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CMN572 > unit 3: gen DM, hypoglycemia > Flashcards

unit 3: gen DM, hypoglycemia Flashcards

1
Q

DM1 age and characteristic of onset

A
  • childhood/adolescence

* rapid development of s/s

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2
Q

DM2 age and characteristic of onset

A
  • most commonly >45

* gradual development of s/s

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3
Q

DM1 nutritional status at time of onset

A

usually undernourished

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4
Q

DM2 nutritional status at time of onset

A

usually obese

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5
Q

DM1 strength of genetic predisoposition

A

moderate

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6
Q

DM2 strength of genetic predisposition

A

very strong

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7
Q

DM1 frequency of ketosis

A

COMMON

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8
Q

DM2 frequency of ketosis

A

RARE

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9
Q

DM1 risk factors

A

family hx

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10
Q

DM2 risk factors

A

overweight/obese
sedentary
family hx
HTN

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11
Q

complications of DM1

A

ketoacidosis

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12
Q

complications of DM2

A

hyperosmolar coma

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13
Q

s/s of DM1

A
  • polyuria, polydipsia, polyphagia
  • rapid weight loss
  • DKA
  • blurred vision
  • pruritis
  • weakness
  • postural hypotension
  • parasthesia
  • vulvovaginitis
  • mood changes/irritability
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14
Q

S/s DM2

A
  • polyuria, polydipsia, polyphagia
  • central obesity
  • HHS (hyperglycemic hyperosmolar state)
  • blurred vision
  • pruritis
  • fatigue
  • chronic skin infections/poor wound healing
  • recurrent vaginal yeast infections
  • dark patches on armpits/neck (acanthosis nigricans)
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15
Q

prevention for DM1

A

none

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16
Q

preventionfor DM2

A

healthy lifestyle

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17
Q

general treatment for DM1

A

insulin

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18
Q

general treatment for DM2

A

diet, exercise
PO hypoglycemics
add insulin if needed

19
Q

how does the body respond to extra glucose in the body?

A

stores in liver/muscles > liver converts glucose to glycogen
*body uses glycogen for energy between meals or is changed to fat & stored in fat cells

20
Q

how does the body respond when BG begins to drop?

A

glucagon signals to liver to break down glycogen > releases glucose into bloodstream > BG levels rise

21
Q

insulin feedback loop is impaired in diabetic pts: ______ response to hypoglycemia is impaired

A

glucagon

22
Q

s/s of hypoglycemia

A

hunger, shakiness, nervousness, sweating, dizziness, sleepiness, confusion, difficulty speaking, anxiety, weakness

23
Q

what causes hypoglycemia in people w diabetes?

A
  • insulins
  • oral DM meds (sulfas, meglitinides, DPP4-inhibs, & combo pills)
  • injectables (pramlintide/symlin, exenatide/byetta)
  • taking pills & insulin
  • changes in eating habits, activity
  • illness
  • ETOH (esp on empty stomach)
24
Q

what oral DM meds can cause hypoglycemia?

A
  • SULFAS
  • chlorpropamide
  • glimeperide
  • glipizide
  • glyburide
  • tolazamide
  • tolbutamide
  • MEGLITINIDES
  • nateglinide
  • repaglinide
  • DPP4- inhibs
  • sitagliptin

*ANY COMBO MED CONTAINING ANY OF THESE

25
Q

SULFAS that can cause hypoglycemia

A 
"ides"
CGGGTT
-chlorpropamide
-glimeperide
-glipizide
-glyburide
-tolazamide
-tolbutamide
26
Q

meglitinides that can cause hypoglycemia

A

“glinides” “nate & repa”

  • nateglinide
  • repaglinide
27
Q

DPP4-inhib that can cause hypoglycemia

A

sitagliptin…. but really only when used w other drugs

28
Q

combo pills that can cause hypoglycemia

A
  • glipizide + metformin (metaglip)
  • glyburide + metformin (glucovance)
  • pioglitazone + glimeperide (duetact)
  • rosiglitazone + glimeperide (avandaryl)
  • sitagliptin + metformin (janumet)
29
Q

injectables that can cause hypoglycemia

A

“tides”

  • pramlintide (symlin_
  • exanatide (byetta) when used in combo w sulfas
30
Q

oral DM agents that DO NOT cause hypoglycemia

A
  • alpha-glucosidase inhibitors
  • acarbose (precose)
  • miglitol (glyset)

*biguanides -(metformin)

  • TZDs
  • pioglitazone (actos)
  • rosiglitazone (avandia)
31
Q

pts taking acarbose or miglitol will need ______ to raise BG during hypoglycemic event bc _______

A

pure, readily absorbable glucose. gel or tabs for oral absorption….

these meds slow digestion of carbs (foods wont work)

32
Q

quick fix foods/solutions for hypoglycemia

A
  • 3-4 glucose tabs
  • 1 serving glucose gel (15gm of sugar)
  • 1/2c (4oz) fruit juice
  • 1/2c (4 oz) soda
  • 1c (8oz) milk
  • 5-6 pieces hard candy
  • 1tbsp sugar or honey
33
Q

severe hypoglycemia (<54) is more likely to occur in DM__?

A

1

34
Q

severe hypoglycemia is defined as BG less than?

A

54

35
Q

treatment for severe hypoglycemia if pt unable to take PO

A

glucagon injection

36
Q

what is HAAF?

A

hypoglycemia associated autonomic failure. basically body stops releasing epi & stress hormones when BG is low

37
Q

advise those w hypoglycemia to aim for ______ glucose targets for ______ term periods. why?

A

higher than usual glucose targets for short term periods (several weeks)
*to break cycle of hypoglycemia & restore stress response

38
Q

do not drink ETOH on an empty stomach bc?

A

hypoglycemia can occur 1-2d later. always drink ETOH w a snack or meal

39
Q

BG goal when treating for hypoglycemia

A

70

40
Q

if meal is 1+hr away s/p hypoglycemia attack and recovery to 70+BG what should pt do?

A

have a snack before meal to sustain BG

41
Q

discontinue _______ once meal-time insulin is added to regime. why?

A

sulfas

*risk of hypoglycemia

42
Q

as ______ function declines, many DM___ pts will require _____.

A
  • beta cell
  • 2
  • insulin

*** this does not mean the pt has failed or is non-compliant

43
Q

physical activity can cause hypoglycemia up to _____h after exercise

A

24

44
Q

if taking insulin or oral meds to increase insulin production & planning physical activity check bg _____ and have a snack if BG is

A

before exercise

under 100

CMN572 (13 decks)

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