Diabetes

Question 1

Is Type 1 diabetes insulin dependent or resistant?

Answer 1

Pancreas does not produce insulin, = Insulin Dependent

Question 2

Is Type 2 diabetes insulin dependent or resistant?

Answer 2

Body is resistant to insulin = +Insulin Resistant_

Body is still producing insulin but is not being used by the tissues

Question 3

Age of diagnosis of Type 1 diabetes?

Answer 3

AKA Juvenile Diabetes

• diagnosed mostly in childhood, can occur at any age

Question 4

Symptoms of Type 1 Diabetes

Answer 4

3 P’s:

• Polyphagia; increased hunger
• Polydipsia; increased thirst
• Polyuria; increased urination

Also:

• Blurry Vision
• Dehydration
• Weight Loss
• Ketoacidosis

Question 5

What is the cause of Type 2 Diabetes?

Answer 5

Occurs secondary to other conditions: obesity, hypothyroidism, Cushing’s

Question 6

What glucose level is indicative of Hypoglycemia?

Answer 6

Glucose < 70 mg/dL

Question 7

What glucose level is indicative of Hyperglycemia

Answer 7

Glucose > 300 mg/dL

Question 8

Early Signs of Hypoglycemia?

Answer 8

COLD and CLAMMY get him a CANDY!

• Pallor and Sweating
• Shakiness
• Tachycardia, palpitations
• Dizziness, Fainting
• Excessive Hunger

Question 9

Late Stages Signs and Symptoms of Hypoglycemia?

Answer 9

Slurred Speech, Drowsiness, Confusion

LOC = Loss of Consciousness

Coma

Question 10

Early signs of Hyperglycemia?

Answer 10

• Weakness
• Dry mouth
• Frequent, scant amounts of urination
• Deep and Rapid Respirations = Kussmaul Breathing
• Diminished Reflexes
• Excessive Thirst

(Essentially DM 1 symptoms)

Question 11

Late signs of Hyperglycemia?

Answer 11

• Fruity Breath (Acetone Breath)
• Hyperglycemic Coma

Question 12

When is appropriate to notify the phycisian/call 911

Answer 12

Incidents of Coma or LOC

Question 13

What is the most important step to take first in cases of hypoglycemia?

Answer 13

Check Blood Glucose (if that is an answer choice)

Question 14

When should we avoid exercise after taking insulin?

Answer 14

Peak insulin hours (2-4 hours), can lead to hypoglycemia.

(1 Hour after should be safe)

Question 15

Where should insulin be injected if exercise is planned?

Answer 15

Usually the abdomen, or any non-active extremity.

Question 16

Why should insulin not be injected into an active extremity?

Answer 16

Insulin is absorbed more quickly in an extremity that is active.

Question 17

How should insulin dosage be changed after exercise?

Answer 17

Should reduce insulin dosage immediately after exercise.

Question 18

What time of day is the best if exercise is planned?

Answer 18

Exercise in the morning, so we can catch if hypoglycemia occurs.

We are unable to monitor signs and symptoms if they are asleep at night.

Question 19

What are safe blood glucose levels to exercise?

Answer 19

100 - 250 mg/dL

Question 20

What blood glucose level should we NEVER exercise in?

Answer 20

BG < 70 mg/dL
BG > 300 mg/dL
Presence of Ketoacidosis

Question 21

Is it safe to exercise between 70 - 100 mg/dL

Answer 21

Yes, first need to provide a carbohydrate snack

Question 22

Is it safe to exercise between 250 - 300 mg/dL

Answer 22

Yes, only if ketones are not present, but still exercise with caution

Question 23

When is it not safe to exercise with a patient with a BG > 250 mg/dL

Answer 23

When Ketone bodies are present, notice a fruity odor on breath?

Question 24

Foot care: washing feet and soaking feet

Answer 24

NO soaking the feet

Question 25

Foot Care: Moisturizers

Answer 25

Good, but no lotion between the toes

Question 26

Foot Care: Socks

Answer 26

White Socks preferred to see if there are any cuts

Question 27

Foot Care: Shoes

Answer 27

Snug fit shoes with laces or velcro

Question 28

Foot Care: Appropriate time to purchase a new pair of shoes?

Answer 28

Later in the day; afternoon as we experience weight gain as the day progresses. Allows us to get a more accurate shoe size.

Question 29

Normal reference range for HbA1c?

Answer 29

4% - 6% (< 5.7%)

Question 30

What HbA1c level indicate immediate insulin therapy?

Answer 30

HbA1c levels above 10%

Question 31

FITT Principle for Exercising with a patient with DM: Frequency

Answer 31

3-7 days per week

Question 32

FITT Principle for Exercising with a patient with DM: Intensity

Answer 32

11-13 RPE Scale

Question 33

FITT Principle for Exercising with a patient with DM: Time/Duration

Answer 33

150 min/week progressed to 300 min/week

Question 34

FITT Principle for Exercising with a patient with DM: Type

Answer 34

Mod intensity aerobic exercise of the large muscle groups

Question 35

How does hyperglycemia affect DTRs?

Answer 35

Hyporeflexia = Decreased Reflexes