Exam 1

What is the term for the elevation of blood sugar levels after food consumption?

Postprandial

What is glyconeogenesis?

The process of producing glucose from fat and protein.

What are ketones?

Byproducts of fat metabolism used for energy.

What role does insulin play in the body?

Insulin is a hormone that promotes the passage of glucose across the cell membrane.

What do alpha cells produce in response to low blood sugar levels?

Alpha cells produce the hormone glucagon.

What is glycogenolysis?

The breakdown of glycogen to glucose in the liver.

What are counter regulatory hormones?

Hormones like glucagon, epinephrine, cortisol, and growth hormone that increase blood sugar levels.

What does 'basal' refer to in diabetes management?

The amount of insulin required to manage normal blood sugar levels.

What do beta cells produce in response to high blood sugar levels?

Beta cells produce the protein insulin.

What is glucagon?

A pancreatic hormone that helps release stored glucose in the liver.

What is glycogen?

Stored glucose in the liver.

What is the normal fasting blood glucose range?

Less than 100 mg/dL.

What fasting glucose level indicates prediabetes?

100-125 mg/dL.

What is the normal A1C range?

5.0-5.7%.

What A1C levels indicate prediabetes?

5.7-6.4%.

What A1C level indicates diabetes?

Greater than 6.5%.

What are the ABC goals for diabetes management?

A: A1C less than 7, B: blood pressure less than 140/90, C: cholesterol goals for LDL less than 100, triglycerides less than 150, HDL greater than 40 for men and 50 for women.

What constitutes rapid acting insulin?

Aspart, lispro, glulisine (Novolog, Humalog, Apidra).

What is the onset of rapid acting insulin?

15 minutes.

What is the peak action time for rapid acting insulin?

2 hours.

What is the duration of rapid acting insulin?

3-5 hours.

What types of insulin are considered short acting?

Novolin R, Humulin R.

What is the onset of short acting insulin?

30 minutes.

What is the peak action time for short acting insulin?

3 hours.

What is the duration of short acting insulin?

5-7 hours.

What is NPH in insulin terms?

Intermediate acting insulin also known as Novolin N or Humulin N.

What is the onset of NPH insulin?

1.5 hours.

What is the peak action time for NPH insulin?

8 hours.

What is the duration of NPH insulin?

16-24 hours.

What are the long acting insulins?

Glargine (Lantus) and Detemir (Levemir).

What is the onset of long acting insulin?

Lantus: 2-4 hours, Levemir: 1-2 hours.

Does long acting insulin have a peak?

No, there is no peak.

What is the duration of long acting insulin?

24 hours.

What does premixed insulin 70/30 contain?

70% intermediate acting insulin and 30% regular insulin.

Which insulin can be given intravenously?

Regular insulin.

How should insulin be stored?

Keep in refrigerator until opened; discard after 28 days.

What is the renal threshold for glucose?

200 mg/dL.

What is polyuria?

Excessive urination.

What is polydipsia?

Excessive thirst.

What is polyphagia?

Excessive hunger.

What is a normal OGTT (Oral Glucose Tolerance Test) level?

Less than 140 mg/dL.

What happens to beta cells in type 1 diabetes?

Beta cells are destroyed and do not produce insulin.

What does DKA stand for and what is it caused by?

Diabetic Ketoacidosis; caused by ketone production outpacing loss by kidneys, leading to dehydration.

What are the signs of DKA?

Abdominal pain, acetone breath, Kussmaul respirations, nausea/vomiting, altered mental status.

What is the treatment for DKA?

Correct dehydration first, electrolyte loss, monitor for fluid overload, and give IV insulin.

When should IV insulin for DKA not be stopped?

Don't stop until subcutaneous insulin is given and patient can eat.

What causes type 2 diabetes?

Excess liver glucose production, insulin resistance, and altered hormone production.

What are the diagnostic criteria for type 2 diabetes?

Obesity, genetic factors, older age, previous gestational diabetes, sedentary lifestyle, ethnicity, and metabolic syndrome.

What is metabolic syndrome?

A condition characterized by abdominal obesity, hyperglycemia, sedentary lifestyle, hypertension, and dyslipidemia.

What is HHS?

Hyperglycemic-Hyperosmolar State; occurs in type 2 diabetes with extracellular dehydration.

What are the signs of HHS?

No ketones, osmolarity greater than 310, blood sugar greater than 600, altered reflexes, seizures.

What is the treatment for HHS?

Hydration to lower plasma osmolarity, using 0.45% or 0.9% normal saline.

What are signs of hypoglycemia?

Sweating, tremors, tachycardia, palpitations, hunger, headache, memory lapse, disorientation.

What is the rule of 15 for treating hypoglycemia?

Treat with 15 grams of carbohydrates, wait 15 minutes, check blood sugar, if less than 70, eat another 20-30 grams.

What is peripheral neuropathy?

Characterized by muscle weakness, sensory loss, balance loss, and joint dislocation.

What is autonomic neuropathy?

Includes painless ischemia, orthostatic hypotension, tachycardia, and decreased gastric emptying.

What is sudomotor neuropathy?

Increased upper body sweating and dryness of feet.

What is Glucophage (metformin) used for?

Suppresses hepatic glucose production, taken during meal time.

What do sulfonylureas (like glyburide) do?

Stimulates beta cells for insulin secretion, given before meals for type 2 diabetes.

What is the Dawn phenomenon?

A hormone surge between 2 and 8 am leading to higher sugars in the morning.

What is the Somogyi effect?

When medications cause blood sugar to crash at night, triggering a hormonal response that raises blood sugar.

What is lipodystrophy?

Atrophy of subcutaneous fat.

What is required to make thyroid hormones?

Iodine, regulated by TSH, includes T3, T4, and calcitonin.

What is congenital hypothyroidism?

A condition where thyroid hormone crosses the blood-brain barrier causing intellectual disabilities.

What is cretinism?

Iodine deficiency during pregnancy leading to severe developmental issues.

What are some symptoms of hypothyroidism?

Weight gain, cold intolerance, bradycardia, constipation, hair loss, fatigue.

What is myxedema coma?

A hypothyroid emergency caused by stress, infection, or non-compliance with medication.

What are signs of myxedema coma?

Lower temperature, respiration, blood pressure, blood sugar, and unresponsiveness.

What is the treatment for myxedema coma?

IV thyroid replacement and steroids.

What are some causes of hypothyroidism?

Hashimoto's thyroiditis, iodine deficiency.

What is the treatment for hypothyroidism?

Levothyroxine, starting with a small dose and increasing it over time.

What is hyperthyroidism?

Excessive activity of the thyroid gland often seen in Graves' disease.

What are symptoms of hyperthyroidism?

Weight loss, increased appetite, heat intolerance, tachycardia, anxiety.

What is the treatment for hyperthyroidism?

Radioactive iodine, beta blockers, anti-thyroid medications such as methimazole.

What is thyroid storm?

A rapid increase in thyroid hormone production caused by stress or infection in patients with hyperthyroidism.

What are symptoms of thyroid storm?

Fever, tachycardia, agitation, heart failure, diarrhea.

What is the synthetic thyroid education?

Take on an empty stomach in the morning, may interact with other meds, and taken at the same time daily.