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Hospital Dentistry - ABGD Oral Boards > Diabetes > Flashcards

Flashcards in Diabetes Deck (33)
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1

What is the most common endocrine disorder?

Diabetes Mellitus

2

How does Diabetes Mellitus manifest?

Manifested by Hyperglycemia

3

What is the #1 cause of End Stage Renal Disease?

Diabetes Mellitus

4

What is the difference between Type I and Type II diabetes?

5

What is Gestational Diabetes?

  • Reported 2-10% of pregnancies
  • 35-60% risk for developing DMII in 10-20 years

6

What is FPG?

What are normal, pre-diabetic, and diabetic values?

  • Fasting Plasma Glucose
  • Normal: < 100 mg/dl
  • Pre-Diabetes: 100-125 mg/dl
  • Diabetes > 126 mg/dl

 

7

What OGTT stand for?

What are the Normal, Pre-Diabetes, and Diabetic lab values?

  • Oral Glucose Tolerance Test
  • Normal: < 140 mg/dl
  • Pre-Diabetes: 140-199 mg/dl
  • Diabetes: > 200 mg/dl 

8

What are HbA1c lab values for Normal, Pre-Diabetes, and Diabetes?

  • Normal: < 5.7%
  • Pre-Diabetes: 5.7 - 6.4 %
  • Diabetes: > 6.5 %

9

Describe the Pathogenesis of Type I DM...

  • Environmental insult triggers autoimmune reaction
  • Microbial, chemical, dietary
  • Cell mediated destruction of Beta Cells

10

Describe the Honeymoon Phase of DM Type I...

  • Recovery of beta cell function after start of insulin therapy
  • Exogeneous insulin requirements drop
  • Insulin secretion will eventually fail

11

What is the Pathogenesis of Type 2 DM?

  • Insulin resistance
  • Results in decreased intracellular glucose transporter activity
  • Beta cell compensation
  • Beta cells gradually fail to compensate for increasing insulin resistance
  • Impaired glucose tolerance
  • Fasting hyperglycemia
  • Eventual beta cell failure

12

How does one self monitor DM?

  • Blood glucose
  • Urine glucose

13

What does HbA1c stand for?

Glycosylated Hemoglobin

Reflects long term control

14

Describe a rapid-acting Insulin...

  • Aspart
  • Lispro
  • Onset 15 minutes
  • Peak 30 minutes
  • Duration: 4-5 hours

15

Describe a short acting insulin...

  • Insulin (Regular)
  • Onset: 30-60 minutes
  • Peak: 50-120 minutes
  • Duration: 5-8 hours

16

Describe a Intermediate acting Insulin...

  • NPH
  • Onset: 1-3 hours
  • Peak: 8 hours
  • Duration: 20 hours

17

Describe a Long Acting Insulin...

  • Glargine
  • Onset: 1 hour
  • Peak: N/A
  • Duration: 24 hours

18

What is an Insulin Pump?

  • Uses portable infusion pump connected to an indwelling subcutaneous catheter
  • Shown to have significant advantages over multiple daily injections
  • Reduces glycemic variability, clinical hypoglycemia

19

What are GLP-1 and GIP?

  • Incretin Mimetics
  • Mimics naturally occurring gut hormones
  • Promotes insulin relase
  • Inhibits glucagon release
  • Gila monster saliva

20

What kind of drug is Metformin?

  • Anti-hyperglycemic agent
  • Decreased HGP (hepatic glucose production)
  • Decreased IR (insulin resistance)
  • Decreased glucose adsorption

21

What kind of drug is Arcarbose?

  • Oral Anti-diabetic agent
  • Glucosidase Inhibitors
  • Delays digestion of carbs and adsorption of glucose

22

What kind of drug is Rosiglitazone?

  • Oral anti-diabetic agent
  • Decreased Insulin Resistance (IR)
  • Decreased Hepatic Glucose Production (HGP)
  • Increased glucose disposal

23

What kind of drug is Januvia?

  • Inhibits enzymatic breakdown of GLP-1 and GIP

24

What do Oral Antidiabetic Agents like Sulfonyureas do?

What are 2 examples?

  • Glyburide
  • Glipizide
  • Increased pancreatic insulin secretion (chronically)

25

What is an example of an oral antidiabetic agent that acts acutley?

  • Meglitinides
  • Increased pancreatic insulin secretion (acutley)

26

When should you see a Diabetic patient as a dentist?

  • Minimize stress: short, midmorning appointments
  • High insulin activity in afternoon
  • Increased risk of hypoglycemia

27

How should a dentist instruct a diabetic patient to eat prior to a dental appointment?

  • Patient should take all usualy meds
  • Continue usual diet
  • Normal procedure dietary intake

28

If a diabetic pt needs to NPO, how do you manage a clinical encounter?

  • May need to alter insulin regimen
  • NPO causes...
  • Increased physiologic and psychologic stress
  • Increased release of epi and corticosteroids
  • Induces hyperglycemia

29

What should you consider if a patient has a HgA1c > 8%?

  • Consider antibiotics (High blood sugar is perfect food for microbes)
  • Pre-op/post-op finger stick
  • Follow-up
  • Consult physician

30

What are signs and symptoms of Hypoglycemia (Initial State)?

  • Initial State:
  • Weakness
  • Trembling
  • Hunger
  • Sweating
  • Tachycardia
  • Anxiety
  • Confusion

31

What are the signs and symptoms of a patient experiencing a Moderate State of Hypoglycemia?

  • Combative 
  • Incoherent

32

What are the signs and symptoms of someone in a severe state of Hypoglycemia?

  • Unconsciousness
  • Hypotension
  • Hypothermia

33

How do you treat Hypoglycemia?

  • GLUCOSE, GLUCOSE, GLUCOSE
  • Soda (not diet), fruit juice
  • Do not force oral administration, aspiration risk
  • IV glucose
  • Glucagon auto injector
  • Cake frosting under tongue
  • When in doubt, give glucose