RNSG 1341 CC EXAM 3 Blueprint with
verified solutions
Prediabetes - correct answer ✔✔defined as:
- impaired glucose tolerance (IGT)
- impaired fasting glucose (IFG)
- or both
These patients are in an intermediate stage between normal BG homeostasis and diabetes.
- often asymptomatic; HOWEVER, long-term damage may already be occurring
- patients at increased risk for Type 2 diabetes
How is prediabetes impaired glucose tolerance (IGT) diagnosed? - correct answer ✔✔if the 2-hour oral
glucose tolerance test (OGTT) values are 140 to 199
How is prediabetes impaired fasting glucose (IFG) diagnosed? - correct answer ✔✔when fasting blood
glucose levels are 100 to 125
Screening for Diabetes in Asymptomatic, Undiagnosed Persons - correct answer ✔✔- screen all adults
with a BMI of >25 and additional risk factors (listed later)
- in the absence of the criteria above, SCREEN BY 45 yrs old
- repeat screening every 3 years
4 Classes of Diabetes - correct answer ✔✔Type 1
Type 2
Gestational
Other (specific types with various causes)
Type 1 Diabetes - correct answer ✔✔- "insulin-dependent diabetes"
,- used to be called "juvenile diabetes"
- ABSENCE OF INSULIN
- pancreas creates NO insulin
Causes:
- viral infection
- destruction of pancreatic beta islet cells (either directly or by an autoimmune process)
- AUTOIMMUNE DISEASE; antibodies destroy insulin or pancreatic islet cells
Idiopathic Diabetes - correct answer ✔✔- a form of type 1 diabetes that is strongly inherited and not
related to autoimmunity
- only occurs in a small number of people
- most often of Hispanic, African, or Asian ancestry.
Latent autoimmune diabetes in adults (LADA) - correct answer ✔✔- a slowly progressing autoimmune
form of type 1 diabetes
- occurs in adults and is often mistaken for type 2 diabetes
Type 1 Diabetes - SYMPTOMS - correct answer ✔✔- ketoacidosis begins and the patient becomes
symptomatic
- 3 P's (polydipsia, polyphagia, polyuria)
- fatigue
- weight loss
Type 1 Diabetes - RISK FACTORS - correct answer ✔✔- more common under 40 yrs old
- patients can be skinny, obese; whatever!
Type 1 Diabetes - Need for Insulin - correct answer ✔✔every single Type 1 diabetic will require insulin
therapy for the rest of their lives
Type 1 Diabetes - Onset - correct answer ✔✔Abrupt! but it may have been present for years
,Type 1 "Honeymoon Period" - correct answer ✔✔remission of diabetes that lasts 3-12 months after the
patient's INITIAL treatment
- pt may need very little insulin bc β-cell insulin production is still sufficient for healthy blood glucose
levels
- THIS ENDS. THIS IS NOT PERMANENT. IMPORTANT TEACHING POINT. THIS WILL NOT EVER OCCUR
AGAIN.
Type 2 Diabetes - correct answer ✔✔- "insulin resistant"
- inadequate production OR use of insulin
- inappropriate glucose production by the liver
- NUTRITION is extremely responsible for Type 2
- CAN occur in skinny people! it all depends on their nutrition
Insulin Resistance - correct answer ✔✔body tissues do not respond to the action of insulin because
insulin receptors are:
- unresponsive
- are insufficient in number
- or both
Where are insulin receptors located? - correct answer ✔✔- skeletal muscle
- fat
- liver cells
SO.... if a patient experiences trauma to muscles or liver, they will be at a higher risk for Type 2 diabetes!
Type 2 Diabetes - SYMPTOMS - correct answer ✔✔- Type 2 diabetics are often asymptomatic
- Fatigue
- Recurrent infections (yeast infections are common 🙀)
- 3 P's
, Type 2 Diabetes - RISK FACTORS - correct answer ✔✔- Obesity
- Older adults
- Family history (First-degree relative with diabetes)
- Native American
- Black
- Female
- HTN
- Sedentary lifestyle
- Metabolic syndrome (increased glucose, abdominal obesity, high BP, high triglycerides, low HDLs)
Type 2 Diabetes - Onset - correct answer ✔✔- insidious; gradual
- patients may go for years with undetected hyperglycemia and few (if any) symptoms
- hyperglycemia sx develop when about 50-80% of pancreatic beta islet cells no longer secrete insulin
- by the time of diagnosis, Type 2 patients have been diabetic for 6.5 years
Type 2 Diabetes - Need for Insulin - correct answer ✔✔Required for some; may progress to need it
Gestational Diabetes - correct answer ✔✔- develops during pregnancy
- higher risk for cesarean delivery
- babies have a higher risk of perinatal death, birth injury, and neonatal complications
- screening occurs at 24-28 weeks
- often have normal BG 6 weeks postpartum
- a hx of gestational diabetes is 63% risk of developing Type 2 diabetes within 16 years
MEMORIZE****** Diagnosis of diabetes is made using 1 of the following 4 methods: - correct answer
✔✔- A1C of 6.5% or higher
- Fasting plasma glucose (FPG) level of ≥126
- 2hr plasma glucose level of ≥200 during an OGTT, using a 75g glucose load
verified solutions
Prediabetes - correct answer ✔✔defined as:
- impaired glucose tolerance (IGT)
- impaired fasting glucose (IFG)
- or both
These patients are in an intermediate stage between normal BG homeostasis and diabetes.
- often asymptomatic; HOWEVER, long-term damage may already be occurring
- patients at increased risk for Type 2 diabetes
How is prediabetes impaired glucose tolerance (IGT) diagnosed? - correct answer ✔✔if the 2-hour oral
glucose tolerance test (OGTT) values are 140 to 199
How is prediabetes impaired fasting glucose (IFG) diagnosed? - correct answer ✔✔when fasting blood
glucose levels are 100 to 125
Screening for Diabetes in Asymptomatic, Undiagnosed Persons - correct answer ✔✔- screen all adults
with a BMI of >25 and additional risk factors (listed later)
- in the absence of the criteria above, SCREEN BY 45 yrs old
- repeat screening every 3 years
4 Classes of Diabetes - correct answer ✔✔Type 1
Type 2
Gestational
Other (specific types with various causes)
Type 1 Diabetes - correct answer ✔✔- "insulin-dependent diabetes"
,- used to be called "juvenile diabetes"
- ABSENCE OF INSULIN
- pancreas creates NO insulin
Causes:
- viral infection
- destruction of pancreatic beta islet cells (either directly or by an autoimmune process)
- AUTOIMMUNE DISEASE; antibodies destroy insulin or pancreatic islet cells
Idiopathic Diabetes - correct answer ✔✔- a form of type 1 diabetes that is strongly inherited and not
related to autoimmunity
- only occurs in a small number of people
- most often of Hispanic, African, or Asian ancestry.
Latent autoimmune diabetes in adults (LADA) - correct answer ✔✔- a slowly progressing autoimmune
form of type 1 diabetes
- occurs in adults and is often mistaken for type 2 diabetes
Type 1 Diabetes - SYMPTOMS - correct answer ✔✔- ketoacidosis begins and the patient becomes
symptomatic
- 3 P's (polydipsia, polyphagia, polyuria)
- fatigue
- weight loss
Type 1 Diabetes - RISK FACTORS - correct answer ✔✔- more common under 40 yrs old
- patients can be skinny, obese; whatever!
Type 1 Diabetes - Need for Insulin - correct answer ✔✔every single Type 1 diabetic will require insulin
therapy for the rest of their lives
Type 1 Diabetes - Onset - correct answer ✔✔Abrupt! but it may have been present for years
,Type 1 "Honeymoon Period" - correct answer ✔✔remission of diabetes that lasts 3-12 months after the
patient's INITIAL treatment
- pt may need very little insulin bc β-cell insulin production is still sufficient for healthy blood glucose
levels
- THIS ENDS. THIS IS NOT PERMANENT. IMPORTANT TEACHING POINT. THIS WILL NOT EVER OCCUR
AGAIN.
Type 2 Diabetes - correct answer ✔✔- "insulin resistant"
- inadequate production OR use of insulin
- inappropriate glucose production by the liver
- NUTRITION is extremely responsible for Type 2
- CAN occur in skinny people! it all depends on their nutrition
Insulin Resistance - correct answer ✔✔body tissues do not respond to the action of insulin because
insulin receptors are:
- unresponsive
- are insufficient in number
- or both
Where are insulin receptors located? - correct answer ✔✔- skeletal muscle
- fat
- liver cells
SO.... if a patient experiences trauma to muscles or liver, they will be at a higher risk for Type 2 diabetes!
Type 2 Diabetes - SYMPTOMS - correct answer ✔✔- Type 2 diabetics are often asymptomatic
- Fatigue
- Recurrent infections (yeast infections are common 🙀)
- 3 P's
, Type 2 Diabetes - RISK FACTORS - correct answer ✔✔- Obesity
- Older adults
- Family history (First-degree relative with diabetes)
- Native American
- Black
- Female
- HTN
- Sedentary lifestyle
- Metabolic syndrome (increased glucose, abdominal obesity, high BP, high triglycerides, low HDLs)
Type 2 Diabetes - Onset - correct answer ✔✔- insidious; gradual
- patients may go for years with undetected hyperglycemia and few (if any) symptoms
- hyperglycemia sx develop when about 50-80% of pancreatic beta islet cells no longer secrete insulin
- by the time of diagnosis, Type 2 patients have been diabetic for 6.5 years
Type 2 Diabetes - Need for Insulin - correct answer ✔✔Required for some; may progress to need it
Gestational Diabetes - correct answer ✔✔- develops during pregnancy
- higher risk for cesarean delivery
- babies have a higher risk of perinatal death, birth injury, and neonatal complications
- screening occurs at 24-28 weeks
- often have normal BG 6 weeks postpartum
- a hx of gestational diabetes is 63% risk of developing Type 2 diabetes within 16 years
MEMORIZE****** Diagnosis of diabetes is made using 1 of the following 4 methods: - correct answer
✔✔- A1C of 6.5% or higher
- Fasting plasma glucose (FPG) level of ≥126
- 2hr plasma glucose level of ≥200 during an OGTT, using a 75g glucose load
