Diabetes Management Quiz

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Questions and Answers

What is the primary goal of diet management in diabetes treatment?

To completely eliminate carbohydrates from the diet

To increase the intake of saturated fats

To maintain blood glucose and lipids levels within normal limits (correct)

To focus solely on protein intake

Which percentage of a diabetic patient's diet should consist of carbohydrates?

12% to 20%

40% to 45%

50% to 55% (correct)

30% to 35%

What is an important consideration before starting an exercise program for diabetic patients?

The blood glucose control level of the patient (correct)

The patient's preference for high-energy exercises

Immediate initiation of high-intensity workouts

Regular consultation with a nutritionist

What type of insulin has an onset time of ½ to 1 hour?

Short-acting insulin Signup and view all the answers

What is a key benefit of exercise for individuals with diabetes?

Improves glucose utilization for energy Signup and view all the answers

Which of the following is not a common type of insulin mentioned?

Delayed-release insulin Signup and view all the answers

What should diabetic patients always have available during exercise?

Emergency supplies for hypoglycemia treatment Signup and view all the answers

What is the primary characteristic of diabetes mellitus?

Abnormal insulin production or impaired insulin utilization, or both Signup and view all the answers

What component of diabetes management does not typically include lifestyle changes?

Pharmacotherapy management Signup and view all the answers

Which of the following is NOT a long-term complication of diabetes?

Common cold Signup and view all the answers

What age is recognized as a risk factor for developing diabetes mellitus?

Age 45 years or older Signup and view all the answers

How does type 1 diabetes differ from type 2 diabetes?

Type 1 is insulin dependent while type 2 is non-insulin dependent Signup and view all the answers

Which risk factor is indicated by a blood pressure reading of ≥140/90 mm Hg?

Hypertension Signup and view all the answers

Which statement is true regarding the incidence of type 1 diabetes?

It primarily occurs more in younger children Signup and view all the answers

What percentage of people with diabetes have type 1 diabetes?

Approximately 5% Signup and view all the answers

Which factor is NOT listed among the common risk factors of diabetes mellitus?

Age under 40 Signup and view all the answers

What is the primary purpose of self-monitoring of blood glucose (SMBG) levels for diabetic patients?

To alter diabetes care dramatically Signup and view all the answers

Which of the following is NOT a common cause of hypoglycemia in diabetic patients?

Excessive carbohydrate consumption Signup and view all the answers

What is a significant complication associated with high doses of insulin therapy?

Lipodystrophy Signup and view all the answers

Which of the following symptoms is a late sign of hypoglycemia?

Confusion Signup and view all the answers

In managing diabetes, what must patients learn to prevent acute fluctuations in blood glucose?

Daily self-care skills and monitoring techniques Signup and view all the answers

What is the definition of hypoglycemia in terms of blood glucose levels?

Blood glucose between 50 – 60 mg/dl Signup and view all the answers

Which of these factors can negatively impact diabetic control?

Physical and emotional stress Signup and view all the answers

What is an allergic reaction to insulin known as?

Insulin hypersensitivity Signup and view all the answers

What is a key nursing diagnosis related to elevated blood glucose levels?

Sensory perceptual alteration related to effect of elevated blood glucose Signup and view all the answers

What blood glucose level is considered a potential indicator of diabetes?

200 mg/dL or more Signup and view all the answers

Which of the following is NOT a recommended intervention for a patient with reduced sensation in their feet?

Regularly check blood pressure Signup and view all the answers

What should a patient do first if they experience hypoglycemia at home and are able to swallow?

Give ½ cup of juice Signup and view all the answers

What does the hemoglobin A1c test measure?

Average blood glucose level over the past 2 to 3 months Signup and view all the answers

What is considered a normal A1c level for individuals without diabetes?

4% to 5.6% Signup and view all the answers

Which items are appropriate fast-acting sources of sugar for treating hypoglycemia?

6-7 hard candies or ½ cup of juice Signup and view all the answers

What is a recommended practice for proper skin and foot care in diabetic patients?

Inspect feet daily for abnormalities Signup and view all the answers

Which of the following is NOT a usual symptom of diabetes?

Frequent headaches Signup and view all the answers

What is the target A1c level for individuals diagnosed with diabetes?

Less than 7% Signup and view all the answers

How should insulin be administered safely?

Rotate the injection site and select accordingly Signup and view all the answers

Which practice should be avoided when washing feet?

Soaking the feet for extended periods Signup and view all the answers

How often should individuals with diabetes have their hemoglobin A1c tested?

Regularly as determined by a doctor Signup and view all the answers

What does a hemoglobin A1c level of 6.5% or higher indicate?

Diabetes Signup and view all the answers

When checking for foot abnormalities, which area should be particularly inspected?

Between the toes Signup and view all the answers

What role does hemoglobin play in the body?

Carries oxygen Signup and view all the answers

What is a common range for blood glucose levels in severe cases related to hyperosmolar hyperglycemic state?

600 to 1,200 mg/dL Signup and view all the answers

Which of the following is a primary goal of medical management in HHNS?

Insulin administration Signup and view all the answers

What condition is associated with a significantly increased risk of cardiovascular disease in individuals with diabetes?

Peripheral vascular disease Signup and view all the answers

What should be closely monitored in patients with hyperosmolar hyperglycemic state to prevent renal failure?

Fluid status and urine output Signup and view all the answers

Which of the following symptoms is NOT typically associated with cerebral dehydration from extreme hyperosmolality?

Increased appetite Signup and view all the answers

What is the significance of monitoring blood glucose in patients with diabetes mellitus?

To check for signs of complications Signup and view all the answers

What electrolyte disturbance is commonly found in patients experiencing severe dehydration?

Hyperkalemia Signup and view all the answers

Which nursing action is essential to ensure patient safety in the presence of altered sensorium due to a hyperosmolar hyperglycemic state?

Implementing fall prevention strategies Signup and view all the answers

Study Notes

Diabetes Mellitus

Diabetes mellitus (DM) is a chronic, multisystem disease related to abnormal insulin production, impaired insulin utilization, or both.
It's a serious health problem globally, with prevalence rapidly increasing.
DM is the seventh leading cause of death worldwide.

Complications

Long-term complications include adult blindness, end-stage kidney disease, and non-traumatic lower limb amputations.
It's a major factor contributing to heart disease and stroke.
Adults with diabetes have heart disease death rates 2 to 4 times higher than those without.
Stroke risk is also 2 to 4 times higher for people with diabetes.
Approximately 67% of adults with diabetes have hypertension.

Risk Factors

Genetic: Family history of diabetes (parents or siblings).
Metabolic: Obesity, emotional and physical stress.
Microbiological: Viral infection (in some types).
Immunological: Age ≥45 years, hypertension (≥140/90 mm Hg), low HDL cholesterol level, triglyceride.
History of gestational diabetes or delivery of babies over 9 lbs

Classification of Diabetes

Type 1 (IDDM): Juvenile-onset or insulin-dependent diabetes.
- Accounts for approximately 5% of all people with diabetes.
- Primarily affects people under 40, with 40% developing it before age 20.
- Incidence has increased slightly in recent decades, occurring more frequently in younger children.
Type 2 (NIDDM): Adult-onset or non-insulin-dependent diabetes.
- Most prevalent type, accounting for 90-95% of cases.
- Risk factors include being overweight/obese, older age, and a family history of type 2 diabetes.
- Increasing incidence due to childhood obesity.
Gestational: Occurs during pregnancy.
Secondary: Associated with other conditions like pancreatitis.

Physiology and Pathophysiology of Diabetes

Insulin: Secreted by beta cells in the islets of Langerhans in the pancreas.
- Insulin is an anabolic (storage) hormone.
- Released when a person eats a meal to move glucose from the blood into muscle, liver and fat cells.
Glucose Metabolism: Insulin facilitates glucose transport and storage, inhibiting the breakdown of stored glucose
- In fasting states, the pancreas secretes basal insulin. Glucagon is released when blood glucose drops; it stimulates the liver to release stored glucose.
The liver also produces glucose through the breakdown of glycogen (glycogenolysis). After 8 to 12 hours without food, the liver forms glucose from amino acids (gluconeogenesis).

Type 1 Diabetes Pathophysiology

Destruction of beta cells results in reduced insulin production and unchecked (high) glucose produced by the liver
Glucose can't be stored in the liver, leading to elevated postprandial (after meals) hyperglycemia.
If blood glucose exceeds renal threshold, glucose appears in the urine (glucosuria), resulting in osmotic diuresis (fluid loss).
Fat breakdown increases, producing excessive ketone bodies which contribute to hyperglycemia.

Type 2 Diabetes Pathophysiology

Key problems are insulin resistance and impaired insulin secretion.
Insulin resistance reduces tissue sensitivity to insulin.
Glucose uptake by tissues and regulation of glucose release are diminished.
Genetic factors likely play a role.
Increased amounts of insulin are secreted to offset resistance, but beta cells may not be able to keep up, leading to high glucose levels.
Uncontrolled Type 2 diabetes may lead to HHNS (hyperglycemic hyperosmolar non-ketotic syndrome). Ketone body production doesn't occur to the same extent in Type 2, so DKA is less common.

Management of Type 1 and Type 2 Diabetes

Diet: Crucial for management.
Exercise: Essential.
Pharmacologic Therapy:
- Insulin therapy (Type 1 and some Type 2)
- Oral hypoglycemic agents (mostly Type 2)
Monitoring: Frequent blood glucose monitoring.
Education: Critical to self-management.

Gestational Diabetes

Any degree of glucose intolerance during pregnancy.
Risk factors include age 25+ or obesity, family history of diabetes or ethnicity with high prevalence.

Complications of Diabetes Mellitus

Acute complications: Diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar nonketotic syndrome (HHNS).
Chronic complications: Cardiovascular disease (CVD), peripheral vascular disease, nephropathy, retinopathy, neuropathy.

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Description

Test your knowledge on the key aspects of diabetes management, including diet, insulin types, exercise considerations, and complications. Understand the differences between type 1 and type 2 diabetes, as well as essential protocols for diabetic patients.