1A majority of type I diabetes patients have destruction of the pancreatic islet B cells through ____ process
autoimmune (90%)
2When does type I diabetes peak?
before school age and at puberty
3What happens first when the body has no insulin?
liver produces more glucose and glucose accumulates in the bloodstream
4What happens after glucose accumulates in the bloodstream?
body needs an alternative source of energy and starts breaking down fat which produces ketones which also builds up in the blood stream
5What happens to the patients water level when glucose and ketones build up into the bloodstream?
decreases because more is needed to clear the glucose and ketones from the blood stream
6Is your risk for type 1 autoimmune mediate diabetes higher if your mother or father is a type 1 diabetic?
father
7Which season is linked to an inccrease in dx cases of autoimmune type I DM?
winter- from increased burden on immune system
8What helps protect kids from autoimmune mediated type I DM?
breastfeeding in the first 6 months
9Which lineages are linked to idiopathic type I DM?
asian and african
10What are the 3 polys of type I DM?
polyuria
polydypsia
polyphagia
11What will you find on lab work for type I DM?
increased urine glucose
increased serum ketones
increased serum glucose
12What level of serum glucose on a random glucose test is diagnostic?
greater than 200 mg/dL
13What level of serum glucose on a fasting glucose test is diagnostic?
greater than 125 mg/dL
14What is the diagnostic criteria for DM when looking at HbA1C?
greater than 6.4
15What is the diagnostic criteria for prediabetes?
5.7-6.4
16How do you assess short term glycemia control?
glucometer
17How do you asses long term glycemic control?
HBA1C
18What are the complications associated with DM?
retinopathy
nephropathy
neuropathy
19What is the first line therapy for type 1 DM patients?
insulin
education (diet and exercise)
20What is the first line therapy for type II DM patients?
education (diet, exercise, weight loss)
medication
21Regular insulin is given?
30-45 minutes before a meal
22Insulin analogues are given?
15 minutes or less before meal
23Which short acting insulin has better HBA1C levels?
analogues
24Lispro is a ____ acting insulin?
short
25Is lispro a regular insulin or an analogue?
analogue
26Neutral Protamine Hagedorn is a ___ insulin?
long acting
27Injecting NPH in which method will result in slower absorption?
sub q
28What is the pH of NPH?
7.0
29does glargine have a peak?
no
30does glargine have a peak? What does this mean in terms of predicatability?
no, its more predictable
31How often is glargine dosed? When is it often given?
once a day at night
32Detemir is a ____ insulin?
long acting
33How often is detemir dosed?
BID
34How does detemir work?
binds to albumin in fatty sub q
35What is degludec?
long acting insulin
36When is degludec active?
at physiological pH
37Between degludec and glargine which has less severe hypoglycemia?
degludec
38What should the ratio of insulin to carbohydrate look like when initiating therapy?
low
39What influences the ratio? By how much?
exercise
normal 1:10-1:15
with exercise 1:25
40What is the target glucose level?
120
41What is the target glucose level?
120
42Men are prone to store fat in
intra abdominal and truncal sites
43females store fat in
buttocks
thighs
upper arms
44What happesn when muscle and liver become less sensitive to insulin
compensatory increase in insulin secretion from the pancreas
45severe hypertriglyceridemia can put patient at risk for:
pancreatitis
46Obesity is strongly associated with the presence of:
ectopic fat in hepatocytes
47Ectopic fat in hepatocytes can progress to
nonalcoholic seatohepatitis which can progress to fibrosis
48What are the most common complications of type 2 diabetes?
impaired glucose tolerance
type II diabetes
49In females insulin resistance/hyperinsulinemia strongly predisposes to the development of:
polycystic ovaries
50In males, obesity is more often associated with:
central hypogonadism
51Insulin resistance is generally worse with what kind of fat distrubution?
central
52Factors that contribute to hyperglycemia?
reduced insulin secretion
decreased glucose utilization
increased glucose production
53What is the main cause of morbidity and mortality in the diabetic population?
cardiovascular disease
54Diabetes is the leading cause of:
end stage renal