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Nursing 337 > Diabetes > Flashcards

Diabetes Flashcards

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1
Q

Define diabetes

A

a chronic multisystem disease related to abnormal insulin production, impaired insulin utilization or both

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2
Q

diabetes is the leading cause of what diseases

A

end-stage kidney disease and nontraumatic lower limb amputations

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3
Q

what are the current theories about the causes of diabetes

A

single or combination of genetic, autoimmune, and environmental factors

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4
Q

where is insulin produced

A

in the Beta cells in the islets of langerhans of the pancrease

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5
Q

what is the stable normal blood glucose level

A

70-120 mg/dL

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6
Q

what is the average amount of insulin secreted by the pancreas

A

40-50 units

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7
Q

what does the rise in insulin after a meal stimulate

A

storage of glucose as glycogen in liver and muscle, inhibits glucogenenesis, enhances fat deposition of adipose tissue and increases protein synthesis

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8
Q

what does the fall of insulin level during normal overnight fasting facilitate in?

A

release of stored glucose from the liver, protein from muscle and fat from adipose tissue

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9
Q

what tissues are considered insulin-dependent

A

insulin dependent tissues are skeletal muscle tissue and adipose tissue

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10
Q

what are the counterregulatory hormones

A

glucagon, epinephrine, growth hormone, and cortisol

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11
Q

What is the etiology and pathophysiology of Type 1 DM

A

it is an immune mediated disease caused by autoimmune destruction of pancreatic beta cells
leading to absence of insulin production

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12
Q

what is the prediposition to type 1 diabetes

A

it is related to Human leukocyte antigens,

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13
Q

how do HLA contribute to type 1 DM

A

when exposed to a viral infection HLA destroy pancreatic beta cells either directly or through an autoimmune response

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14
Q

what is idiopathic diabetes

A

a form of type 1 DM that is strongly inherited not related to autoimmunity

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15
Q

what is latent autoimmune diabetes in adults (LADA)

A

a slowly progressing autoimmune form of type 1 DM usually occurs in people who are over the age of 35 and who are not obese

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16
Q

what is the onset of type 1 DM

A

the islet cell autoantibodies responsible for beta cell destruction are present for months to years before the onset of symptoms

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17
Q

what are the key manifestations of type 1 dm

A

polyphagia, polydipsia, polyuria

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18
Q

without insulin from an outside source what will happen to a type 1 DM

A

patient will develop diabetic ketoacidosis (DKA) a life-threatening condition resulting in metabolic acidosis

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19
Q

what is the most prevalent type of diabetes?

A

type 2 DM

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20
Q

what are risk factors for developing type 2 DM

A

overweight/obese
older age
family history

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21
Q

what is the etiology and pathophysiology of type 2 DM

A

the pancreas produces some endogenous insulin but the insulin produced is either insufficient for the needs of the body or is poorly used by the tissues or both.

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22
Q

what are the major metabolic abnormalities that have a role in the development of type 2 diabetes

A
  1. ) insulin resistance- body does not respond to the action of insulin because receptors are unresponsive or insufficient number
  2. ) decrease in the pancreas’s ability to produce insulin, as the beta cells become fatigued from the compensatory overproduction of insulin when beta cell mass is lost
  3. ) inappropriate glucose production by the liver
  4. ) alltered production of hormones and cytokines by adipose tissue
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23
Q

what is the onset of type 2 DM

A

usually gradual

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24
Q

what is prediabetes

A

individuals that are at increased risk of development of type 2 diabetes

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25
how is preediabetes diagnosed
an impired glucose tolerance (140-199) or impaired fasting glucose (100-125 mg/dL)
26
how do people with prediabetes reduce their risk of developing type 2 DM
maintaining a health weight, exercising regularly, and eating a healthy diet
27
what is gestational diabetes
diabetes that develops during pregnancy and occurs in about 2-10% of pregnancies
28
women with gestational diabetes are at risk for
cesarean delivery, perinatal death, birth injury, and neonatal complications
29
who is at risk for gestational diabetes
women who are obese, advanced maternal age, family history of diabetes
30
when are women screened for gestational diabetes
at 24-28 weeks using a 2 hour oral glucose test
31
what are some disease or treatments that cause diabetes
cushing syndrome, hyperthyroidism, recurrent pancreatitis, cystic fibrosis, hemachromatosis, parenteral nurtrition.
32
What is diabetes?
a chronic multisystem disease related to abnormal insulin production, impaired insulin utilization or both
33
what are the classes of diabetes?
Type 1 Type 2 Gestational other specific types
34
What is the etiology of diabetes
combination of causative factors including - genetics - autoimmune - environmental
35
where is insulin produced
by beta-cells in the islets of langerhans in the pancreas
36
when is insulin normally released
released continuously into bloodstream in small increments with larger amounts released after food
37
what is the normal glucose range
70-120mg/dL
38
what are the normal functions of insulin (5)
promote glucose transport in skeletal muscle and adipose tissue - storage of glucose as glycogen - inhibits gluconeogenesis - enhance fat deposition - increase protein synthesis
39
What are the counterregulatory hormones (4)
Glucagon epinephrine growth hormone cortisol
40
what are the functions of counterregulatory hormones
oppose effects of insulin stimulate glucose production by liver decreased movement of glucose into cell help maintain normal blood glucose levels
41
what is the onset of type 1 DM
younger- less than 40
42
what is the etiology of type 1 DM
- autoimmune destruction of beta cells - total absence of insulin - genetic predisposition and viral exposure - HLA-DR3 and HLA- DR4 - idiopathic diabetes - latent autoimmune diabetes in adults (LADA)
43
what is the manifestations of the development of type 1 DM
develop when pancreas can no longer produce insulin- rapid onset of ketoacidosis
44
what is the most prevalent form of DM
type 2
45
what are some risk factors of type 2 DM
overweight obesity advancing age family history
46
what is the etiology of type 2 DM
pancreas continues to produce some endogenous insulin | insulin is insufficient or poorly utilized
47
what are the four major metabolic abnormalities associated with type 2 DM
1. ) insulin resistance 2. ) decreased insulin production by pancreas 3. ) inappropriate hepatic glucose production 4. ) altered production of hormones and cytokines by adipose tissue
48
what are the metabolic syndromes that increase the risk for developing type 2 DM
- elevated glucose levels - abdominal obesity - elevated BP - high levels of triglycerides - decreased levels of HDLs
49
what is the onset of type 2 DM
gradual onset | hyperglycemia may go many years without being detected
50
what is prediabetes
individuals that exhibit some symptoms of type 2 DM and are at greater risk for developing type 2 DM
51
what are the tests to determine if someone is prediabetic
Impaired Glucose Intolerance- oral glucose tolerance test and impaired fasting glucose
52
what are some important teachings for prediabetes
- undergo screening - mange risk factors - monitor for symptoms of diabetes - Maintain healthy weight, exercise, healthy diet
53
what is gestational diabetes
diabetes that occurs during pregnancy
54
what are some increased risks from gestational diabetes
increased risk of need for cesarean delivery | perinatal complications
55
when do you screen for gestational diabetes
high risk pt at first visit | others at 24-28 weeks
56
what are the clinical manifestations of type 1 diabetes
``` classical symptoms - polyuria - polydipsia - polyphagia wt loss weakness fatigue ```
57
clinical manifestations of type 2 diabetes
``` nonspecific symptoms polyuria polydipsia polyphagia fatigue recurrent infection recurrent fungal infection prolonged wound healing visual changes ```
58
what are the diagnostic studies of diabetes
hemoglobin A1C Fasting plasma glucose two-hour plasma glucose level during OGTT Classic symptoms of hyperglycemia with random plasma glucose level
59
what level indicates diabetes with hemoglobin A1C
6.5% or higher
60
what level indicates diabetes with fasting plasma glucose level
126 mg/dL
61
what level indicates diabetes with two-hour plasma glucose levels during OGTT
200 mg/dL
62
what level indicates diabetes with random plasma glucose level
200 mg/dL
63
what are the goals of diabetes management
``` Goals of diabetes management Decrease symptoms Promote well-being Prevent acute complications Delay onset and progression of long-term complications ```

Nursing 337 (9 decks)

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