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Overview of Diabetes Mellitus
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Overview of Diabetes Mellitus

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Questions and Answers

Which of the following statements accurately describes the A1C measurement?

  • Increases in A1C indicate fluctuations in daily blood glucose levels.
  • A1C levels are not relevant for diagnosing diabetes.
  • It measures blood glucose levels only within the past week.
  • It reflects blood glucose levels over the previous 2 to 3 months. (correct)

    • What defines the threshold for fasting plasma glucose (FPG) to indicate diabetes?

  • A level below 100 mg/dL (5.6 mmol/L).
  • A level of 126 mg/dL (7.0 mmol/L) or greater. (correct)
  • A level of 140 mg/dL (7.8 mmol/L) or greater.
  • A level of 110 mg/dL (6.1 mmol/L) or greater.

    • What characterizes Diabetes Mellitus?

  • Chronic multisystem disease characterized by hyperglycemia (correct)
  • An acute illness primarily caused by viral infections
  • Hypoglycemia from excessive insulin production
  • A hereditary disease that only affects the kidneys

    • Which statement best describes prediabetes?

    <p>It indicates elevated glucose levels but not high enough for a diabetes diagnosis.</p> Signup and view all the answers

    Which of the following is NOT a risk factor for developing Diabetes Mellitus?

    <p>Being younger than 45 years</p> Signup and view all the answers

    What is the 2-hour plasma glucose threshold during an OGTT that indicates diabetes?

    <p>200 mg/dL (11.1 mmol/L) or greater.</p> Signup and view all the answers

    What role does insulin play in the regulation of blood glucose levels?

    <p>Facilitates glucose transport from blood into cells</p> Signup and view all the answers

    What is a target A1C goal for patients with diabetes according to the ADA?

    <p>Less than 7.0%.</p> Signup and view all the answers

    Which of the following best describes gestational diabetes?

    <p>It may increase the risk of complications during Cesarean delivery.</p> Signup and view all the answers

    Which hormone is considered a counterregulatory hormone to insulin?

    <p>Glucagon</p> Signup and view all the answers

    What is the normal glucose range maintained by insulin?

    <p>70 to 120 mg/dL</p> Signup and view all the answers

    What are common symptoms to monitor for in diabetes?

    <p>Fatigue, slow-healing wounds, and frequent infections.</p> Signup and view all the answers

    Which of the following is a common cause of Type 1 Diabetes Mellitus?

    <p>Genetic and autoimmune factors</p> Signup and view all the answers

    What glucose levels are associated with impaired glucose tolerance (IGT)?

    <p>140 to 199 mg/dL (7.8 to 11.0 mmol/L).</p> Signup and view all the answers

    What is the consequence of impaired insulin production or use?

    <p>Elevated blood glucose levels (hyperglycemia)</p> Signup and view all the answers

    What can be considered a direct result of elevated blood glucose over time?

    <p>End stage renal disease and adult blindness</p> Signup and view all the answers

    Why should insulin not be taken orally?

    <p>It is inactivated by gastric fluids.</p> Signup and view all the answers

    What is the primary purpose of rotating insulin injection sites?

    <p>To reduce the risk of excess bruising and lipodystrophy.</p> Signup and view all the answers

    What does U100 insulin signify?

    <p>There are 100 units of insulin per 1 mL.</p> Signup and view all the answers

    What is the recommended angle for administering insulin injections?

    <p>45-90 degrees.</p> Signup and view all the answers

    Which of the following is a reason for using an insulin pump?

    <p>To simplify meal planning and insulin delivery.</p> Signup and view all the answers

    What should be done if a patient experiences hypoglycemia and does not improve after administering glucagon?

    <p>Re-administer glucagon after 20 minutes.</p> Signup and view all the answers

    What is one possible local reaction to insulin that may occur at the injection site?

    <p>Erythema.</p> Signup and view all the answers

    What does the Somogyi effect describe?

    <p>Morning hyperglycemia resulting from rebound hyperglycemia after hypoglycemia.</p> Signup and view all the answers

    Which condition results from a high dose of insulin leading to a decline in blood glucose levels during the night?

    <p>Somogyi effect</p> Signup and view all the answers

    What is a recommended treatment for the Somogyi effect?

    <p>Having a bedtime snack</p> Signup and view all the answers

    Which method is effective for confirming morning hyperglycemia caused by the Somogyi effect?

    <p>Monitor blood glucose between 2:00 and 4:00 AM</p> Signup and view all the answers

    What is the primary action of Metformin in drug therapy?

    <p>Reduce glucose production by the liver</p> Signup and view all the answers

    What is a characteristic feature of the dawn phenomenon?

    <p>Hyperglycemia upon awakening</p> Signup and view all the answers

    Which nursing consideration is critical when administering a-glucosidase inhibitors like Glyset?

    <p>Take with the first bite of each meal</p> Signup and view all the answers

    What adjustment may be necessary to treat the dawn phenomenon?

    <p>Increase insulin dosage or adjust timing</p> Signup and view all the answers

    Which of the following best describes the effect of the dawn phenomenon compared to the Somogyi effect?

    <p>Dawn phenomenon occurs in the morning, while Somogyi effect occurs overnight</p> Signup and view all the answers

    What is the primary action of sulfonylureas in managing diabetes?

    <p>They stimulate β-cells in the pancreas to secrete more insulin.</p> Signup and view all the answers

    What is a common side effect experienced by patients using meglitinides?

    <p>Hypoglycemia</p> Signup and view all the answers

    Which dietary component is emphasized by MyPlate for managing blood sugar levels?

    <p>Low carbs and lean meats</p> Signup and view all the answers

    What condition is characterized by hyperglycemia, ketosis, acidosis, and dehydration?

    <p>Diabetic Ketoacidosis (DKA)</p> Signup and view all the answers

    What physiological process occurs due to lack of insulin during hyperglycemia?

    <p>Breakdown of fat stores for energy.</p> Signup and view all the answers

    What role does patient education play in diabetes management?

    <p>It reinforces medication administration and dietary instructions.</p> Signup and view all the answers

    What triggers dehydration in patients with Diabetic Ketoacidosis (DKA)?

    <p>The body's use of fat stores for energy.</p> Signup and view all the answers

    Which of the following foods is least likely to raise blood sugar levels?

    <p>Lean meats</p> Signup and view all the answers

    Study Notes

    Overview of Diabetes Mellitus

    • Chronic multisystem disease characterized by hyperglycemia due to abnormal insulin production or impaired use.
    • Major complication risks include end-stage renal disease, adult blindness, and nontraumatic lower limb amputations.

    Risk Factors

    • Family history of diabetes.
    • Prior glucose intolerance (gestational diabetes or prediabetes).
    • Ethnic background, particularly Hispanic heritage.
    • Age over 45 years.
    • Presence of obesity.
    • History of childbirth with an infant weighing over 9 pounds.

    Etiology and Pathophysiology

    • Type 1 and Type 2 diabetes influenced by genetic, environmental, and autoimmune factors (especially Type 1).
    • Insulin, produced by β cells in the pancreas, regulates blood glucose levels, aiming for a normal range of 70-120 mg/dL.
    • Counterregulatory hormones (glucagon, epinephrine, GH, cortisol) maintain glucose levels during fasting and eating.

    Diagnostic Criteria for Diabetes

    • A1C level of 6.5% or higher indicates diabetes, reflecting average blood glucose over 2-3 months.
    • Fasting plasma glucose (FPG) ≥ 126 mg/dL after 8 hours of no caloric intake.
    • OGTT: 2-hour plasma glucose level of 200 mg/dL or greater after a 75 g glucose load.
    • Random plasma glucose level ≥ 200 mg/dL with classic hyperglycemia symptoms (e.g., polyuria, polydipsia).

    Prediabetes

    • Diagnosed via impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).
    • IGT: OGTT values of 140-199 mg/dL.
    • Generally asymptomatic, but increases risk for developing Type 2 diabetes.

    Gestational Diabetes

    • Occurs during pregnancy, increasing the risk for cesarean delivery.
    • Screening typically performed between 24-28 weeks of gestation.
    • Insulin administered subcutaneously due to inactivation by gastric fluids.

    Insulin Delivery

    • Insulin pumps provide continuous subcutaneous insulin infusion.
    • Basal rate can be adjusted based on factors like carbohydrate intake and physical activity.
    • Risks include infection if sites are not rotated frequently.

    Problems with Insulin Therapy

    • Hypoglycemia treated with glucagon (0.5-2 mg, IM) and carbohydrate replenishment.
    • Allergic reactions might occur, manifested by itching and erythema at injection sites.
    • Lipodystrophy can develop from frequent use of the same injection site.
    • Somogyi effect: morning hyperglycemia resulting from nocturnal hypoglycemia; managed by adjusting insulin dose or having a bedtime snack.
    • Dawn phenomenon: morning hyperglycemia; often treated by increasing insulin or altering administration timing.

    Pharmacotherapy for Diabetes

    • Biguanides (Metformin): Reduces liver glucose production; promotes weight loss and suitable for overweight individuals.
    • α-Glucosidase Inhibitors (Glyset, Precose): Slows carbohydrate metabolism; best taken with first food intake.
    • Sulfonylureas (Glucotrol, Glynase): Stimulates insulin secretion; common side effect is hypoglycemia.
    • Meglitinides (Prandin): Stimulates rapid insulin release from the pancreas; hypoglycemia is a frequent effect.

    Interprofessional Care

    • Emphasis on patient education for medication adherence, administration, and lifestyle management.
    • Nutrition therapy aligns with USDA guidelines (MyPlate concept); focus on balanced food sources.

    Acute Complications of Diabetes

    • Diabetic Ketoacidosis (DKA): A critical condition resulting from severe insulin deficiency leading to hyperglycemia, ketosis, acidosis, and dehydration.
    • Symptoms stem from cell inability to utilize glucose, forcing reliance on fat breakdown for energy, leading to ketoacidosis and severe dehydration.

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    Description

    Test your knowledge on the complexities of diabetes mellitus, including its risks, symptoms, and pathophysiology. This quiz covers essential diagnostic criteria and major complications associated with diabetes, providing a comprehensive overview of the condition's impact on health.

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