Diabetes

Front 1

What is Hemoglobin A1c (HgA1c) and what should be your target HgA1c?

Back 1

It the average blood sugar reading over the past 3 months. The target HgA1c is <6.5?.

Front 2

What is an ideal fasting blood sugar for someone with type 1 and type 2 diabetes?

Back 2

An ideal fasting blood sugar is between 70-130mg and <140mg at bedtime.

Front 3

What is the ideal post-meal ( 2-hours after a meal) glucose level?

Back 3

The target post-meal blood sugar level should be <160mg.

Front 4

What is the target lipid level (LDL and TG) for someone with type 1 and type 2 diabetes?

Back 4

Ideally patients with diabetes should have their LDL<100 (<70 if heart or vascular disease is already present). The triglyceride level should be <250 (<150 if heart disease is already present)

Front 5

What is an ideal blood pressure in patients with type 1 and 2 diabetes?

Back 5

An ideal blood pressure in patients with type 1 and type 2 diabetes is <130/80.

Front 6

How do sulfonylurea agents work?

Back 6

Sulfonylurea agents work by stimulating the pancreas to secrete insulin.

Front 7

How does metformin work?

Back 7

Metformin works by decreasing the output of glucose from the liver, increases the uptake of glucose in the tissue, and decreases the absorption of glucose in the gut.

Front 8

How often should I check my blood sugar?

Back 8

You should check your blood sugar first thing in the morning, before and ocasionally after meals, and at night before bed when taking insulin.

Front 9

What are some macrovascular diseases caused by diabetes?

Back 9

Some macrovascular diseases caused by diabetes include, heart attack (myocardial infarction), stroke (cerebral vascular accident), and peripheral vascular disease (PVD) or arteriosclerosis.

Front 10

What are some microvascular diseases caused by diabetes?

Back 10

Some microvascular diseases caused by diabetes are kidney disease (nephropathy) and vision loss (retinopathy).

Front 11

What are some differences between type 1 and type 2 diabetes?

Back 11

Type 1 diabetics do not produce their own insulin. Type 1 is usually developed at a younger age patients who are usually lean. Type 2 diabetes usually develop later in life. Type 2 diabetics are usually overweight. There is also a strong family history of the disease.

Front 12

What is the initial treatment in patients with Type 2 diabetes?

Back 12

The initial treatment for type 2 diabetes should focus on diet and exercise. This will help to overcome “insulin resistance.”

Front 13

What Body Mass Index (BMI) is considered overweight? Obese?

Back 13

A BMI of >25 is considered overweight and a BMI >30 is considered obese

Front 14

What is the significance of a HgA1c of >8.5%?

Back 14

Oral diabetics usually only lower HgA1c by 1-2 %. Usually when the HgA1c is >8.5% insulin should be strongly considered.

Front 15

What is a more ideal sulfonylurea agent, one that is short acting or long acting?

Back 15

Short acting medication is ideal because there is less risk of hypoglycemia.

Front 16

What is lactic acidosis and what oral medication can cause it?

Back 16

Lactic acidosis is potential side effect that happens when using metformin in the setting of kidney disease. It can be very dangerous so your doctor should monitor your kidney function on a regular basis when you are on this medication.

Front 17

What is considered normal kidney function?

Back 17

A blood level of creatinine (abbreviated Cr) of <1.3 is considered normal.

Front 18

Which diabetic oral medication causes weight gain and which oral medication helps with weight loss, metformin or sulfonylurea?

Back 18

Metformin helps with weight loss and sulfonylurea may cause weight gain.

Front 19

What are some side effects of metformin?

Back 19

Metformin can cause temporary gastrointestinal (GI) side effects, such as, loss of appetite, nausea, vomiting, abdominal discomfort, and diarrhea. These side effects can occur in up to 20% of patients. Fortunately, these symptoms are transient and should go away with time.

Front 20

What are some potential side effects of Thiazolidinediones (TZDs) and which TZD should be used with caution because of the risk of heart attacks?

Back 20

TZDs can cause fluid retention which could exacerbate heart failure. They also can pose a risk of fractures. Rosiglitozone should not be used because of the risk heart attack.

Front 21

What is autonomic neuropathy and what are some examples?

Back 21

Some examples of autonimic neuropathy are gastroparesis or slow transport of intestional contents, diarrhea, impotence, dizziness when standing from a seated or supine position, and urinary incontinence or retention.

Front 22

What is an example for peripheral neuropathy?

Back 22

Peripheral neuropathy is a loss of or a painful sensation that can occur due to nerve injury. The typical location is the “glove and stocking” distribution. It is cause painful or annoying “pins and needles” sensation.

Front 23

What is basal and bolus insulin?

Back 23

Basal is the insulin that is excreted on a continuous basis throughout the day. Basal output helps to keep the glucose at a normal level by keeping the glucose that is put out by the liver in check. Bolus insulin is used to manage the glucose loads that come after meals.

Front 24

What type of insulin is used for basal and bolus insulin?

Back 24

Intermediate or long acting insulin is used for basal insulin and short or rapid acting insulin is used for bolus insulin.

Front 25

How often long or intermediate acting insulin usually given?

Back 25

Long or intermediate acting insulin is usually given once or twice daily.

Front 26

Name 3 risk factor for developing diabetes?

Back 26

Risk factors for developing diabetes include, age ≥45 years, overweight (body mass index ≥25 ), family history diabetes in a first-degree relative, habitual physical inactivity, belonging to a high-risk ethnic or racial group (eg, African-American, Hispanic, Native American, Asian-American, and Pacific Islanders), history of delivering a baby weighing >4.1 kg (9 lb) or of gestational diabetes mellitus, hypertension (blood pressure ≥140/90), having abnormal lipids or dyslipidemia (defined as having a high-density lipoprotein (HDL) cholesterol concentration ≤35 and/or a triglyceride (TG) level ≥250 , previously identified impaired fasting glucose, polycystic ovary.

Front 27

How is diabetes diagnosed?

Back 27

Diabetes is diagnosed after a patient presents with typical symptoms of diabetes- drinking excessive amounts of fluids, urinating frequently, or weight loss (usually with type 1), along with a random blood sugar or ≥ 200mg. You can also diagnose diabetes when a patient has a fasting (no food for >8 hours) blood sugar of ≥126mg (confirmed on 2 separate occasions).

Front 28

What is impaired fasting gluocse and how is it diagnosed?

Back 28

Impaired fasting gluocse is a fasting (no food for >8 hours) between 100-125.

Front 29

What are some typical symptoms of diabetes?

Back 29

Typical symptoms of diabetes are urinating frequently (polyuria), drinking too much fluids (polydipsia), and weight loss (usually in with type I). Other symptoms include fatigue, weakness, or recurrent skin infections, or in women , recurrent yeast infections.

Front 30

What is the “Honeymoon Period”?

Back 30

It the period after a type 1 diabetic is initially diagnosed. Blood sugar levels can return back to normal without any treatment. This period usually lasts up to a year until the body returns to elevated blood sugar levels.

Front 31

How do you adjust the long or intermediate dose insulin?

Back 31

If long or intermediate acting insulin is being given once daily then the morning fasting sugar should be used to adjust the dose. Usually the insulin is increased by 2 to 3 units every three days until the after-meal blood glucose target is achieved.

Front 32

Aspirin should be given to every diabetic what risk factors?

Back 32

Aspirin should be given to every diabetic >40 years, cigarette smoker, hypertension, obesity, protein in the urine, elevated lipids, or a family history of heart disease).