NRSG265 (questions n answers)A+
graded
Cause of T1DM - ANS ✔results from beta cell destruction leading to severe or absolute insulin
deficiency and chronic hyperglycemia
2 types:
Idiopathic -beta cell destruction in the absence of autoimmune response
Non-immune mediated diabetes -secondary to other conditions -pancreatitis
Pathophysiology T1DM - ANS ✔Destruction of beta cells leads to very little/ no insulin
production
GLUT-4s are not activated and glucose cannot be taken up by cells
Glucose continues to be released by liver - insulin is not available to regulate this release.
Increased production of glucagon --> continued glucose not being taken up by the cells -->
hyperglycaemia
T1DM Clinical Manifestations - ANS ✔The 3 P's (polydipsia, polyuria, and polyphagia), fatigue,
weight loss, N & V abdominal pain, confusion, weakness, tachycardia, ketonic breath,
tachycardia, tachypnoea, metabolic acidosis, seizures, coma
T1DM acute complications - ANS ✔hypoglycaemia, DKA
T1DM management - ANS ✔Insulin, BGL monitoring, meal planning, annual health checks,
exercise plan
,T2DM causes - ANS ✔caused by insulin resistance at target tissues and a relative insulin
deficiency
T2DM risk factors - ANS ✔genetic factors and family history, overweight and obese, hx of
gestational diabetes
T2DM pathophysiology - ANS ✔Decreased beta cell responsiveness to increased glucose levels,
decreased insulin production, increased insulin resistance at the cell (reduction in number of
binding sites, decreased in the amount of insulin biding to the receptors)
T2DM signs and symptoms - ANS ✔3 P's (polyphagia, polyuria, polydipsia), fatigues,
hyperglycaemia, repeated infections, poor wound healing, blurred vision, weight changes
T2DM acute complications - ANS ✔Hyperglycaemia, HHS
T2DM management - ANS ✔Healthy diet, Exercise, close BGL monitoring, possible need for oral
hypoglycaemic agents, insulin
Biguanides (Metformin) - ANS ✔Decreased hepatic release of glucose, decreases intestinal
absorption of glucose, improves insulin sensitivity by increasing peripheral uptake of glucose -->
reduced BGL
Sulphonylureas (gliceride) - ANS ✔stimulates insulin secretion from the beta cells -->
hypoglycaemia
T1DM pathophysiology - ANS ✔genetic predisposition
immune response against beta cells
beta cell destructions
lack of insulin
, GLUT-4s are not activated
glucose unable to be taken up
Hyperglycaemia
interventions for DKA and HHS - ANS ✔Fluid resus, reverse hyperglycaemia, correct acid base &
electrolyte balance, cardiac monitoring, 1/24 obs
Recurrent infections with diabetes causes - ANS ✔Neuropathy, impaired vision, high glucose
environment
HbA1C - ANS ✔assess long term control of diabetes, forms irreversibly from glucose and
haemoglobin
measures the average blood glucose throughout the life span
Coronary heart disease/coronary artery disease (CAD) - ANS ✔Blood vessel disorder that is
included in the general category of atherosclerosis
can be asymptomatic or develop as chronic/stable angina
Myocardial Ischaemia - ANS ✔imbalance between oxygen supply and demand. Vasoconstriction
(atherosclerosis is a common cause) --> anaerobic respiration forms lactic acid --> cells viable for
20mins --> cell death --> inflammation, granulation tissue formation and scarring --> Thrombus
Manifestations of MI - ANS ✔pain (may radiate to neck, lower jaw, left arm, left shoulder
occasionally back or down right arm), pallor, diaphoresis, dyspnoea
Angina - ANS ✔imbalance between myocardial oxygen demand and supply --> ischemia --
>insufficient oxygen to meet cardiac needs = decreased tissue perfusion = angina sectors (chest
pain)
graded
Cause of T1DM - ANS ✔results from beta cell destruction leading to severe or absolute insulin
deficiency and chronic hyperglycemia
2 types:
Idiopathic -beta cell destruction in the absence of autoimmune response
Non-immune mediated diabetes -secondary to other conditions -pancreatitis
Pathophysiology T1DM - ANS ✔Destruction of beta cells leads to very little/ no insulin
production
GLUT-4s are not activated and glucose cannot be taken up by cells
Glucose continues to be released by liver - insulin is not available to regulate this release.
Increased production of glucagon --> continued glucose not being taken up by the cells -->
hyperglycaemia
T1DM Clinical Manifestations - ANS ✔The 3 P's (polydipsia, polyuria, and polyphagia), fatigue,
weight loss, N & V abdominal pain, confusion, weakness, tachycardia, ketonic breath,
tachycardia, tachypnoea, metabolic acidosis, seizures, coma
T1DM acute complications - ANS ✔hypoglycaemia, DKA
T1DM management - ANS ✔Insulin, BGL monitoring, meal planning, annual health checks,
exercise plan
,T2DM causes - ANS ✔caused by insulin resistance at target tissues and a relative insulin
deficiency
T2DM risk factors - ANS ✔genetic factors and family history, overweight and obese, hx of
gestational diabetes
T2DM pathophysiology - ANS ✔Decreased beta cell responsiveness to increased glucose levels,
decreased insulin production, increased insulin resistance at the cell (reduction in number of
binding sites, decreased in the amount of insulin biding to the receptors)
T2DM signs and symptoms - ANS ✔3 P's (polyphagia, polyuria, polydipsia), fatigues,
hyperglycaemia, repeated infections, poor wound healing, blurred vision, weight changes
T2DM acute complications - ANS ✔Hyperglycaemia, HHS
T2DM management - ANS ✔Healthy diet, Exercise, close BGL monitoring, possible need for oral
hypoglycaemic agents, insulin
Biguanides (Metformin) - ANS ✔Decreased hepatic release of glucose, decreases intestinal
absorption of glucose, improves insulin sensitivity by increasing peripheral uptake of glucose -->
reduced BGL
Sulphonylureas (gliceride) - ANS ✔stimulates insulin secretion from the beta cells -->
hypoglycaemia
T1DM pathophysiology - ANS ✔genetic predisposition
immune response against beta cells
beta cell destructions
lack of insulin
, GLUT-4s are not activated
glucose unable to be taken up
Hyperglycaemia
interventions for DKA and HHS - ANS ✔Fluid resus, reverse hyperglycaemia, correct acid base &
electrolyte balance, cardiac monitoring, 1/24 obs
Recurrent infections with diabetes causes - ANS ✔Neuropathy, impaired vision, high glucose
environment
HbA1C - ANS ✔assess long term control of diabetes, forms irreversibly from glucose and
haemoglobin
measures the average blood glucose throughout the life span
Coronary heart disease/coronary artery disease (CAD) - ANS ✔Blood vessel disorder that is
included in the general category of atherosclerosis
can be asymptomatic or develop as chronic/stable angina
Myocardial Ischaemia - ANS ✔imbalance between oxygen supply and demand. Vasoconstriction
(atherosclerosis is a common cause) --> anaerobic respiration forms lactic acid --> cells viable for
20mins --> cell death --> inflammation, granulation tissue formation and scarring --> Thrombus
Manifestations of MI - ANS ✔pain (may radiate to neck, lower jaw, left arm, left shoulder
occasionally back or down right arm), pallor, diaphoresis, dyspnoea
Angina - ANS ✔imbalance between myocardial oxygen demand and supply --> ischemia --
>insufficient oxygen to meet cardiac needs = decreased tissue perfusion = angina sectors (chest
pain)
