Diabetes

Question 1

Types of rapid acting insulin

Answer 1

Aspart (Novolog)
Glulisine (Apidra)
Lispro (Humalog)

Question 2

Types of short acting insulin

Answer 2

Regular

Question 3

Types of long acting insulin

Answer 3

Glargine (Lantus)

Detemir (Levemir)

Question 4

What is the onset time of rapid acting?

Answer 4

5-15 mins

Question 5

What is the onset time of short acting?

Answer 5

30-60 mins

Question 6

What is the onset time of NPH?

Answer 6

2-4 hrs

Question 7

What is the onset time of Glargine (Lantus) and Detemir (Levemir)?

Answer 7

2-4 hrs

Question 8

What is the peak time of rapid acting?

Answer 8

30-90 mins

Question 9

What is the peak time of short acting?

Answer 9

2-3 hrs

Question 10

What is the peak time of NPH?

Answer 10

8hrs

Question 11

What is the peak time of Glargine (Lantus) and Detemir (Levemir)?

Answer 11

No peak

Question 12

What is the effective duration time of rapid acting?

Answer 12

Less than 5 hrs

Question 13

What is the effective duration time of short acting?

Answer 13

6-8 hrs

Question 14

What is the effective duration time of NPH?

Answer 14

10-16 hrs

Question 15

What is the effective duration time of long acting insulin?

Answer 15

20-24 hrs

Question 16

S/S of Type 1 diabetes:

Answer 16

Polyuria 
Polyphagia (appetite)
Polydipsia (thirst)
Unexplained weight loss 
Dehydration 
Fatigue

Question 17

S/S of Type 2 diabetes:

Answer 17

Fatigue
Recurrent infections
Prolonged wound healing
Visual changes

Question 18

What is the targeted HbA1C level for someone with diabetes?

Answer 18

6.5-7%

Question 19

What are the two type of complications?

Answer 19

Acute

Chronic

Question 20

What is the an acute complication for Type 1?

Answer 20

DKA

Question 21

What is the acute complication of Type 2?

Answer 21

HHS

Hyperglycemic Hyperosmolar Syndrome

Question 22

S/S of HHS

Answer 22

Coma
Confusion
Convulsions
Dry mouth, dry tongue
Fever
Increased thirst
Increased urination (at the beginning of the syndrome)
Lethargy
Nausea
Weakness
Weight loss
Abdominal distension

Question 23

What is the treatment for HHS?

Answer 23

Aggressive rehydration
Monitoring and replacement of electrolytes
Correction of hyperglycemia with insulin (addition of glucose to IVF when blood sugar reaches 250)

*Potassium should be corrected (if needed) before insulin

Question 24

What will hyperglycemia, hypertension, and hyperlipidemia cause when presented together?

Answer 24

Impaired sensation/perception
Nervous system dysfunction
Impaired perfusion
Impaired oxygenation

Question 25

What is macrovasuclar disease?

Answer 25

Disease of large and medium sized blood vessels

Question 26

What is microvascular disease?

Answer 26

Specific to diabetes | Result from thickening of vessel membranes in capillaries and arterioles

Question 27

Microvascular disease is in response to what?

Answer 27

Chronic hyperglycemia

Question 28

What are the areas most noticeably affected by microvascular disease?

Answer 28

Eyes (retinopathy) (blindness) Kidneys (nephropathy) (kidney failure) Skin (dermopathy)

Question 29

What is critical for preventing or delaying small vessel disease?

Answer 29

``` Tight glucose control BP management ACE inhibitors (used even when not hypertensive) (prevent nephropathy) Angiotensin II receptor antagonists Yearly screening (eye and urine) ```

Question 30

What are characteristics of diabetic neuropathy?

Answer 30

Loss of sensation Abnormal sensations Pain Paresthesias

Question 31

What can diabetic neuropathy affect in the autonomic nervous system?

Answer 31

``` Gastroparesis Delayed gastric emptying Cardiovascular abnormalities Sexual function Neurogenic bladder ```

Question 32

What are key educational considerations?

Answer 32

Control your glucose, BP, and cholesterol Early treatment of foot, eye, kidney, and heart problems No Smoking Education about diabetes, nutrition, and exercise

Question 33

What is a common long term complication of diabetes affecting 50%?

Answer 33

Peripheral neuropathy

Question 34

Peripheral neuropathy affects what?

Answer 34

Functioning sensory, motor, and autonomic nerve fibers

Question 35

What is the most common form of peripheral nerve dysfunction and the form most closely associated with ulcer aetiology ?

Answer 35

Sensory neuropathy

Question 36

What are some chronic complications of diabetes?

Answer 36

``` Retinopathy Nephropathy Cardiac failure Neuropathy Amputation ```

Question 37

What is a main difference between DKA and HHS?

Answer 37

Speed of symptom development | DKA is faster than HHS

Question 38

In people with Type 1 diabetes, DKA can be precipitated by what?

Answer 38

Infection such as UTI or respiratory Insulin errors and omissions MI Diarrhea and vomiting (Illness)

Question 39

DKA is a result of what? | And increases the production of what counter-regulatory hormones?

Answer 39

Relative or absolute lack of insulin Glucagon Catecholamines Cortisol Growth hormone

Question 40

What are some examples of food that contains 15g?

Answer 40

``` Apple 1 slice of bread Bran cereals 1/2 cup Cookie, fat free, 2 small Cupcake no frosting Ice cream (light) 1/2 cup Milk 8oz Orange juice 1/2 cup Potato Rice 1/3 cup Saltine crackers (6) Sugar/honey 1 Tsp Yogurt, fat free, with sugar substitute 1 cup ```

Question 41

Type of intermediate acting insulin ?

Answer 41

NPH