Unit 3 Diabetes Mellitus

Front 1

Where is the pancreas located?

Back 1

Behind the stomach

Front 2

A&P of the Pancreas

Back 2

*Lies behind the stomach
*Has endocrine & exocrine functions
*Islets of Langerhans perform endocrine functions
*Alpha cells secrete glucagon
*Beta cells secrete insulin

Front 3

Major stimulus for insulin secretion

Back 3

Carbohydrates

Front 4

The pancreas has _______cells & _________cells.

Back 4

Alpha cells & Beta cells

Front 5

Alpha cells

Back 5

Responsible for creating glucagon

Front 6

Beta cells

Back 6

Create insulin

Front 7

Glucose homeostasis

Back 7

Gluconeogenesis
Glycogenolysis

Front 8

Glucagon

Back 8

Hormone released to increase blood glucose levels

Front 9

Insulin

Back 9

Lowers blood glucose levels
Increase after a meal
Inhibits gluconeogenesis

Front 10

High blood sugar >>>Pancreas>>>Insulin>>>Tissue cells>>>Lowers Blood Sugar

Back 10

Low blood
sugar>>>Pancreas>>>Glucagon>>>Liver>>>Raises Blood Sugar

Front 11

Diabetes patients are more at risk to develop what disease?

Back 11

Cardiovascular disease

Front 12

Diabetes patients are also at risk for ____________.

Back 12

infection

Front 13

What is Diabetes Mellitus?

Back 13

A disturbance in CHO, protein, and lipid metabolism because of a deficiency of insulin, marked by hyperglycemia.

Front 14

Diabetes Mellitus is a multisystem disease related to:

Back 14

*Abnormal insulin production
*Impaired insulin utilization
*both abnormal production and impaired utilization

Front 15

What is the leading cause of heart disease, stroke, adult blindness, and non-traumatic lower limb amputations?

Back 15

Diabetes Mellitus

Front 16

Why is the patient not getting enough insulin?

Back 16

1. The pancreas isn't producing enough insulin.
2. Insulin is being released by the pancreas, but it isn't being utilized by the body.
3. A combination of both 1 & 2.

Front 17

What happens between meals?

Back 17

Blood glucose low>>pancreas secretes glucagon>>liver changes glycogen to glucose>>Glucose sent to target tissues.

Front 18

What happens after a meal?

Back 18

Blood glucose high>>pancreas secretes insulin>>glucose goes to the liver (Glygogen) & goes to target tissues

Front 19

Diabetes Mellitus Classification

Back 19

*Type 1 Diabetes
*Type 2 Diabetes
*Metabolic Syndrome (Syndrome X)
*Gestational Diabetes Mellitus

Front 20

Which type of Diabetes is insulin dependent?

Back 20

Type 1

Front 21

Which type of Diabetes is non-insulin dependent?

Back 21

Type 2

Front 22

Which type of diabetes is "Insulin resistant"?

Back 22

Metabolic Syndrome (Syndrome X)

Front 23

What type of diabetes would you see in pregnant women?

Back 23

Gestational diabetes mellitus

Front 24

Gestational diabetes mellitus

Back 24

Develops during pregnancy. Normally goes away after the baby is born. Increases your risk for developing diabetes later in life by 80%

Front 25

Who is more at risk to develop Type 1 Diabetes?

Back 25

White females with a lean body type

Front 26

Type 1 Diabetes

Back 26

Autoimmune disorder - beta cell destruction in the pancreas occurs in a genetically susceptible individual.
Without insulin, glucose builds up causing hyperglycemia.
Causes fluid and electrolyte imbalances.
Most often occurs in people under 30 yrs old.
Peak onset between ages 11 & 13.

Front 27

Clinical Manifestations of Type 1 Diabetes
Develop when the pancreas can no longer produce insulin

Back 27

*weight loss
*polyuria
*polydipsia
*polyphagia
*weakness & fatigue
*Diabetic Ketoacididosis (DKA)
*Kussmaul's respirations

Front 28

Polyuria

Back 28

Frequent urination

Front 29

Polydipsia

Back 29

Excessive thirst

Front 30

Polyphagia

Back 30

Excessive hunger

Front 31

What type of diabetes is preventable?

Back 31

Type 2 Diabetes

Front 32

Which type of diabetes accounts for 90% of patients with DM?

Back 32

Type 2 diabetes

Front 33

Type 2 Diabetes

Back 33

*Accounts for 90% of patients with DM
*Usually occurs in people over 40 years of age.
*80-90% of patients are overweight
*Etiology & Pathophysiology
Pancreas continues to produce some endogenous insulin
*Onset of disease is GRADUAL

Front 34

Type 2 Diabetes
Major Risk Factors

Back 34

*Family history
*Obesity > or = 20% above ideal
*Race:Native American, Hispanic, African American
*Age >40 yrs old
*Impaired glucose tolerance
*Hypertension, hyperlipidemia
*Gestational diabetes, babies>9 pounds

Front 35

Diagnostic Studies for DM

Back 35

*Fasting blood glucose
*Oral glucose tolerance test
*Glycosylated hemoglobin-hemoglobin A1c
*Urine ketones
*Urine glucose
*Self-monitoring of blood glucose

Front 36

Fasting blood glucose

Back 36

NPO for 8 hours.
Should be less than 100.
If you test >126 on 2 different occasions you will be diagnosed with diabetes

Front 37

Oral glucose tolerance test

Back 37

Drink a sugary drink & get tested 1 hr later, 2 hrs later, 3 hours later, ect.
Sometimes used to test for gestational diabetes.

Front 38

Glycosylated hemoglobin

Back 38

Blood test to see where sugars have been over a 3 month period. over 6% = diabetic

Front 39

Urine ketones

Back 39

Ketones could be an indicator to evaluate further

Front 40

Urine glucose

Back 40

Sugar is greater than 300 if in the urine

Front 41

How often should a type 1 diabetic check their glucose?

Back 41

4 times a day.

Front 42

How often should a type 2 diabetic check their glucose?

Back 42

one time a day unless they don't feel well

Front 43

Type 1 Diabetes Treatment Options

Back 43

1. Insulin
2. Nutrition and diet
3. Exercise

Front 44

You should teach your diabetic patient to exercise how often?

Back 44

30 minutes, 5 times a week

Front 45

Which type of Insulin can be given IV?

Back 45

Regular

Front 46

Rapid Insulin

Back 46

Humalog
(Lispro)
Novolog
Apidra

Front 47

Short Insulin

Back 47

Regular

Front 48

Intermediate Insulin

Back 48

NPH

Front 49

Long Acting Insulin

Back 49

Lantus
Levemir
Typically give once per day. Usually given at bedtime.

Front 50

Mixed Insulin

Back 50

Regular & NPH
70/30
75/25
50/50

Front 51

Where do you give insulin injections?

Back 51

#1 site Abdomen, #2 site Arm, #3 site Thigh. Avoid rubbing. Rotate sites (1 1/2 inches apart)

Hint 51

Subcutaneous injections

Front 52

Name the different ways you can administer insulin

Back 52

Syringes -most common 100 unit. Insulin pen - you don't have to keep it in the fridge. Good for people who work. Insulin pump - used by very compliant & intelligent patients.

Hint 52

Proper disposal required. Cost varies.

Front 53

What is the most important thing a diabetic can do?

Back 53

Carb counting

Front 54

What is the total carbohydrate goal/meal For diabetics

Back 54

45-60g/meal

Front 55

Foods containing carbohydrates

Back 55

Starches (bread, cereal, pasta, rice, grains, potatoes, beans, corn). Fruits & fruit juices. Milk & yogurt. Sweets, desserts, beverages

Front 56

Approx ______g___carbs/snack

Back 56

15g

Front 57

How many snacks per day can a diabetic have?

Back 57

2 snacks per day. Approx 15g carb/snack

Front 58

What do you teach your diabetic patient about food choices?

Back 58

Drink skim or 1% milk instead of whole milk. Avoid sweet tea & coke. Eat an apple or and orange instead of drinking the juice.

Front 59

If ____or more grams of fiber in serving, may subtract grams of fiber from total carbohydrate count per serving

Back 59

5. Ex: 60 total carbs, 7 g of fibers = 53g of total carbs

Front 60

Carbs turn to ___________, sugar turns to __________.

Back 60

Carbs turn to sugar, sugar turns to Fat.

Front 61

Long acting insulin

Back 61

Lantus. Onset 2-4 hrs, no peak time, duration 24 hrs

Back 62

Type diabetic medication