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Chronic Rehab > Diabetes Pt 1 > Flashcards

Diabetes Pt 1 Flashcards

(59 cards)

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1
Q

what leads to the metabolic derangements associated with type 1

A

loss of insulin (auto immune destruction)

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2
Q

describe type 1 dieabetes

A 
Beta cell destruction (leads to insulin deficiency)
Immune mediated (autoimmune)
Idiopathic
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3
Q

what is insulin normally secreted by

A

Beta cells

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4
Q

what increases glucose transport into tissue and the liver

A

insulin

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5
Q

Must be present for muscle and fat tissues to use glucose

for energy

A

insulin

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6
Q

what does insulin regulate

A

glucose metabolism- to produce energy for

cellular functions

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7
Q

mechanism by which insulin promotes fat storage

A

*Insulin promotes glucose into fat cells where it is broken down
*One of breakdown products is A-glycerophosphate,
combines with fatty acids which ultimately forms
triglycerides

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8
Q

when insulin is lacking what happens to fat

A

fat is released into the bloodstream

as free fatty acids.

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9
Q

when insulin is lacking what happens to protein

A

causes protein breakdown into amino acids

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10
Q

what does insulin potentiate the effect of

A

growth hormone

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11
Q

describe insulin’s role in protein metabolism

A

insulin increases body protein by increasing transport of amino acids into cells

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12
Q

major stimulus of insulin secretion

A

glucose

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13
Q

hormones that raise blood glucose levels

A

Cortisol, Glucagon, Growth hormone, Epinephrine, Estrogen, Progesterone

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14
Q

factors that inhibit insulin secretion

A

hypoxia, hypothermia, stimulation of alpha adrenergic 2 receptors

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15
Q

macrovascular complications of diabetes

A

Cardiovascular &

Cerebrovascular

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16
Q

microvascular complications of diabetes

A

Retinopathy (vision problems)
Nephropathy (kidney dysfunction)
Neuropathy (nerve dysfunction)
Male erectile dysfunction

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17
Q

no matter what type of diabetes the main feature is

A

hyperglycemia

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18
Q

by the time type 1 symptoms appear what has occured

A

80% of beta cells are already gone

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19
Q

what does idiopathic (type 1) mean

A

permanent insulin deficiency

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20
Q

insulin dependent diabetes mellitus

A

IDDM

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21
Q

what percent of those with diabetes are type 1

A

10%

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22
Q

what type of insulin is required for type 1

A

exogenous insulin

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23
Q

what is type 1 associated with

A

high incidence of complications

usually has sudden onset

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24
Q

manifestations of type 1

Study These Flashcards
A
  • Polyuria
  • Polydipsia
  • Polyphagia
  • Hyperglycemia
  • Glucosuria
25
what is type 2 characterized by
hyperglycemia and insulin resistance
26
what does type 2 result from
increased production of glucose by liver and | decreased uptake of glucose in liver, muscle and fat cells
27
what is insulin resistance
higher than usual concentrations of | insulin are required
28
general characteristics of type 2
* Occurs at any age * Gradual onset * Less severe symptoms initially * Easier to control * More MIs and strokes * 90% of those with diabetes are Type 2 * multifactorial
29
risk factors associated with type 2
Family history * Obesity * Inactivity * Race/ethnicity * History of gestational DM * HTN * Metabolic Syndrome
30
what is pre diabetes
at risk for developing diabetes, HD, stroke
31
what is an impaired plasma glucose
2hr plasma glucose greater than 200 | during an oral GTT
32
what is prediabetes characterized by
``` HgA1C levels ( 6.5% or greater) FBS: FBS greater than 126mg/dl ```
33
normal HgA1C level
normal 4-6%
34
how does diabetes confirmation testing work
Fasting Blood Sugar * No calories for 8 hours * Normal 100 mg/dl or less * Significant >100 but < 126 = impaired
35
how is DM diagnosed
Two separate tests greater that 126 mg/dL | Or Casual BG of > 200 mg/dl with symptoms
36
what is an oral glucose tolerance test
* Most sensitive but has issues – cost, inconvenience, timely * Standard for DM * Diagnosis is made if 75 g for 2 hr test or 100 g for 3 hr test
37
values of OGTT
* Normal < 140 mg/dl * Significant >140 but <200 * Diagnostic >200 mg/dl
38
describe HbA1c
Shows average blood glucose levels during the previous 120 days (usually followed not more than 90 days at a time)
39
what is HbA1c used for other than diagnosis
to monitor control of DM
40
values of HbA1c
*Normal 4-6%, level of 6.5% is enough to make a | diagnosis of diabetes, 5.7% to 6.49% is a high risk
41
how to check effective control of DM
HbA1C <7, test urine for ketones and glucose
42
Self Monitoring Blood Glucose (SMBG) for type 1
3-4x day for type 1 | multiple pump injections
43
Self Monitoring Blood Glucose (SMBG) for type 2
post prandial BG
44
the length of time after given before insulin hits bloodstream and begins to lower blood glucose.
onset
45
is the time during which insulin is at its maximum effectiveness at lowering blood glucose.
peak
46
length of time insulin continues to lower blood glucose
duration
47
can insulin be given orally
no
48
types of rapid acting insulin
Humalog (lispro) Novolog (aspart) Apidra (glulisin)
49
types of intermediate acting insulin
NPH (N) | Lente (L)
50
types of short acting insulin
Regular (R) humulin or novolin | Velosulin (for use in the insulin pump)
51
types of long acting insulin
Ultralente (U) Lantus Levemir (detemir)
52
types of pre mixed insulin
Humulin 70/30 Novolin 70/30 Novolog 70/30 Humulin 50/50
53
advantage of premixed insulin
fast and long acting is combined in one injection
54
rapid acting onset, peak, duration
onset: 15 min peak: 1-1 1/2 hr duration: 3-4 hr
55
short acting onset, peak, duration
onset: 30 min- 1 hr peak: 2-3 hr duration: 4-6 hr
56
NPH peak, onset, duration
onset: 2 hr peak: 6-8 hr duration: 12-16 hr
57
detemir onset, peak, duration
onset: none peak: none duration: 17-24 hr
58
long onset, peak, duration
onset: none peak: none duration: 24 hr
59
mixed onset, peak, duration
onset: 30 min peak: 4-8 hr duration: 24 hr

Chronic Rehab (18 decks)

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