Diabetes 1

Question 1

Diabetes mellitus

Answer 1

A chronic disease related abnormal insulin production( disprder of the pancreas)
Impaired insulin utilisation
Characterized hy hyperglycemia

Question 2

Normal glucose level

Answer 2

4-7.8 mmol/l (diabetes aus)

3.9- 6.1 mmol/l ( brown)

Question 3

Regulation of blood glucose level

Answer 3

Pancreas

Liver

Question 4

Pancreas

Answer 4

A digestive and endocrine gland

Endocrine function: Secretes glucose, insulin , somatostatin

Question 5

Liver

Answer 5

Glucose metaolism
Glycogen storage
Glycogenesis
Glycogenolysis
Regualtion of blood glusoce concentration

Question 6

Normal insulin metabolism

Answer 6

Only hormone that directly lowers bgl
Produced by b cells in islet of
langerhan 
Promotes glucose transport across cell memebranes
Stimulates glycogenesis, glycogenolysis
Increase protoen synthesis

Question 7

Glycogenesis

Answer 7

Storage of glucose as glycogen

Question 8

Hormones that opsoe the effects of insulin

Answer 8

Glucagon , epinephrine, growth hormone, cortisol
Stimulate glucose production by liver
Decrease movement of glucose

Question 9

Type 1 diabetes

Answer 9

No insulin being produced

Question 10

Type 2 diabetes

Answer 10

Person is resistant to the insulin being produced

Question 11

Diabetes aetiology

Answer 11

Person eats/drinks-
Blood glucose rises
Vete cells in pancreas detect rise in blood glucose
Pancreas releases insulin into the blood
( 1 : no insulin 2: resistant to insulin)
Tissue cells take up glucose
Blood glucose falls

Question 12

Diabetes 1 risk factor

Answer 12

Not inherited, but genetic predisposition combined with immunologic and possibly environmental factor

Question 13

Type 2 diabetes risk factor

Answer 13

Family history 
Race
Pbese
Poor nutrition 
Smoking
High bp

Question 14

Clinical manifestation of high bgl

3 ps

Answer 14

Polyuria: urine
Polydipsia: excessive thrist
Polyphagia : excessive hunger

Question 15

Other symptoms of high bgl

Answer 15

Weight loss
Weakness
Blurred vision
Headache
Numbness of feet
Wounds slow to heal
Recurrent infection

Question 16

Classifications of diabetes

Answer 16

Type 1
Type 2 
Gestational
Pre diabetes 
Secondary diabetes

Question 17

Type 1 diabetes

Answer 17

Insulin producing b cells in pancreas destroyed by autoimmune process
No insulin production

Question 18

Wffects of lack of glucose in insulin production

Answer 18

Catabolism
Adipogenesis
Glycogenesis 
Result
- poor utilisation of glucose lead to feeling of hunger, tiredness, increased breakdown of alternate engery sources

Question 19

Catabolism

Answer 19

Impeded due to the lack of transport of glucose into the cytoplasm

Question 20

Adipogenesis

Answer 20

Glucose conversion into fattty acid is limited due to the lack of insulin

Question 21

Glycogenesis

Answer 21

Glucose is stored in liver and muscle as glycogen. This is activated by insulin l, therefore limited

Question 22

Treatment of type 1 diabetes

Answer 22

Insulin injections

Question 23

Type 2 diabetes

Answer 23

Pancreas continues to produce insulin by insufficient or poorly utilised by body

Question 24

Pathophysiology of type 2 diabetes

Answer 24

Insulin resistance
Decreased insulin production
Increased glucose production
Altered production of hormones and cytokines bu adipose tissue

Question 25

Type 2 diabetes symptoms

Answer 25

Slow progressive glucose intolerance Hyperglycaemia Asymptomatic for years byt type 1 diabetes may be experienced

Question 26

Treatment of type 2 diabetes

Answer 26

Treated initially with diet and exercise Oral hypoglycemic agents may be used Insulin may ultimately

Question 27

Prediabetes

Answer 27

High risk for type diabetes 2 Have impaired glucose tolerance Asymptomatic but long-term damage already occuring Undergo screening Manage risk factors Monitor for symptoms of diabetes Maintain healthy weight, exercise, healthy diet

Question 28

Gestational diabetes

Answer 28

Glucose intolerance develops during pregnancy Management Similar to type 2 diabetes Dietary modification Oral agents avoided Post pregnancy Bgl levels return to norma after delivery (6weeks) Increased risk of developing type 2 diabetes early in life

Question 29

Secondary diabetes

Answer 29

Can result form damage or injury, interferance , destruction of b cells in the pancreas medications, medical conditions Can be resolved if condition is treated or medication is didscontinued

Question 30

Management of diabetes mellitus primary goal

Answer 30

Keep blood sugar level simlar as normal as possible | Normalize activity of insulin and glucose

Question 31

Other goal management of diabetes

Answer 31

Reduce symptoms Promote wellbeing Prevent acute complication Delay long term complications

Question 32

Major components of care

Answer 32

``` Patient teaching Self monitoring of bgl Nutritional therapy Exercise Pharmacologic therapy ```

Question 33

Multidisciplinary care

Answer 33

Multidisciplinary team train is diabetes care is managaing the patient

Question 34

Diagnosing and monitoring diabetes

Answer 34

Fasting blood glucose >=7.0mmol/L Random plasma glucose >=11.1 mml/L 2 hour OGTT>= 11.1 mmol/L HbA1c>=6.5%

Question 35

Self monitoring of BGL

Answer 35

With insulin- 2-4 times a day , before meals and at bedtime | No insulin: 2 hours before and after the largest meal(2-3 times per week)

Question 36

Type 1 diabetes target range

Answer 36

4-8 mmol/l before meals | >10 mmol/L two hours after starting meal

Question 37

Type 2 diabetes bgl target range

Answer 37

6-8 mmol/L before meals | 6-10 mmol/L 2 hours after meals

Question 38

Risk of hypoglycaemia bgl range

Answer 38

Less than 4mmol/L if insulin or certian type of tables are used

Question 39

Blood glucose monitoring nursing considerations

Answer 39

Nurse competency Quality control tests of blood glucose meter - once dailt or new strips or new machine or new batteries - high and low range testing - documentation in logbook Lancet use - sharps precautions, ppe