Diabetes Mellitus

Question 1

Diabetes

Answer 1

group of metabolic diseases which result from:

• a combination of the defects and actions of insulin
• defects in the secretion of insulin

Question 2

what does diabetes often present with

Answer 2

hyperglycemia
metabolism disruption
blood vessel damage

Question 3

microvascular diabetes complications

Answer 3

small blood vessels
retinopathy
nephropathy
neuropathy

Question 4

macrovascular diabetes complications

Answer 4

damage to arteries
CVD - 68%
stroke - 16% due from stroke
PVD

Question 5

Autonomic Neuropathy

Answer 5

results when nerves become damaged that manage bodily functions including: heart rate, sweating, bowel and bladder emptying, blood pressure, digestion

Question 6

Type 1

Answer 6

inadequate production of insulin

usually diagnosed at young age

Question 7

Type 2

Answer 7

insulin-resistant

most commonly diagnosed in adulthood

Question 8

Gestational

Answer 8

Altered glucose metabolism due to increased pregnancy hormone levels

Question 9

Insulin-Dependent DM

Answer 9

Type 1
juvenile-onest
childhood-onset

Question 10

Type 1 Factors

Answer 10

presence of type 1 in a first-degree relative
little to no secretion of insulin
5010% of diabetic cases in North America

Question 11

What cells are destroyed in Type 1 DM

Answer 11

pancreatic B-Cells

Question 12

Type 2 Factors

Answer 12

Most common type of diabetes 
can often be controlled by diet and exercise 
metabolic disorder 
tissue-wide insulin resistance 
reduced insulin levels

Question 13

Type 2 Risk factors

Answer 13

ethnic origin (African American, Native American, Hispanic, Asian American, Pacific Islander)

Obesity 
Genetics 
Poor Diet 
PCOS 
>45 
vascular disease 
smoking

Question 14

When is a fasting glucose test given

Answer 14

24th-28th week pregnancy

Question 15

How much does having gestational diabetes increase risk of future development

Answer 15

50%

Question 16

GD effect on child:

Answer 16

delayed fine motor skills
delayed gross motor skills
inattention, hyperactivity

Question 17

Diagnosis of DM

Answer 17

Urinalysis, glucose tolerance tests, thirst, itchy skin, familial tendency, decreased hair growth

Question 18

Semmes-Weinstein Test

Answer 18

Monofilaments used to map sensory loss

Question 19

Semmes-Weinstein 10g results

Answer 19

protective/some sensation

Question 20

Semmes-Weinstein 75g results

Answer 20

absent sensation

Question 21

Type 1 Symptoms

Answer 21

frequent urination
increased thirst
increased appetite
blurred vision

Question 22

Polyuria

Answer 22

frequent urination

Question 23

polydipsia

Answer 23

increased thirst

Question 24

polyphagia

Answer 24

increased appetite

Question 25

retinopathy

Answer 25

Blurred vision underlying microvascular occlusion of the retina progressive areas of retinal ischemia and tissue death vision impairment

Question 26

Type 2 symptoms

Answer 26

``` gradual onset blurred vision neuropathic complications inflections significant blood lipid abnormalities ```

Question 27

Normal Fasting Plasma Glucose Test

Answer 27

<100 mg/dl

Question 28

Prediabetes Fasting Plasma Glucose Test

Answer 28

100-125 mg/dl

Question 29

Diabetes Fasting Plasa Glucose Test

Answer 29

>125 mg/dl

Question 30

Atherosclerosis Type 1

Answer 30

Begins earlier, more extensive | changes large blood vessels

Question 31

Atherosclerosis Undiagnosed Type 2

Answer 31

significantly higher risk for CAD, CVA, PVD | smoking increases risk

Question 32

Nephropathy

Answer 32

kidney failure requiring dialysis or transplantation | presence of small amounts of albumin in urine

Question 33

What is the leading cause of end-stage renal disease

Answer 33

DM

Question 34

Dialysis

Answer 34

helps when filtration of the blood is compromised hemodialysis and peritoneal dialysis considered if kidneys filtering ability reduces to 10%

Question 35

Hemodialysis

Answer 35

use of a dialyzer to purify blood treatment 4 hours, 3x a week must be done until able to get a transplant

Question 36

Advantages to Hemodialysis

Answer 36

not required everyday

Question 37

disadvantages to hemodialysis

Answer 37

patients will need to check in with dialysis center to ensure opening International travel can be costly diet and fluid intake restrictions

Question 38

Peritoneal Dialysis

Answer 38

continuous ambulatory peritoneal dialysis (4 per day) automated (7-10 hours a day) put insulin in dialysate

Question 39

Peritoneal Dialysis Advantages

Answer 39

more convenient scheduling travel is easier fewer diet and fluid restrictions

Question 40

Disadvantages of Peritoneal Dialysis

Answer 40

must be performed daily infection of peritoneal increased potential for lethargy weight gain

Question 41

Infection

Answer 41

chronic, poorly controlled DM significant risk for infection skin, urinary tract, vaginal infections

Question 42

Motor Neuropathy

Answer 42

produced weakness and atrophy | diabetic amyotrophy

Question 43

Sensory Polyneuropathy

Answer 43

usually affecting hand and feet | causing mild tingling, burning, numbness or pain or complete loss of sensation

Question 44

Sensory Neuropathy

Answer 44

Diabetic peripheral neuropathic pain | charcot food

Question 45

Wagner Ulceration Grade 0

Answer 45

no ulcer but high risk foot

Question 46

Wagner Ulceration Grade 1

Answer 46

superficial ulcer of skin or subcutaneous tissue

Question 47

Wagner Ulceration Grade 2

Answer 47

Deep Ulcer, no bony involvement or abscess

Question 48

Wagner Ulceration Grade 3

Answer 48

Deep ulcer with osteomyelitis

Question 49

Wagner Ulceration Grade 4

Answer 49

Localized gangrene (heel, toes, etc)

Question 50

Wagner Ulceration Grade 5

Answer 50

extensive gangrene of entire foot