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Symptoms Of Diabetes Mellitus Quizlet

Diabetes Pathophysiology

Diabetes Pathophysiology

Blood glucose regulation (6) 1. When blood glucose levels rise above a set point, 2. the pancreas secretes insulin into the blood. 3. Insulin stimulates liver and muscle cells to make glycogen, dropping blood glucose levels. 4. When glucose levels drop below a set point, 5. the pancreas secretes glucagon into the blood. 6. Glucagon promotes the breakdown of glycogen and the release of glucose into the blood. (The pancreas signals distant cells to regulate levels in the blood = endocrine function.) Insulin and Glucagon (Regulation) (10) 1. High blood glucose 2. Beta cells 3. Insulin 4. Glucose enters cell 5. Blood glucose lowered 6. Low blood glucose 7. Alpha cells 8. Glucagon 9. Liver releases glucose from glycogen 10. Blood glucose raised What is the manifestations (symptoms) of Type 1? (10) 1. Extreme thirst 2. Frequent urination 3. Drowsiness, lethargy 4. Sugar in urine 5. Sudden vision change 6. Increased appetite 7. Sudden weight loss 8. Fruity, sweet, or wine like odor on breath 9. Heavy, laboured breathing 10. Stupor, unconsciousness DKA Processes (5) 1. sympathetic nervous system response: additional glucose converted from glycogen 2. Glycogen depleted; body burns fat & protein for energy 3. fat metabolisms produce acidic substances called ketone bodies which accumulate in blood and urine and lead to metabolic acidosis 4. protein metabolism results in loss of lean muscle mass and negative nitrogen balance 5. high osmotic pressure created by excess glucose leads to osmotic diuresis (polyuria leads to dehydration and fluid and electrolyte deficits) HHNS Warning Signs (9) 1. Plasma glucose lvl over 600mg/dl 2. Dry, parched mouth 3. Extreme thirst may gradually subside 4. Warm, dry skin (no sweat) 5. High fever 6. Sleepiness or confusion 7. Loss of vision 8. Halluci Continue reading >>

Ch. 10 Flashcards | Quizlet

Ch. 10 Flashcards | Quizlet

Which of the following is/are a sign or symptom of hypoglycemia? II. sudden onset IV. fruity odor on breath Practice starts in 30 minutes. One of your diabetic athletes just checked his blood sugar and found it to be 88 gm/dL. What is your recommendation for this athlete? Which of the following are considered a sign or symptom of hyperglycemia? II. pallor and diaphoresis IV. severe thirst What is the underlying pathophysiology of insulin-dependent diabetes mellitus? Which of the following organs secretes thyroid-stimulating hormone and works to regulate During exercise, glucose releases from the liver into the blood ________________. Excessive sweating not associated with activity is referred to as: Which of the following conditions is associated with muscle enzyme leakage and a cascade of potentially life-threatening electrolyte imbalances? Which of the following conditions is associated with cola or tea colored urine? Which of the following signs and symptoms is NOT typically associated with pathology of Which of the following is NOT a sign or symptom of hyperglycemia? Which of the following is the body's primary source of energy? Which of the following hormones decreases blood glucose level? Which of the following hormones is released during exercise? With a change in body temperature, which endocrine gland receives information from the Which gland directly affects overall body metabolism? Which gland secretes antidiuretic hormone? Very high volume endurance exercise increases secretion of which hormone? Very intense exercise decreases secretion of which hormone? Left upper quadrant or generalized epigastric pain can be caused by which endocrine Insulin-dependent diabetes affects which gland? Insulin-dependent diabetes affects metabolism of: What intervention is nec Continue reading >>

Diabetes Mellitus And Metabolic Syndrome

Diabetes Mellitus And Metabolic Syndrome

-characterized by: high levels of blood glucose, resulting from the body's inability to produce/utilize insulin a hormone produced by the beta cells of the islets of Langerhans, specialized tissue within the pancreas -rise in blood glucose stimulates the pancreas to release insulin -Glycogenesis: the process of glycogen formation -Glycogenolysis: the process of glycogen breakdown --- starvation, body capable of producing glucose, breakdown glycogen and gluconeogenesis -times of starvation/fasting, glycogen stores in the liver will be depleted. Amino acids and fats are converted into glucose -fatty acids accumulate, converted into ketoacids or ketones -ketone accumulation in the bloodstream is known as: ketosis or ketoacidosis -condition that develops in those with NO insulin reserves, such as uncontrolled type 1 diabetes -Type 1 diabetics often present with DKA when 1st diagnosed. critical,, requires immediate treatment -when there is no glucose entering the cells, cells go into starvation mode -condition, very low levels of glucose in the blood, cannot support efficient brain function -pancreatic glucagon-> breaks down glycogen stores -> raise blood glucose -very high levels go glucose in the blood stream, commonly caused by the body's lack of insulin or cellular resistance to insulin Chronic hyperglycemia, endothelial injury -causes endothelial injury, activates inflammation, lipid and macrophage deposition within injured site=foam cells, precursor to atherosclerotic plaque -simultaneously, endothelial membranes secrete enothelin, which inhibits arterial vasodilation and promotes vascular smooth muscle proliferation, this narrows the diameter of arterial vessels a condition when body cells are resistance to insulin -the pancreas attempts to compensate for the body's Continue reading >>

Diabetes Mellitus - Clinical Manifestations

Diabetes Mellitus - Clinical Manifestations

3 hr test: fasting, 30 mins, 60 mins, 120 mins, 180 mins - Measures/estimates the avg. blood glucose for the past 2 to 3 months - Problems: Not accurate in iron deficiency anemia - No specific test to ABSOLUTELY distinguish btw Type 1 and Type 2 - Circulating auto-antibodies (positive results associated w/ autoimmune Type 1; absence of pancreatic autoantibodies DOES NOT rule out the possibility of T1DM) - ACUTE hyperglycemia of DM associated w/ diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar non-ketotic syndrome (HHNKS) - CHRONIC hyperglycemia of DM associated w/ long-term damage, dysfunction, and failure of various organs... Mild: hunger, shakiness, weakness, pallor, blurry vision, increased heart rate/palpitations... Moderate to Severe: irritability/frustration, extreme tiredness/fatigue, confusion... MILD: Frequent urination, sweet, fruity breath, thirst, thirst, blurred vision... MODERATE: dry mouth, stomach cramps, nausea & vomiting SEVERE: labored breathing, confusion, extreme weakness, unconsciousness Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

Sort reduces hepatic glucose production, enhances tissue response to insulin and improves glucose transport into cells, may improve blood lipid levels, withhold for procedures using contrast dye for 48 hr afterwards, excreted thru kidney and liver biguanide (popular) synthetic verision of natural hormone amylin (amylin works w/ insulin to control the low of sugar from food in the bloodstream, decr gastric emptying time) use is only in addition to insulin SUBQ, hypoglycemia, nausea, vomiting, abdominal pain, headache, fatigue, dizziness (side effects) Amylinomimetic (mimics amylin (symlin) DO NOT WANT TO CONTAMINATE REGULAR INSULIN WITH THE INTERMEDIATE 1. GENTLY ROTATE NPH (INTERMEDIATE) 2. CLEANSE TOPS OF BOTH INSULIN VIALS W/ ALCOHOL 3 IN SYRINGE, DRAW BACK AMOUNT OF AIR TO EQUAL NPH INSULIN DOSE AND INJECT AIR INTO VIAL 4. IN SYRINGE, DRAW BACK AMT OF AIR TO EQUAL REGULAR INSULIN DOSE AND INJECT AIR INTO VIAL 5. INVERT REGULAR INSULIN VIAL AND WITHDRAW EXACT DOSE 6. PLACE NEEDLE/SYRINGE BACK IN TO THE INTERMEDIATE INSULIN AND WITHDRAW THE EXACT TOTAL AMOUNT NEEDED hypoglycemia symptoms weakness, or shaking moist skin, sweating, fast heartbeat (tachycardia) dizziness sudden hunger headache irritability nervousness confusion <70 mg/dl hyperglycemia symptoms polyphagia polydipsia polyuria dry or itchy skin feeling tired or sleepy blurred vision frequent infections slow healing of cuts or sores Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

Sort Elevated BG levels, Increase in urination, increase in appetite followed by lack of appetite, weakness and fatigue, blurred vision, headache, glycosuria, nausea and vomiting, abdominal cramps, progression to DKA or HHS Symptoms of Hyperglycemia caused by deficiency of insulin, characterized by hyperglycemia, ketosis, acidosis, and dehydration. likely in Type 1 DM, death occurs if untreated. symptoms include; dehydration signs, tachycardia, hypotension, vomiting, sweet breath. BG>250 pH< 7.30 Diabetic Ketoacidosis (DKA) Severe hyperglycemia, osmotic diuresis, and extracellular fluid depletion. higher BG levels increase serum osmolality and produce more severe neurologic manifestations such as somnolence, coma, seizures, hemiparesis, and aphasia. BG>600 Hyperosmolar Hyperglycemic Syndrome (HHS) Continue reading >>

Diabetes Mellitus: Pathophysiology; Symptoms; Diagnosis; Treatments

Diabetes Mellitus: Pathophysiology; Symptoms; Diagnosis; Treatments

CHRONIC COMPLICATION OF DM: People w/ diabetes and its associated Metabolic Syndrome have an increased risk for...? 1. MACROvascular complications (stroke, ischemic heart disease, peripheral vascular disease) 2. MICROvascular complications (retinopathy, nephropathy, neuropathy) ***Leading cause of blindness, chronic kidney disease, and non-traumatic limb amputation in the US. ***2 to 4 times more likely to develop heart disease or suffer a stroke ***Gestational diabetes is a principal cause of congenital malformations, perinatal mortality, and premature mortality. What is the difference between diabetes mellitus, impaired fasting glucose, & impaired glucose tolerance? DM- diagnosed dt increased plasma glucose >200mg/dL when randomly taken impaired fasting glucose is seen in glucose intolerance when Fasting BG <100mg-<126 mg/L What is the principal cause of congenital malformations, perinatal mortality, and premature mortality? Acute Symptoms of DM are commonly what 5 things? ACUTE SX include: polyuria, polydipsia, polyphagia, weight loss, blurred vision DM Patients have the possibility of presenting with increased: (alternative two things to primary 5 acute Sx) increased susceptibility to infections (e.g. recurrent vaginal candidiasis or urinary tract infections) Chronic Symptoms of DM typically present when? Many remain asymptomatic for long periods, so that the first presentation of the disease is frequently a chronic complication--VASCULAR DAMAGE CAUSES .... 50% of newly diagnosed type 2 diabetes will already have developed an irreversible vascular complication WHAT ARE THE VALUES NEEDED TO DIAGNOSE DIABETES MELLITUS? Glucose intolerance, denoted by what two variables? How are they found? A denoted risk factor based on a patients fasting BG and post-prandial BG leve Continue reading >>

Diabetes Mellitus Flashcards | Quizlet

Diabetes Mellitus Flashcards | Quizlet

Islets of Langerhans in the pancreas secrete glucagon and insulin Their job is to keep tight control of the blood sugar levels Our bodies need glucose and oxygen for our primary energy source, so relatively constant levels of both need to be maintained throughout the day Release of hormones into the blood controlled by the negative feedback system Alpha cells - glucagon (raises BS by breaking down glycogen) Beta cells - insulin (decrease BS by moving the sugar back into cell) Delta cells - somatostatin (prohibiting production of glucagon and insulin) 3) Insulin facilitates movement of sugar into the cells 5) Insulin is no longer secreted by the pancreas... NEGATIVE FEEDBACK 6) Any extra glucose not taken into the cell is stored in the liver as glycogen 1) Your blood sugar drops...sugar going elsewhere 2) Your pancreas stops secreting insulin... 4) Glucagon signals the liver to break down the stored glycogen into glucose 5) The liver releases glucose into the blood 7) The pancreas stops secreting glucagon...NEGATIVE FEEDBACK! How Pancreas Knows When to Secrete Insulin Glucose in the blood after a meal is controlled by the emptying rate of the stomach and delivery of nutrients to the small intestines Incretin hormones secreted in response to the presence of food in the stomach, increase insulin secretion, inhibit glucagon secretion and slow the rate of gastric emptying thereby preventing hyperglycemia Maintained through the action of insulin and glucagon All body tissues and organs require a constant supply of glucose Not all tissues require insulin for glucose uptake The brain, the liver, the intestines and the renal tubules DO NOT require insulin. Skeletal muscle and adipose tissue DO require insulin for glucose movement into the cells Includes a group of hormones that Continue reading >>

Treatment Of Diabetes Mellitus

Treatment Of Diabetes Mellitus

-Glucagon is released from a cells and upper GI if blood glucose is low -Stimulates glycogen breakdown and gluconeogenesis in the liver -Insulin released from B cells if blood glucose is high -Stimulates the liver, adipose and muscle to take up glucose -The liver is central to controlling glucose levels -Diabetes occurs when regulation of blood glucose is disrupted. Diabetes of a form that develops especially in adults and most often obese individuals and that is characterized by high blood glucose resulting from impaired insulin utilization coupled with the body's inability to compensate with increased insulin production. -Natural progression from prediabetes to diabetes -Due to disruption of an individuals ability to handle glucose -Might not yet appear to have diabetes but may have hyperinsulinemia due to lower insulin sensitivity -Full diabetes progresses when beta-cell failure surpasses a critical threshold usually~90% Interferes with beta cell ion channels to potentiate insulin secretion Well tolerated but can lead to weight gain -Block ATP-sensitive K+ channels in membrane -Causes B cell to depolarise and leads to insulin secretion -Only work if B cells of the pancreas are functional. Newer drugs that act in the same way on Katp channels but are not sulphonylureas. -Increased insulin sensitivity and lowers blood glucose in T2D -Can cause weight gain and fluid retention Used as an additive to metformin and sulphonylureas. PPAR-gamma ligands promote transcription of genes important in insulin signalling: Liporotein lipase, FA transporters, Glut-4 etc Continue reading >>

Type I Diabetes Mellitus & Clinical Symptoms

Type I Diabetes Mellitus & Clinical Symptoms

How is diabetes mellitus best characterized? a deficiency of insulin secretion or action resulting in hyperglycemia and the probable development of complications over time. While DM is characterized by elevated levels of glucose in blood there is a reduction (shortage) of glucose inside the cells. What is another name for Type I Diabetes Mellitus? Is it more severe than Type II? Insulin dependent (IDDM) and it is the more severe form of diabetes. Type 1 DM accounts for about 10% of all cases of DM. What is IDDM characterized by? Can it be immune mediated? characterized by an absolute deficiency of insulin. Associated with an autoimmune mediated destruction or degeneration of the pancreatic islet beta (B) cells. What is believed to be the most likely cause of Type I Diabetes (IDDM)? Coxsackievirus B4 (CVB4), an environmentally acquired Enterovirus (Picornaviridae). Type 1 is considered to be an "immune sequel" disorder in that it occurs after an immune response to antigen that is not related to the actual disease! In regards to HLA What are some genetic "determinants" of IDDM? Increased risk of Type 1 IDDM (IDDM1) has been repeatedly linked to inheritance of HLA-A8, HLA-W16, HLA-DR3, HLA-DR4 and HLA-DQw8 markers. How does having the HLA alleles that predispose one to IDDM lead to IDDM? The presence of these markers will facilitate viral infections (such as CV) which results in humoral immunization. These antibodies are able to destroy the viral antigen but also "crossreact" with similar ("heterologous") antigens that also occur on human cells. This is the etiology of the so called "autoantibodies". What type of autoantibodies do the majority of Type I diabetics present with? microinsulin autoantibodies, islet cell autoantibodies, glutamic acid decarboxylase (GAD65) auto Continue reading >>

Focus On Diabetes Mellitus

Focus On Diabetes Mellitus

Sort Type 1 Diabetes Mellitus more common in young persons, can occur at any age S/S abrupt, but disease process may br present for several years 5-10% of all types Virus and Toxins Endogenous insulin is minimal or absent Thin, normal or obese nutritional status Thirst, Polyuria, polyphagia, fatigue and weight loss nutritional therapy essential insulin required for all frequent vascular and neurologic complications Tyoe 2 Diabetes Mellitus ususally 35 and older, can occur at any age, increasing in children may go undiagnosed for years 90-95% of all types obesity and lack of exercise endogenous insulin is probably excessive, adequate but delayed secretion or reduced utilization obes or normal nutritional status nutritional therapy is essential insulin required for some Nursing implementation: Ambulatory and Home care overall goal is to enable patient or caregiver to reach an optimal level of independence insulin therapy and oral agents personal hygiene medical identification and travel card (must carry identifications indicating diagnosis of diabetes) patient and family teaching (educate on disease process, physical activity, medications, monitoring blood glucose, diet, resources) (enable patient to become most active participant in care) Hypoglycemia signs and symptoms low blood glucose under 70 mg/dl too much insulin in proportion to glucose in the blood cold, clammy skin, diaphoresis numbeness of fingers, toes, and mouth rapid heartbeat confusion, irritability headache nervousness, tremors faintness, dizziness unsteady gait, slurred speach hunger changes in vision seizures, coma Gerontoligic considerations prevalence increases with age presence of delayed pscyhomotor function could interfere with treating of hypoglycemia must consider patient's own desire for treatmen Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

Sort List the 6 classes of oral hypoglycaemic mediations 1. sulfonylureas (gliclazide) primary involvement with stimulating the pancreas to secrete insulin 2. biguanides (metformin) enhancing the glucose lower and combined with other oral hypoglycaemic 3. sulfanylureas & biguanide combination (mixed) 4. thiazolidinediones (pioglitazone) enhance insulin action at receptor cite by increasing insulin secretion from beta cells - targets beta cells 5. alpha-glycosidase inhibitors (acarbose) 6. glitinide (novanorm) lowering glucose level agent What is the action of insulin? insulin allows glucose to move into cells to make energy. It does this by: * glycogenisis - promotes production & storage of glycogen * glycogenolysis - inhibits glycogen breakdown into glucose * increases protein and lipid synthesis * inhibits tissue breakdown by inhibiting liver glycogenolysis (ketogenesis - converts fats to acids) and gluconeogenisis (conversion of proteins to glucose) * in muscle, promotes protein and glycogen synthesis * in fat cells, promotes triglyceride storage List the physical signs of DKA * altered mental status without evidence of head trauma * tachycardia * tachypnea or hyperventilation (kussmaul respirations) * normal/low BP Increased capillary refill time - poor perfusion * lethargy and weakness * fever * acetone door of the breath reflecting metabolic acidosis Describe the treatment management of DKA * initial stabilisation: ABCD, 1/2 hourly BP HR urine output, hourly capillary BGL, 2 hourly electrolytes especially potassium * fluids & electrolytes: most pt's have a deficit of several litres (40-80 ml/kg), rapid fluid reuses for hypovolaemia (first 24hrs give 1/3 fluid in the first 5-6 hours of N/saline), potassium replacement (if not above 6mmol/L give 1/2-2g, 6-26mmol/hr Continue reading >>

Chapter 11 Sdp Flashcards | Quizlet

Chapter 11 Sdp Flashcards | Quizlet

Ductless glands secrete hormones into bloodstream to Target tissues Regulates and integrates the body's metabolic activities Has billions of nerve cells that regulate and coordinate body activities Links the nervous system to the endocrine system via the pituitary gland. Function: hormones of this gland help regulate the functions of other endocrine glands. Two parts: anterior lobe and posterior lobe. Gigantism results from hypersecretion of hGH during the growing years Acromegaly results from hypersecretion of hGH in adulthood Incision through the nose to remove tumor Causes serious complications and can be life shortening due to overgrowth of bones and soft tissue What hormones are deficient in Hypopituitarism? Depend on age of client, deficient hormones Slow emergence of secondary sexual characteristics What hormone are deficient in diabetes insipidus? Polyuria (4 to 16 liters of urine in 24 hours) What are the physicians looking for when they palpate the neck during a patient's exam? Thyroid enlarges when it cannot secrete enough of thyroid hormones T3, T4 Serious complication of untreated Graves Disease can cause it Cretinism result of congenital deficiency of hormones Myxedema result of deficiency of hormones in later childhood or adulthood Signs and Symptoms of Hypothyroidism in adulthood Fatigue, constipation, intolerance to cold, muscle cramps, mental clouding Later symptoms include mental clouding, diminished appetite and weight gain, dry skin, brittle hair and nails What are the results of the blood test performed to diagnose Hashimoto thyroiditis? Can a patient with thyroid cancer who has radioactive therapy be in close contact with children and pregnant women? Signs and Symptoms of hyperparathyroidism Continue reading >>

Diabetes Mellitus Flashcards | Quizlet

Diabetes Mellitus Flashcards | Quizlet

Short acting:Regular insulin:onset 30-60 mins peak 2-4 hrs duration 6-8 hrs used for dosing pts with sliding scale only form of insulin that can be given IV monitor for hypoglycemia, have oral carb availible. What are the classic signs and symptoms of Diabetes mellitus the quantity of nitrogen in the blood in the form of urea. The normal concentration is 8 to 25 mg/100 mL; An increase in the BUN level often indicates decreased renal function abnormally high blood sugar usually associated with diabetes abnormally low blood sugar usually resulting from excessive insulin or a poor diet do not mix this insulin with any other medications. It is Clear. Administer Sub Q. Monitor for weight. Monitor for hypoglycemia & redness at injection site., insulin glargine Insulin lispro, Rapid-Acting Insulin, Onset: 15-30 min, Peak: 0.5-2.5 hrs, Duration: 3-6.5 hrs Excessive urination, excessive thirst, dry mouth, and dry skin, acetone breath (fruity smell) blurred vision and headache, rapid pulse, lower blood pressure, and loss of consciousness. Record info let dentis know. More blood sugar in blood level. Why are diabetics more prone to infection Usually occurs during the night, but manifests as an elevated glucose in the morning and may be inadvertently treated with an increase in insulin dosage. Check blood glucose around 3:00 a.m. Adjusting insulin to avoid peaking during the night will correct this effect. Another tx for Diabetes Insipidus (not often used) - 1st generation sulfonuric agent that was used for type II diabetes but is not often used any more. It can increase ADH secretion or it can improve the affect ADH has on the kidneys. Given to pts with nephrogenic DI b/c it improves the use or ability of the existing ADH to have an effect. stimulate release of insulin from pancr Continue reading >>

Diabetes Mellitus Flashcards | Quizlet

Diabetes Mellitus Flashcards | Quizlet

Do all DM patients present with symptoms? No, most patients dont and are found on screening tests Is it better to identify diabetics when they have symptoms or through screening Through screening, catching diabetes before complications occur is the goal What four diagnostic tests for Type 1 AND 2 should be confirmed to confirm a dx 2-hour post 75 oral glucose tolerance test Fasting plasma glucose higher than or equal to what value is indicative of DM 2-hour post 75 gram Oral glucose tolerance test higher or equal to what value is indicative of DM HgbA1C greater or equal to what percent indicates DM Random glucose test of greater or equal to what value is indicative of DM What is the "in-blood" major energy source for all tissues? What receptor transports glucose from the blood stream or interstitium to the intracellular side? Glucose in the blood or interstitium comes from one of three places: 2. Liver via gluconeogenesis + glycogenolysis 3. Local tissue glycogenolysis (ie. muscle tissues) Different tissues have variable amounts of GLUT receptors which determines the way in which blank uptake for that tissue is regulated If GLUT 1 is insulin dependent and GLUT 3 is not which organ would have mostly GLUT 3? The brain because it is not as dependent on insulin to transport glucose into the cells Insulin is a blank that is the key regulator of serum blank concentration Where is the precursor of insulin synthesized ? What is the precursor of insulin cleaved into? Stimulates glucose uptake by blank and blank tissues Regulates blank turnover (decreases AA release) Electrolyte balance (drives blank intracellularly) glucose uptake by muscle and adipose tissues suppresses lipolysis and ketogenesis in liver Glucagon only acts in the blank and is secreted from the blank glucagon a Continue reading >>

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