Diabetes Mellitus

Question 1

Definition by lab test

Answer 1

Normal = 100 mg/dL

Impaired Fasting plasma glucose
= 5.6 mmol/L or 115mg/dL

Diabetes
= >7 mmol/L or >126mg/dL

Question 2

Type 1 vs Type 2 DM

Answer 2

Type 1:
- Insulin-dependent
- Juvenile onset
- Immune system problem–>Loss of pancreatic beta cell function

Type 2:
- Insulin resistant
- Adult onset (usually)
- Caused by poor response of peripheral tissues to insulin

Question 3

Hypoglycemia S/S, ways to avoid, treatment

Answer 3

S/S:

• dizziness, nausea
• weakness, unsteady gait/incoordination
• confusion, fainting
  sweating profusely (sweating profusely rules out orthostatic hypotension)
• cold/clammy/sweaty skin, pallor.

Treatment:
- 15g of sugar, wait 15 min and re-treat as necessary

Avoid:
exercising during peak period of insulin activity (2-4 hours after injection)

Question 4

Hyperglycemia S/S

Answer 4

• Blurred vision
• Rapid, shallow pulse
• Fatigue, weakness
• polydipsia (excessive thirst)
• polyuria (frequent urination)
• acetone breath

Question 5

Ketoacidosis

Answer 5

Mainly in Type 1 DM (Type 2 can too)

Cause:
- no insulin–>no glucose absorption by muscle/other tissue
- liver break down fat for energy–>ketone produced too quickly–>pH drop

S/S:
lethargy
vomiting
abdominal pain
weakness
confusion
acetone breath

Question 6

Exercise consideration

Answer 6

Avoid exercise at night–>may go sleep and slip into hypoglycemic coma

• Talk to medical doctor about insulin levels for exercise
• Have snack before exercise (have raisins/juice available to boost sugar levels if necessary).
• Monitor blood sugar levels pre, during, and post exercise.