Diabetes type 1&2 Flashcards by Karlee Porter

What is the only hormone to have a direct effect on lowering blood glucose?

insulin

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What are the two main controls of blood sugar?

insulin and glucagon

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How does insulin use to promote glucose uptake?

target cells

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What does insulin store blood glucose as?

glycogen

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What does insulin prevent the breakdown of?

fat and glycogen breakdown

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What does insulin increase the synthesis of?

protein

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What releases digestive juices through a duct to the duodenum?

exocrine pancreas

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What releases hormones into the blood?

endocrine pancreas

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What are the pancreatic hormones?

glucagon
insulin
Amylin
Somatostatin

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What hormone causes cells to release stored food into the blood?

Glucagon

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What hormone allows cells to take up glucose from the blood – lowering blood sugar?

insulin

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What hormone stabilizes blood sugar by – slowing glucose absorption in small intestine and suppressing glucagon secretion?

Amylin

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What hormone decreases GI activity and suppresses glucagon and insulin secretion?

Somatostatin

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What changes when there is insufficient insulin release?

metabolic changes

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What is Glycosuria?

Sugar is spilled into the urine

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What is Polyphagia?

Increased hunger

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What is Polydipsia?

Increased thirst

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What is Lipolysis?

Fat breakdown

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What is Ketosis?

Ketones cannot be removed effectively

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What is Acidosis?

Liver cannot remove all of the waste products

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What are the s/s of acidosis?

N/V and tachypnea

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What is a group of diseases marked by high level of blood glucose as a result of defects in insulin production, insulin action, or both?

diabetes

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What accounts for most new cases of blindness, end-stage kidney disease requiring dialysis or transplant, and foot or leg amputations?

diabetes

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What do 68% of people with diabetes die from?

cardiovascular disease or stroke

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What is diabetes the leading cause of?

dental disease and sexual dysfunction

What is diabetes mellitus (DM) a contributing factor in the development of?

``` cardiovascular disease hypertension renal failure blindness stroke ```

What are the risk factors for DM?

Genetics-Type 1 or Type 2 Toxins and viruses predispose individuals by destroying the beta cells leading to Type 1 DM Obesity, physical inactivity, and HTN Pancreatitis and Cushing’s disease

What type of DM is pancreatic beta cell destruction?

type one

What is the predominant cause of type 1 DM?

an autoimmune process

What type of DM is a combination of beta cell dysfunction and insulin resistance?

type 2

What are some of the other types of DM?

Genetic defects in insulin production or action Diabetes secondary to other diseases Drug interactions Gestational Diabetes

What diabetes has a higher prevalence in adults?

type 2 (95% of all cases)

What is the chance of developing diabetes within 10-20 years of delivery with GDM?

35-60%

When is the onset of age for Type 1 DM?

before age 30

What does type 1 DM require?

insulin injections

How does a viral infection cause Type 1 DM?

autoantibodies against bet cells

What does beta cell destruction result in with Type 1 DM?

NO insulin production

What happens when 90% of beta cells have been destroyed?

enhanced decomposition of fat and protein catabolism occurs - they loose allot of weight

Is Type 1 DM have a slower or quicker onset?

quicker

What are the typical symptoms seen with the onset of Type 1 DM?

polydipsia polyuria polyphagia

What age do people usually get Type 2 DM?

usually over age 40

What may treat Type 2 DM effectively?

diet and exercise

What may be required if diet and exercise doesn't treat Type 2 DM effectively?

oral agents and/or insulin

What causes Type 2 DM?

Impaired insulin secretion Inappropriate production of liver glucose Insensitivity to peripheral insulin receptor

What are the two biggest risk factors for Type 2 DM?

Obesity and sedentary lifestyle

What is insulin resistance?

decreased ability to respond to insulin

When there is a decreased insulin secretion, what does this lead to?

beta-cell failure

What is Secondary Diabetes - MODY?

mature onset of diabetes in youth

How does MODY present?

identical to Type 2 DM

What kind of onset does Type 2 DM usually have?

slow and insidious - usually unaccompanied by symptoms

What is gestational DM?

Glucose intolerance during pregnancy | Placental hormones counteract insulin

What does gestational DM increase the risk for?

type 2 DM later

What is hyperglycemia without meeting diagnostic criteria for diabetes mellitus?

Pre-Diabetes

What are the levels for Pre-Diabetes with fasting plasma glucose (FPG)?

100-125mg/dL - impaired fasting glucose

What Fasting Plasma Glucose (FPG) level indicates diabetes?

over 126mg/dL

What are the levels for pre-diabetes with a 2hr post 75-g oral glucose tolerance test?

140-199mg/dL - impaired glucose tolerance

What is the A1c percent for Pre-Diabetes?

5.7-6.4%

What is the A1c percent for diabetes?

greater than 6.5%

Is diabetes still diagnosed with glucose tolerance test?

How is Diabetes diagnosed now?

with random blood sugar of 200 or higher with symptoms (the P's, fatigue, etc.)

If the random blood sugar is 199, what does it indicate?

pre-diabetes

What are the symptoms of DM?

``` Polyuria Polydipsia Polyphagia Weight loss (Type 1) HA Muscle cramps Numbness & tingling Delayed healing ```

What are the clinical s/s of hyperglycemia?

``` fatigue lethargy irritation glycosuria polyphagia polydipsia polyuria itchy skin ```

What is Metabolic Syndrome?

``` Abdominal obesity Increased blood triglyceride levels Decreased HDL levels Increased blood pressure Increased fasting plasma glucose ```

In Metabolic Syndrome, what is the pre-diabetic waist circumference for men and women?

men >40 inches | women >35 inches

In Metabolic Syndrome, what is the pre-diabetic Triglyceride level?

>150

In Metabolic Syndrome, what is the pre-diabetic HDL level for men and women?

Men <50

In Metabolic Syndrome, what is the pre-diabetic blood pressure?

greater than or equal to 130/85

In Metabolic Syndrome, what is pre-diabetic FPG?

>/=100

What will be screened for diabetes?

all individuals 45 and older, every three years

When are adults screened sooner than 45 years old?

``` BMI >25 andPhysically inactive First degree relative with DM Ethnicity - #1 native Americans, #2 African American History of GDM or delivery of > 9lb baby HTN >/= 140/90 HDL /= 250 PCOS or acanthosis nigricans – dark ring around neck IGT or IFG previously History of vascular disease ```

What do insulin injections prevent with type 1 DM?

hyperglycemia and ketosis

What kind of disease is Type 2 DM?

metabolic disease

What can Type 2 DM result from?

loss of receptor sensitivity to insulin poor control of liver glucose output decreased beta cell function

What ethic populations have the highest prevalence of Type 2 DM?

``` #1 native americans #2 african americans #3 hispanics ```

What is the glycosylated hemoglobin (HbA1c) criteria diagnosing diabetes?

>/= 6.5%

What is Fasting plasma glucose criteria diagnosing diabetes?

>126 mg/dL

What is the 2-hr plasma glucose criteria level for diagnosing diabetes?

>200 mg/dL post 75-g oral glucose challenge

What is the Random plasma glucose criteria for diagnosing diabetes?

>200 mg/dL with symptoms of diabetes (polyuria, polyphagia, and polydipsia)

What are the ABCs of diabetes?

A1c<7% Blood pressure Cholesterol levels

What are the Cholesterol treatment level goals with diabetes (LDL, HDL, and Trig)?

LDL 40 men HDL >50 women Trig <150

What is the treatment goal for blood pressure?

<130/80

What does Prandial mean?

meal

What is the pre-prandial treatment goal for A1c7%?

70-130

What is the A1c7% treatment goal for peak pp glucose level?

<180

If a patient's blood sugar is diet controlled, how often should they monitor it?

1-2 x day

If a patient's blood sugar is controlled by oral meds, how often should they check it?

1-2 x day

If a patient's blood sugar is controlled by daily insulin, how often should they check it?

1-2 x day

If a patient's blood sugar is controlled with BID insulin, how often should they check it?

2-4 x day

If a patient's blood sugar is controlled with TID-QID insulin, how often should they check it?

3-6 x day

When should patients monitor their blood sugar more often?

if they become ill or having blood sugar fluctuations

What do morning value (before eating) BS level reflect?

effectiveness of overnight insulin

What do pre-meal BS values reveal the effectiveness of?

basal insulin or insulin from previous meal

What can all pre-meal BS values do?

guide adjustment of meal-related insulin doses

What do post-meal BS values reveal?

effect of food eaten

What doe post-meal BS values measure?

match of food and insulin

Diabetes type 1&2 Flashcards

(96 cards)