness have on blood glucose concentrations?

Answer 28

Elevates

Question 29

What effect does an illness have on the appetite?

Answer 29

Decreases

Question 30

Women with Pre-existing diabetes are vulnerable to what?

Answer 30

Vulnerable to fetal complications

Question 31

Gestational Diabetes (GDM)?

Answer 31

Begins in pregnancy and is resolved at parturition

Question 32

Increased insulin in Gestational Diabetes causes __________?

Answer 32

macrosomia

Question 33

Gestational Diabetes makes up what percentage of pregnancies?

Answer 33

5% to 6% of pregnancies

Question 34

Gestational Diabetes is associated with what?

Answer 34

Obesity - but weight loss is not recommended during pregnancy

Question 35

In individuals with Gestational Diabetes they are at a greater risk for what?

Answer 35

Increased risk for later development of Type 2 DM (occurs in 20% to 50% of women with GDM

Question 36

Postpartium recommendations?

Answer 36

- Screening for 6 or more weeks after delivery - Maintaining ideal body weight - Eating a low-fat diet - Exercising regularly - Breastfeeding

Question 37

Type 2 diabetes in the young is related to what?

Answer 37

Related to increase in childhood obesity

Question 38

Other signs and symptoms that may indicate a risk for Type 2 DM include what?

Answer 38

- acanthuses - nigricans - polycystic ovarian syndrome - hypertension (Girls more susceptible than boys)