Diabetes Overview: Insulin and Types

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Questions and Answers

What is the primary function of insulin in relation to glucose?

Promotes glucose release from fat

Stimulates glucose transportation and storage (correct)

Inhibits glucose production in muscle

Increases the breakdown of glucose

What condition occurs when Type I diabetes is diagnosed?

Chronic kidney disease

Diabetic ketoacidosis (DKA) (correct)

Sudden hyperglycemia without symptoms

Gradual weight gain and fatigue

Which of the following is a common clinical manifestation of Type I diabetes?

Frequent hunger without weight loss

Stable weight with no thirst

Increased skin elasticity

Frequent urination, thirst, and hunger (correct)

Which of the following statements about the risk factors for Type 1 diabetes is true?

It requires a genetic predisposition combined with environmental factors. Signup and view all the answers

What hormone's production is compromised in Type I diabetes?

Insulin from beta cells Signup and view all the answers

Type II diabetes initially affects which of the following?

Insulin sensitivity and beta cell function Signup and view all the answers

Which of the following symptoms is NOT associated with the clinical presentation of diabetes?

Dizziness upon standing Signup and view all the answers

What initial treatment is typically advised for managing Type II diabetes?

Strict dietary restrictions and regular exercise Signup and view all the answers

What is considered a random glucose level indicating diagnosis of diabetes?

11.1 mmol L Signup and view all the answers

What is a necessary adjustment for a patient using an insulin pump when skipping a meal?

Hold the insulin dose Signup and view all the answers

Which type of insulin has an onset of action lasting about 5 to 15 minutes?

Rapid-acting insulin Signup and view all the answers

Which of the following symptoms is NOT associated with hypoglycemia?

Polyuria Signup and view all the answers

What is the purpose of dietary management in diabetes care?

To achieve and maintain reasonable weight Signup and view all the answers

What should a nurse advise a patient if ketones are present in their urine?

To avoid any form of exercise Signup and view all the answers

What should be administered for the immediate management of hypoglycemia?

15 grams of fast-acting carbohydrates Signup and view all the answers

How long does intermediate-acting insulin typically last?

Up to 24 hours Signup and view all the answers

What metabolic condition results from inadequate amounts of insulin?

Diabetic Ketoacidosis Signup and view all the answers

Which of these symptoms is indicative of the CNS effects of severe hypoglycemia?

Severe disorientation Signup and view all the answers

What effect does fibre have on glucose absorption?

It slows down glucose absorption Signup and view all the answers

What is the recommended carbohydrate intake before moderate exercise in cases of hypoglycemia?

15g Signup and view all the answers

How should insulin delivery be structured for a patient engaging in daily exercise?

Adjust insulin based on meals and exercise Signup and view all the answers

What is the significance of an AIC level of 6.5 in diabetes management?

It confirms a diabetes diagnosis Signup and view all the answers

What is the pH level commonly associated with metabolic acidosis in diabetic ketoacidosis?

Below 7.0 Signup and view all the answers

What should be included in a snack recommended for someone experiencing hypoglycemia?

Fast-acting carbohydrates and protein Signup and view all the answers

What physiological effects are associated with Ketoacidosis?

Low PCO2 reflecting respiratory compensation Signup and view all the answers

Which of the following is a recommended intervention for managing DKA?

Monitor renal function and electrolyte levels Signup and view all the answers

What is a key characteristic of Hyperglycemic Hyperosmolar Syndrome (HHS)?

Presence of osmotic diuresis Signup and view all the answers

Which statement about the blood glucose levels in DKA is accurate?

Blood glucose levels can range significantly Signup and view all the answers

What should be monitored closely during HHS treatment to ensure effective management?

Fluid intake and blood pressure Signup and view all the answers

How can DKA be prevented in patients with Type I diabetes?

By ensuring routine testing of blood sugar levels Signup and view all the answers

What is a common complication of severe hyperglycemia in HHS?

Dehydration and concentrated electrolytes Signup and view all the answers

Which symptom is typically not associated with DKA?

Electrolyte retention Signup and view all the answers

Study Notes

Diabetes Functions of Insulin

Insulin transports and metabolizes glucose for energy
Stimulates glucose storage in liver and muscle as glycogen
Signals the liver to stop releasing glucose
Enhances storage of fat
Accelerates amino acid transport
Inhibits the breakdown of glucose, protein, and fat

Type 1 Diabetes

Beta cells in the pancreas are destroyed by an autoimmune process
The body produces little to no insulin
Diabetic Ketoacidosis (DKA) sets in when diagnosis occurs
Symptoms include polyuria, polydipsia, and polyphagia (frequent urination, thirst, and hunger)

Type 2 Diabetes

Impaired beta cell function leading to reduced insulin production
Initially managed with diet and exercise
Clinical manifestations include fatigue, irritability, skin wounds, vaginal infections, blurred vision, and sudden weight loss, nausea, stomach pain

Diagnostic Findings

Glycated hemoglobin (A1C) of 6.5% or more
Random glucose exceeding 11mmol/L
Oral glucose tolerance test exceeding 7.0mmol/L
Fasting plasma glucose above 7.0mmol/L

Dietary Management

Meet energy needs
Achieve and maintain a reasonable weight
Prevent fluctuations of blood glucose levels
Monitor serum lipids

Glycemic Index

How much food raises blood glucose
Fiber slows absorption of glucose in fruit, starchy foods, and protein don't spike the glycemic index

Insulin Therapy: Onset

Rapid-acting (5-15mins)
Short-acting (30-60mins)
Intermediate (2-4hrs) - NPH
Very long-acting (1-6hrs) - continuous

Insulin Therapy: Two or more daily injections

May need to adjust daily exercise & diet regime, premixed cannot be adjusted
Test blood more often
Adjust doses for meals and exercise
More flexible doses
Insulin pump
Bolus occurs at mealtimes, must manage diabetes for 1 year, and then can get a pump

Hypoglycemia

Low blood glucose (<3.7mmol/L)
Symptoms include sweating, tremors, tachycardia, palpitations, nervousness, and hunger
CNS symptoms include headache, lightheadedness, confusion, slurred speech, disorientation, seizures, difficulty arousing from sleep, and loss of consciousness
Management involves giving 15g of fast-acting carb, 125ml of juice/soda, 3 hard candies, 15ml of sugar

Diabetic Ketoacidosis (DKA)

Inadequate amount of insulin
Abnormal metabolism of carb, fat, and protein
Features include hyperglycemia, dehydration, and electrolyte loss, acidosis with a PH value <7.5.

Risk Factors

Type 1: Inherited, but likely genetic predisposition combined with environmental factors (possibly viral)
Type 2: Family history of diabetes, ethnicity, age over 45, obesity, hypertension, gestational diabetes. Babies weighing over 9.165 lbs.

Prevention of DKA

Follow "sick-day rules" (take insulin as usual, test blood glucose every 3-4 hrs, may need to take supplemental doses of regular insulin, cannot skip meals.)
Hyperglycemic Hyperosmolar Syndrome (HHS): lack of effective or absent insulin, hyperglycemia causes osmotic diuresis with loss of water and electrolytes.
Management involves hydration, insulin administration, monitoring fluid and electrolytes

Long-term Complications of Diabetes

Macrovascular changes (atherosclerotic changes, coronary artery disease, ex: ulcers, strokes, and MI)
Microvascular damage to eyes and kidneys
Neuropathic changes (peripheral neuropathy, autonomic neuropathies, and sexual dysfunction)

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Description

Explore the essential functions of insulin and its role in diabetes management. This quiz covers the differences between Type 1 and Type 2 diabetes, their symptoms, and key diagnostic findings. Test your knowledge on how insulin impacts glucose metabolism and storage in the body.