Diabetes Mellitus and Renal System / Urinary Tract Infections

Comprehensive vocabulary flashcards covering pathophysiology, diagnostic standards, pharmacological management, and nursing considerations for Diabetes Mellitus and Urinary Tract Infections.

Pancreatic Beta Cells

Cells located in the islets of Langerhans of the pancreas that produce and release insulin continuously in small increments, with larger bursts after eating.

Pancreatic Alpha Cells

Endocrine cells in the pancreas that release glucagon when blood glucose is low, signaling the liver to raise blood glucose levels and prevent hypoglycemia.

Pancreas Exocrine Function

The secretion of digestive enzymes, such as amylase and lipase, directly into ducts leading to the gastrointestinal tract.

Diabetes Mellitus (DM)

A metabolic disorder resulting from either inadequate production of insulin by the pancreas or the inability of the body's cells to respond to insulin.

Type 1 Diabetes Mellitus

An autoimmune disorder where the immune system destroys pancreatic beta cells, leading to an absolute deficiency of insulin, sudden weight loss, the three Ps, and high risk for DKA.

Diabetic Ketoacidosis (DKA)

An acute metabolic complication occurring when cells lack glucose and the body breaks down fat for energy, producing ketones that lead to metabolic acidosis.

Type 2 Diabetes Mellitus

A progressive metabolic disorder characterized by cellular insulin resistance and declining pancreatic production; clients often have the condition for an average of $6.5\,\text{years}$ before diagnosis.

Fasting Blood Glucose Test

A diagnostic blood test performed after at least $8\,\text{hours}$ without caloric intake; a result greater than $126\,\text{mg/dL}$ on two separate days is diagnostic of diabetes (normal is $74-106\,\text{mg/dL}$).

Casual Blood Glucose Test

A random blood test where a glucose reading greater than $200\,\text{mg/dL}$, in the presence of classic manifestations of diabetes, meets diagnostic criteria (normal is $< 200\,\text{mg/dL}$).

Glycosylated Hemoglobin (HbA1C)

A diagnostic measurement reflecting average blood glucose control over the previous $120\,\text{days}$ ($4\,\text{months}$); normal is $4\% - 6\%$, while a value greater than $6.5\%$ confirms diabetes.

Pre-Diabetes

An intermediate, asymptomatic stage where blood glucose levels are above normal but do not yet meet the diagnostic criteria for diabetes, during which long-term vascular damage may already occur.

Basal-Bolus Insulin Regimen

An intensive therapy designed to mimic endogenous insulin release using mealtime rapid- or short-acting (bolus) insulin combined with once- or twice-daily intermediate- or long-acting (basal) background insulin.

Rapid-Acting Insulin

Insulins such as insulin lispro (Humalog), insulin aspart (Novolog), and insulin glulisine (Apidra); onset is $15-30\,\text{min}$, peak is $0.5-3\,\text{hours}$, duration is $3-5\,\text{hours}$, and administration occurs within $15\,\text{minutes}$ of a meal.

Regular Insulin (Humulin R)

A short-acting insulin with an onset of $0.5-1\,\text{hour}$, peak of $1-5\,\text{hours}$, and duration of $6-10\,\text{hours}$, administered within $15-30\,\text{minutes}$ of a meal.

NPH Insulin (Humulin N)

An intermediate-acting, cloudy insulin with an onset of $1-2\,\text{hours}$, peak of $4-14\,\text{hours}$, and duration of $14-24\,\text{hours}$; must be gently agitated before administration and is the only intermediate insulin that can be mixed with short-acting insulin.

Long-Acting Insulin

Peakless basal insulins such as insulin glargine (Lantus) and insulin detemir (Levemir) with an onset of $1-4\,\text{hours}$ and duration of $24\,\text{hours}$; administered once daily at the same time, never mixed, and never given IV.

Lipodystrophy (Lipohypertrophy / Lipoatrophy)

Adverse changes in subcutaneous fatty tissue at injection sites caused by repeated injections in the same location; prevented by systemically rotating injection sites.

Subcutaneous Insulin Injection Sites

Anatomical sites used for insulin administration, absorbing fastest from the abdomen, followed by the arms, thighs, and buttocks.

Drawing Up Mixed Insulin Technique

Procedure for mixing insulins in one syringe: inject air into the cloudy (NPH) vial, inject air into the clear (regular) vial, draw up the clear (regular) insulin first, then draw up the cloudy (NPH) insulin.

Metformin

A biguanide that reduces hepatic glucose production, improves tissue insulin sensitivity, and slows intestinal carbohydrate absorption; must be held for $48\,\text{hours}$ before and after IV contrast.

Sulfonylureas (Second Generation)

Oral antidiabetic medications (e.g., glipizide, glyburide) that stimulate insulin release from the pancreas and increase tissue sensitivity over time; taken $30\,\text{minutes}$ before meals and require avoiding alcohol.

Meglitinides

Oral hypoglycemics (e.g., repaglinide) that stimulate pancreatic insulin release to lower post-prandial hyperglycemia; taken $15-30\,\text{minutes}$ before meals, must be accompanied by food within $30\,\text{minutes}$, and skipped if the meal is skipped.

Alpha-Glucosidase Inhibitors

Oral agents like acarbose that delay intestinal carbohydrate absorption to reduce post-prandial hyperglycemia; taken with the first bite of each main meal and require liver function tests every $3\,\text{months}$.

GLP-1 Receptor Agonists

Medications like semaglutide that mimic natural glucagon-like peptide-1 to enhance insulin release, slow gastric emptying, and induce satiety; given as weekly subcutaneous injections or daily oral doses.

Hypoglycemia

A blood glucose level below $70\,\text{mg/dL}$, presenting with cool, clammy skin, diaphoresis, tremors, tachycardia, confusion, weakness, and blurred vision.

Hyperglycemia

A blood glucose state starting around $250+\,\text{mg/dL}$, classically presenting with hot, dry skin, fruity breath, and osmotic diuresis.

Diabetic Neuropathy

Peripheral nerve damage resulting from chronic hyperglycemia, manifesting as numbness, tingling, and pain in the extremities.

Diabetic Nephropathy

Microvascular damage to the renal glomeruli caused by long-standing diabetes, leading to progressive chronic kidney disease.

Urinary System Anatomy

The body system comprising the upper tract (two kidneys) and the lower tract (two ureters, urinary bladder, and urethra) that filters blood plasma and produces urine.

Nephron Anatomy

The structural and functional unit of the kidney, consisting of the glomerulus, Bowman's capsule, tubular loops, and the collecting duct.

Glomerular Filtration Rate (GFR)

The volume of blood filtered per minute by the renal glomeruli; older adults routinely experience an age-related reduction in this rate.

Serum Creatinine

A renal diagnostic blood parameter reflecting muscle breakdown and filtration capacity, with a normal reference range of $0.6-1.2\,\text{mg/dL}$.

Blood Urea Nitrogen (BUN)

A diagnostic lab measurement of urea nitrogen waste in blood plasma, with a normal range of $8-20\,\text{mg/dL}$.

Minimum Urine Output

The essential threshold of urine elimination required to prevent waste accumulation and indicate adequate renal perfusion, defined as greater than $30\,\text{mL/hr}$.

Escherichia coli (E. coli)

The most common bacterial pathogen responsible for urinary tract infections in both community and hospital settings.

Cystitis

Inflammation and localized bacterial infection of the urinary bladder wall, presenting with dysuria, urinary frequency, urgency, and lower abdominal discomfort.

Acute Pyelonephritis

An upper urinary tract infection of the renal parenchyma, commonly ascending from the lower tract and characterized by flank pain, high fever, chills, tachycardia, and tachypnea.

Urosepsis

A life-threatening systemic infection resulting from a urinary tract infection that has entered systemic blood circulation.

Complicated UTI

A urinary infection coexisting with obstructions, calculi, indwelling catheters, diabetes, neurologic disorders, or pregnancy, conferring higher risk for renal damage and urosepsis.

Phenazopyridine (Pyridium)

A local urinary analgesic that provides soothing relief to irritated urinary tract mucosa; taken with food and characteristically turns urine a red-orange color.