Comprehensive NR 325 Exam 1 Review Notes
for Nursing Students
Endocrine System Function
Produce hormones and secrete them directly into the bloodstream
Insulin
Regulator of metabolism and storage of ingested carbohydrates, fats, and proteins
(anabolic or storage hormone).
Facilitates glucose transport across cell membranes
Counterregulatory Hormones
Oppose the effects of insulin, and increase blood glucose levels. They provide a regulated
release of glucose for energy, and help maintain normal blood glucose levels.
Ex: glucagon, epinephrine, growth hormone, cortisol
Glucagon
Normally produced by pancreatic alpha cells when blood sugar is low to raise blood
glucose levels. In diabetes II, glucagon is still produced, but because there is so much
insulin, our pancreas doesn't respond normally.
Diabetes Mellitus
A chronic, multi-system disease related to abnormal insulin production, impaired insulin
utilization, or both. There is no cure, but diabetic complications can be delayed or
prevented with good management. African Americans, Hispanic/Latino Americans, and
Native Americans have a higher incidence of diabetes.
Diabetes Complications
Diabetes is the leading cause of adult blindness, end-stage renal failure, and non-
traumatic lower limb amputations. It is also a major contributing factor to heart disease
and stroke.
Gerontologic Considerations with Diabetes
,Diabetes prevalence increases with age related to reduced B-cell function, decreased
insulin sensitivity (!!), and altered carb metabolism. Undiagnosed and untreated diabetes is
more common in older adults, partly due to the normal physiologic changes of aging
resembling that of DM.
Diabetes is present in at least 25% of people over age 65.
Diabetes Type I Epidemiology
Formerly known as "juvenile onset" or "insulin dependent" diabetes.
Most often occurs in people under 40 years old, and accounts for 5-10% of all people with
diabetes.
Has a sudden onset.
It is an autoimmune disease, in which B-cells responsible for insulin production are
destroyed. A genetic predisposition and exposure to a virus are factors that may contribute
to the development of DM I. Autoantibody are produced and destroy B-cells.
Manifestations occur after the pancreas is unable to produced insulin, and symptoms are
rapid. Usually patients present to ER with DKA.
Diabetes Type I Classic Symptoms
Polyuria
Polydipsia
Polyphagia
Weight loss
Prediabetes
Known as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).
Prediabetes Labs
IFG: fasting glucose levels 100-126 mg/dl
IGT: 2 hour plasma glucose 140-199 mg/dl
A1C: in the range of 5.7-6.4%
A1C Lab
It is a test that determines how well your glucose was stabilized within the last three
months.
If you have a high A1C, that means you have had high glucose levels in the last 3 months
Diabetes Type II Etiology
, Probably has a genetic basis.
A genetic mutation leading to insulin resistance, and as the disease progresses, less insulin
production. There is also an increased risk for obesity.
Obesity is the most powerful risk factor, especially obesity with an increased waist
circumference.
Type II DM is now being seen in children due to epidemic of childhood obesity.
Type II accounts for 90% of diabetics.
Pancreas continues to produce insulin, but the body can't use the insulin.
Diabetes Type II Risk Factors
Obesity
Aging
Sedentary lifestyle
Family history of Type II DM
Urbanization
Certain ethnicities (AA, NA, Latino)
Diabetes Type II Clinical Manifestations
Nonspecific symptoms, may have classic symptoms of type I
Fatigue
Recurrent infections
Recurrent vaginal yeast or monilia infections
Prolonged wound healing
Visual changes
The onset of symptoms is gradual.
Diagnosing Diabetes: Fasting Plasma Glucose Level
>126 mg/dl
Fasting is no caloric intake for at least 8 hours. The FPG test needs to be confirmed by
repeating testing on another day.
Diagnosing Diabetes: Random Plasma Glucose Measurement
>200 mg/dl plus symptoms
Diagnosing Diabetes: Two-Hour OGTT Level
>200 mg/dl using a glucose load of 75g.
You have the patient drink a syrup drink and evaluate how well the body tolerates large
doses of sugar.
for Nursing Students
Endocrine System Function
Produce hormones and secrete them directly into the bloodstream
Insulin
Regulator of metabolism and storage of ingested carbohydrates, fats, and proteins
(anabolic or storage hormone).
Facilitates glucose transport across cell membranes
Counterregulatory Hormones
Oppose the effects of insulin, and increase blood glucose levels. They provide a regulated
release of glucose for energy, and help maintain normal blood glucose levels.
Ex: glucagon, epinephrine, growth hormone, cortisol
Glucagon
Normally produced by pancreatic alpha cells when blood sugar is low to raise blood
glucose levels. In diabetes II, glucagon is still produced, but because there is so much
insulin, our pancreas doesn't respond normally.
Diabetes Mellitus
A chronic, multi-system disease related to abnormal insulin production, impaired insulin
utilization, or both. There is no cure, but diabetic complications can be delayed or
prevented with good management. African Americans, Hispanic/Latino Americans, and
Native Americans have a higher incidence of diabetes.
Diabetes Complications
Diabetes is the leading cause of adult blindness, end-stage renal failure, and non-
traumatic lower limb amputations. It is also a major contributing factor to heart disease
and stroke.
Gerontologic Considerations with Diabetes
,Diabetes prevalence increases with age related to reduced B-cell function, decreased
insulin sensitivity (!!), and altered carb metabolism. Undiagnosed and untreated diabetes is
more common in older adults, partly due to the normal physiologic changes of aging
resembling that of DM.
Diabetes is present in at least 25% of people over age 65.
Diabetes Type I Epidemiology
Formerly known as "juvenile onset" or "insulin dependent" diabetes.
Most often occurs in people under 40 years old, and accounts for 5-10% of all people with
diabetes.
Has a sudden onset.
It is an autoimmune disease, in which B-cells responsible for insulin production are
destroyed. A genetic predisposition and exposure to a virus are factors that may contribute
to the development of DM I. Autoantibody are produced and destroy B-cells.
Manifestations occur after the pancreas is unable to produced insulin, and symptoms are
rapid. Usually patients present to ER with DKA.
Diabetes Type I Classic Symptoms
Polyuria
Polydipsia
Polyphagia
Weight loss
Prediabetes
Known as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).
Prediabetes Labs
IFG: fasting glucose levels 100-126 mg/dl
IGT: 2 hour plasma glucose 140-199 mg/dl
A1C: in the range of 5.7-6.4%
A1C Lab
It is a test that determines how well your glucose was stabilized within the last three
months.
If you have a high A1C, that means you have had high glucose levels in the last 3 months
Diabetes Type II Etiology
, Probably has a genetic basis.
A genetic mutation leading to insulin resistance, and as the disease progresses, less insulin
production. There is also an increased risk for obesity.
Obesity is the most powerful risk factor, especially obesity with an increased waist
circumference.
Type II DM is now being seen in children due to epidemic of childhood obesity.
Type II accounts for 90% of diabetics.
Pancreas continues to produce insulin, but the body can't use the insulin.
Diabetes Type II Risk Factors
Obesity
Aging
Sedentary lifestyle
Family history of Type II DM
Urbanization
Certain ethnicities (AA, NA, Latino)
Diabetes Type II Clinical Manifestations
Nonspecific symptoms, may have classic symptoms of type I
Fatigue
Recurrent infections
Recurrent vaginal yeast or monilia infections
Prolonged wound healing
Visual changes
The onset of symptoms is gradual.
Diagnosing Diabetes: Fasting Plasma Glucose Level
>126 mg/dl
Fasting is no caloric intake for at least 8 hours. The FPG test needs to be confirmed by
repeating testing on another day.
Diagnosing Diabetes: Random Plasma Glucose Measurement
>200 mg/dl plus symptoms
Diagnosing Diabetes: Two-Hour OGTT Level
>200 mg/dl using a glucose load of 75g.
You have the patient drink a syrup drink and evaluate how well the body tolerates large
doses of sugar.
