Questions And 100% Correct Answers.
the term "diabetes mellitus" comes from? - Answer greek "fountain" and "honey"
diabetes mellitus is a disorder of? - Answer carbohydrate metabolism
diabetes mellitus is a deficiency of? - Answer insulin (or resistance to the action of insulin)
When does type 1 diabetes develop? - Answer during childhood or adolescence, but can
develop during adulthood
symptom onset for type 1 diabetes is? - Answer relatively abrupt
of all diabetes mellitus cases, how many does type 1 account for? - Answer 5%
what is the primary defect of type 1 diabetes mellitus? - Answer destruction of pancreatic
beta cells due to autoimmune process (beta cells do not secrete insulin)
what is insulin resistance? - Answer body tissues do not respond to the action of insulin
---insulin receptors are unresponsive
---insulin receptors are deficient in numbers
what is the most common type of diabetes mellitus? - Answer Type 2
type 2 causes what percentage of diabetes cases? - Answer 90-95%
what is the primary defect of type 2 diabetes mellitus? - Answer insulin resistance and
impaired insulin secretion
what percentage of expecting mothers develop gestational diabetes? - Answer 2-10%
,what are the signs and symptoms of hyperglycemia? - Answer -frequent urination (polyuria)
-extreme thirst (polydipsia)
-hunger (polyphagia)
-weight loss, nausea, vomiting
-dehydration
-poor skin turgor
-fatigue
-tachycardia
-fruity breath (suggest acidosis, DKA)
-coma and death
-glycosuria (excess sugar in urine)
hyperglycemia - Answer high blood sugar
how is diabetes treated? - Answer -maintain glucose levels within acceptable range
-screen for co-morbidities
---type 1 (diet, self-monitoring, exercise, insulin, manage dyslipidemia and hypertension)
---types 2 (stepwise approach - 1: diet/exercise with metformin 2: add second drug 3: add third
drug 4: add insulin)
what kind of cell synthesizes insulin? - Answer beta cells in the islet of Langerhans in the
pancreas
insulin is secreted in response to - Answer glucose
describe the cellular transport of glucose - Answer anabolic (primarily), for storing/using
energy
medication insulin restores patient with T1DM ability to: - Answer -metabolize carbohydrates,
fats, and proteins
-store glucose in the liver
,what percentage of individuals with T2DM will use insulin at some point? - Answer 40%
what type of insulin is lispro (humalog)? - Answer short-duration, rapid acting
describe the onset, peak, and duration of insulin lispro (short-duration, rapid acting) - Answer -
rapid onset (10-20min)
-peak action (30-90min)
-short duration (3-5hrs)
when is insulin lispro administered? - Answer immediately before eating or just after
what type of insulin is regular insulin (humulin R, Novolin R)? - Answer short duration, slower
acting
by what routes can we give regular insulin? - Answer subQ injection, subQ infusion, IM
injection, oral inhalation
describe the onset, peak, and duration of regular insulin (short duration, slower acting) - Answer
-onset (30-60min)
-peak (1-5hrs)
-duration (6-10hrs)
what type of insulin is NPH? - Answer intermediate duration
how often is NPH injected? - Answer 2-3 time daily for glycemic control between meals and
during the night
which insulin is suitable for mixing with other short-acting insulins? - Answer NPH
NPH insulins must be ____ before administering - Answer mixed
by which route is NPH administered? - Answer subQ injection only
, what kind of insulin is insulin glargine? - Answer long duration
describe the onset, peak, and duration of insulin glargine (long duration) - Answer -onset
(70min)
-peak (none)
-duration (18-24hrs)
describe the appearance of insulin - Answer except for NPH (cloudy suspension), all insulins
are formulated as clear, colorless solutions
what should we do with insulin if it looks abnormal? - Answer discard
what 2 concentrations of insulin are available? - Answer -100 units/mL (U-100)
-500 units/mL (U-500)
where should unopened vials of insulin be stored? - Answer refrigerator (do not freeze)
how long after opening can insulin be kept? - Answer 1 month
describe the 3 different insulin dosing schedules - Answer -twice daily premixed insulin
regimen
-intensive basal/bolus strategy
-continuous subQ injection
name the risks of the basal/bolus strategy - Answer -increased risk of hypoglycemia
-increased weight gain
-increased complexity and expense
sliding scale insulin orders are used to - Answer bolus a patient with a short acting insulin to
cover carbohydrate intake and hyperglycemia