Type 1 diabetes Part 1

wasabi's version from 2015-10-14 19:03

Section 1

Question Answer
type one diabetes results from b-cell destruction, leading to absolute insulin deficiency
type one diabetes may be confirmed by:presence of 1+ autoantibodies to (GAD or 1A 2B) is present in 85-90% when fasting hyperglycemia is initally detected
T1DM accounts for what percent of diabetes?5 to 10 percent
T1DM increasing?3 to 4% per year in youths and even more in children under 5
which race highest rate of new cases for T1DM?non hispanic white youth
greater rate of T2DM than T1DM in what raceasian/pacific islander and american indian
rate of T1DM and T2DM equal what racenon hispanic black and hispanic
what contains beta cells?islet of langerhans in the pancreas. accounts for 1-2 percent of pancreatic mass
what is co secreted with insulin?amylin. regulates post prandial glucose by slowing gastric emptying and decreasing food intake and suppresseing glucagon secretion
what secretes glucagonalpha cells
what secretes somatastatindelta cells
what secretes pancratic polypeptide?pp cells
glucose stored as whatglycogen in liver and muscle
pre clinical phase immune markers present. b cell destruction likely occurs
clinical onsethyperglycemia. 80 to 90% of b cells destroyed. insulin secretion insufficient to regulate hepatic glucose production
honeymoon phaseinsuline secretion improves from the residual small b cell population remaining. exogenous insulin requirements decrase dramatically may last up to one year
established diseaseb cell destruction is essentially complete. insulin def is usually absolute.
polyuriawhen plasma glucose conc exceed renal threshold of 180 mg/dL glucosuria results in osmotic diureses leading to increased peeing
polyphagiaincreased appetite
symptoms in young childrenill with unexplained dehydration and or acidosis, severe candidal diaper rash, metabolic decompensation
diagnosis of diabetes A1Cequal to or above 6.5. cannot be used in pregnancy
diagnosis of diabetes fasting glucoseequal to or above 126 (fasting no caloric intake at least 8 hrs)
diagnosis diabetes 2 hour plasma glucoseequal to or above 200 using 75 gram glucose load
diagnosis diabetes random plasma glucose equal to or above 200 with classic symptoms of hyperglycemia or hyperglycemic crises

Section 2

Question Answer
A1c target in adultsunder 7
could be less stingent goal under 8 A1C people withhistory severe hypoglycemia. limited life expectancy, advanced microvascular or complications, extensive comorbid conditions
glycemic goals preprandial70-130
glycemic goals postprandial (1-2 hrs)under 180
under 6 yoa glucose goal rangebefore meals= 100-180 bedtime/overnight= 110-200. A1C under 8.5%
6-12 yoa goal glucose rangebefore meals=90-180 bedtime/overnight=90-150. A1C under 8%
13-19 yoa goal glucose rangebefore meals=90-130 bedtime/overnight= 90-150 A1C under 7.5%
A1C target in pregnant females with diabetesunder 6%
gestational diabetes fasting goal under or equal to 95
gestational 1 hour post prandialunder or equal 140
gestational 2 hours post prandialunder or equal 120
pre-exisint diabetes pregnant glycemic goals pre-meal, bedtime, and overnight 60-99
pre-existing diabets pregnant peak postprandial goal of 100-129

Section 3

Question Answer
Aspartnovolog. rapid acting
lisprohumalog. rapid acting
glulisineapidra. rapid acting
regular insulinhumulin R and Novolin R. short acting
NPH insulinHumulin N and Novolin N. intermed acting
detemirlevemir. long acting
glarginelantus. long acting
which is cloudy?NPH

Section 4

Question Answer
novolog mix 70/3070% aspart protamine susp and 30% insulin aspart solution
humalog mix 75/2575% insulin lispro protamine susp and 25% insulin lispro solution
humalog mix 50/5050% insulin lispro protamine and 50% insulin solution
humulin 70/3070% NPH 30% regular
novolin 70/3070% NPH and 30% regular

Section 5

Question Answer
rapid acting onset15-30 mins
rapid acting peak1-2 hours
rapid acting duration3-5 hours
short acting onset30-60 mins
short acting peak2-3 hours
short acting duration4-6 hours
intermed acting onset2-4 hours
intermed acting peak4-8 hours
intermed acting duration8-12 hours
long acting onset2 hrs levemir and 4-5 hrs lantus.
long acting peakrelatively flat
long acting durationlevemir 12-24 hours and lantus 22-24