SHERPATH: Diabetes Mellitus

Which is considered a classic sign of diabetes? A. Fatigue B. Weight loss C. Recurrent infections D. Excessive urine output

D. Excessive urine output Excessive urine output, known as polyuria, is a classic sign of diabetes. Other classic signs include polydipsia (increased thirst) and polyphagia (increased appetite).

Which person is most at risk for developing hyperosmotic hyperglycemic nonketotic state (HHNS)? A. Child with type 1 diabetes B. Female who is 48 years old and is premenopausal C. School-aged student with type 1 diabetes D. Male who is 65 years old and has type 2 diabetes

D. Male who is 65 years old and has type 2 diabetes HHNS/HHS occurs in people who are over 60 years of age and have type 2 diabetes. Therefore, this person is at risk for HHNS.

Place the phases of the autoimmune reaction in the order in which it occurs. 1. Glucose is unable to enter the cells 2. The individual develops hyperglycemia 3. Beta cells are destroyed by islet cell autoantibodies 4. The individual experiences an altered metabolism of protein, fat, and carbohydrates 5. The body is unable to produce insulin

3, 5, 1, 2, 4 Islet cell autoantibodies destroy beta cells. This creates a reduction of 80%-90% of normal pancreatic functioning. The destroyed beta cells result in a lack of insulin. The lack of insulin means no glucose enters the cells. Without glucose entering the cells, the individual develops hyperglycemia. Once hyperglycemia sets in, there is altered metabolism of protein, fat, and carbohydrates.

Which are clinical manifestations of diabetic ketoacidosis? Select all that apply. A. Nausea B. Seizures C. Polyuria D. Polydipsia E. Somnolence

A. Nausea Nausea (and vomiting) is a clinical manifestation of DKA due to the acidosis and electrolyte imbalance. C. Polyuria Polyuria (increased urination) is a clinical manifestation of DKA due to the hyperglycemic effect that causes osmotic diuresis. D. Polydipsia Polydipsia (increased thirst) is a clinical manifestation of DKA due to the hyperglycemic effect that causes dehydration.

Match the classic sign of diabetes to its correct description. A. Increased thirst B. Increased appetite C. Excessive urine output 1. Polyphagia 2. Hyperglycemia 3. Polyuria 4. Polydipsia 5. Glucosuria

A-4 B-1 C-3

Which statement describes the "honeymoon period" with regard to insulin? A. A time of remission when the body is able to sustain adequate insulin B. A period of time when the person with diabetes receives initial insulin treatment C. A time frame when the person with diabetes cannot receive any exogenous insulin D. A time period when the body rejects the exogenous insulin and causes hypoglycemia

A. A time of remission when the body is able to sustain adequate insulin The honeymoon period is a time of remission when the body is able to sustain adequate insulin. This period takes place 3-12 months after the initial insulin treatment begins.

Which primary cell is damaged or dysfunctional in diabetes? A. Beta cell B. Alpha cell C. Exocrine cell D. Pancreatic islet cell

A. Beta cell Pancreatic beta cells are destroyed or dysfunctional in diabetes.

Which statement is true of both type 1 and type 2 diabetes? A. Both types can lead to hyperglycemia B. Both often present with hypoglycemia C. Insulin resistance is the end result of both types of diabetes D. Autoimmune reactions are responsible for causing both types of diabetes

A. Both types can lead to hyperglycemia Hyperglycemia is high blood sugar and is the end result for both types of diabetes, since the body is unable to regulate glucose adequately.

Which are predisposing factors for type 2 diabetes? Select all that apply. A. Age B. Race C. Obesity D. Prediabetes E. Type 1 diabetes

A. Done estimated finish: 1hr 9min left Question 2 of 5 Which are predisposing factors for type 2 diabetes? Select all that apply. Age Race Obesity Prediabetes Type 1 diabetes Exactly! Age The risk of type 2 diabetes increases as people get older. Out of all the people in the United States with type 2 diabetes, approximately 50% are older than 55. B. Race There is a higher prevalence of type 2 diabetes in individuals of African American, Hispanic, and Native American descent. C. Obesity Obesity is a risk factor for type 2 diabetes, and the prevalence of the disease increases for those who are overweight. D. Prediabetes Prediabetes is a condition in which a person has elevated blood glucose, but the increased glucose values are not yet high enough to diagnose a person with type 2 diabetes. However, prediabetes is a predisposing factor for type 2 diabetes.

Which are clinical manifestations of type 1 diabetes? Select all that apply. A. Fatigue B. Weight loss C. Fluid overload D. Low blood sugar E. Decreased food intake

A. Fatigue Fatigue is a clinical manifestation of type 1 (as well as type 2) diabetes, because glucose does not enter the cells properly and the cells lack energy and get tired. B. Weight loss Weight loss is a clinical manifestation of type 1 diabetes because the body is unable to process and synthesize macronutrients like fats and proteins.

Which is associated with an increased risk for developing diabetic ketoacidosis (DKA)? A. Increasing stress level B. Feelings of fatigue with increased hunger C. Experiencing an absence of recent illness D. Consuming a low carbohydrate, low fat diet

A. Increasing stress level Stress is a causative agent of DKA, so the person with diabetes feeling very stressed at work could put the individual at risk of DKA. Stress increases the body's demand for insulin, which is why higher glucose levels can occur with DKA.

Which pathophysiologic processes occur in type 1 diabetes? Select all that apply. A. Insulin deficit occurs B. Insulin is endogenously produced C. Beta cells destruction occurs in the pancreas D. An autoimmune reaction affects beta cells E. Cellular insulin receptors have decreased sensitivity

A. Insulin deficit occurs With type 1 diabetes, insulin deficit occurs as a result of the lack of insulin production in the body. C. Beta cells destruction occurs in the pancreas Type 1 diabetes is the result of physiological processes that affect the function of the pancreas in which beta cell destruction results in no insulin production. D. An autoimmune reaction affects beta cells With type 1 diabetes, an autoimmune reaction may be present, which can result in islet cell autoantibodies destroying pancreatic beta cells.

Which are true of the clinical manifestations and complications of microangiopathy? Select all that apply. A. May lead to cataracts B. Can cause retinopathy C. May cause renal failure D. May lead to nerve degeneration E. May lead to impaired sensation in the legs

A. May lead to cataracts Cataracts, or clouding of the lenses, is one of the possible effects of microangiopathy. B. Can cause retinopathy Retinopathy is a possible effect with microangiopathy. C. May cause renal failure Renal failure can occur with microangiopathy because thickening in the capillary basement membrane leads to occlusion, which damages kidney glomeruli.

Which statement describes microangiopathy? A. Microangiopathy leads to tissue necrosis B. Microangiopathy causes myocardial infarction C. Microangiopathy affects the large blood vessels D. Microangiopathy is a condition that affects the peripheral nerves

A. Microangiopathy leads to tissue necrosis Tissue necrosis can result from microangiopathy because the capillary basement membrane becomes thickened and hardened, reducing blood flow.

Which statement describes the prevalence of type 1 diabetes? A. One out of every 500 children is diagnosed with type 1 diabetes B. More people are diagnosed with type 1 diabetes than type 2 diabetes C. Type 1 diabetes occurs in roughly 50% of all the people who have diabetes D. The number of people in the United States who have type 1 diabetes is 27.6 million

A. One out of every 500 children is diagnosed with type 1 diabetes Approximately one out of every 400-500 children has type 1 diabetes, which was once called "juvenile diabetes" since it most frequently occurs in children and adolescents. Out of all the people diagnosed with diabetes, type 1 diabetes occurs in approximately 5%.

Which statements describe the pathophysiology of type 2 diabetes? Select all that apply. A. Pancreatic islet cells do not function properly B. Cellular insulin receptors have decreased sensitivity C. Pancreatic islet cell autoantibodies destroy beta cells D. Beta cell insulin production stays sufficient enough for glucose control E. An autoimmune reaction causes the destruction of pancreatic beta cells

A. Pancreatic islet cells do not function properly After a transient increase of insulin production, pancreatic islet cells experience dysfunction, leading to decreased synthesis of insulin and increased glucagon and glucose synthesis in the liver. B. Cellular insulin receptors have decreased sensitivity Decreased sensitivity of insulin receptors leads to altered macronutrient metabolism of proteins, fats, and carbohydrates.

Which is accurate regarding the two types of neuropathy associated with diabetes? Select all that apply. A. Peripheral neuropathy affects the sensations in the body B. Autonomic neuropathy is damage to the small blood vessels C. Peripheral neuropathy is a recurrent infection of the nervous system D. Peripheral neuropathy is a condition that can cause kidney failure and retinopathy E. Autonomic neuropathy affects the nerves that handle breathing and digestion F. Autonomic neuropathy occurs because the body's immune defenses are weakened by excess glucose in the blood

A. Peripheral neuropathy affects the sensations in the body Peripheral neuropathy affects the nerves between the brain and the spinal cord, thus affecting sensation and causing impairment such as tingling and numbness. E. Autonomic neuropathy affects the nerves that handle breathing and digestion Autonomic neuropathy affects and damages the nerves that handle daily functions, such as breathing, digestion, and respiration.

Which are clinical manifestations of hyperosmolar hyperglycemic state (HHS)? Select all that apply. A. Seizures B. Fruity breath C. Metabolic acidosis D. Nausea and vomiting E. Kussmaul respirations

A. Seizures Seizures are clinical manifestations of HHS because of the high blood glucose levels that increase neurologic events. D. Nausea and vomiting Nausea and vomiting are clinical manifestations of HHS due to electrolyte imbalance

Which condition related to diabetes causes increased heart rate and feelings of anxiety? A. The low levels of blood sugar in the blood cause epinephrine to be released B. The cells in the body need glucose for energy and cannot rely on fats or proteins C. The body goes into stress, which precipitates the release of glucagon and cortisol D. The brain relies on glucose in the cells for energy, but when the glucose is too low, the body prepares itself for brain damage

A. The low levels of blood sugar in the blood cause epinephrine to be released Low glucose stimulates the sympathetic nervous system. This causes epinephrine to be released.

Which is the effect of autoantibodies in a person with type 1 diabetes? A. They destroy pancreatic beta cells B. They cause the production of insulin C. They enhance cellular insulin receptors D. They stimulate metabolism of macronutrients

A. They destroy pancreatic beta cells Autoimmune reactions, such as islet cell autoantibodies, destroy pancreatic beta cells.

Which is a common clinical manifestation of type 2 diabetes? A. Weight gain B. Rapid healing C. Bursts of energy D. Infrequent infections

A. Weight gain A person with type 2 diabetes is usually overweight or obese.

Which is a clinical manifestation of type 1 diabetes? A. Weight loss B. Hypoglycemia C. Urinary retention D. Decreased appetite

A. Weight loss Weight loss is common in a person with type 1 diabetes.

Match the terms to the correct descriptions. Another name for juvenile diabetes A predisposing factor for type 1 diabetes The hormone needed to regulate blood glucose A cause of type 1 diabetes Family history Type 2 diabetes No insulin production Insulin Type 1 diabetes Beta cells

Another name for juvenile diabetes- T1D A predisposing factor for type 1 diabetes- Family Hx The hormone needed to regulate blood glucose- Insulin A cause of type 1 diabetes- No insulin production

Which statement describes prediabetes? A. A form of diabetes in an advanced stage B. A type of diabetes that precedes type 2 diabetes C. A type of metabolic syndrome that causes type 2 diabetes D. A form of diabetes that indicates a person will get type 1 diabetes

B. A type of diabetes that precedes type 2 diabetes Prediabetes is a cause and a predeterminant of type 2 diabetes. When a person has prediabetes, it means that blood sugars are higher than normal but not high enough to be considered diabetes.

Which is accurate regarding the clinical manifestation of increased urination in a person with type 1 diabetes? A. Cells in the body are becoming starved of nutrients B. Glucose in the urine puts osmotic pressure on the filtrate C. The increased need to urinate is caused by increased thirst D. The glucose in the blood is causing an impairment of the immune system

B. Glucose in the urine puts osmotic pressure on the filtrate Polyuria is excessive urine output and is caused by glucose in the urine exerting osmotic pressure in the filtrate. Patients lose subsequent fluid and electrolytes this way.

Which describes the rationale for increased thirst in type 1 diabetes? A. Increased thirst is due to cellular nutrient starvation B. Increased thirst is due to fluid loss through the urine C. Increased thirst is due to glucose not being able to enter the cells D. Increased thirst is due to the osmotic pressure being exerted on the filtrate by glucose

B. Increased thirst is due to fluid loss through the urine Fluid loss occurs with diabetes through the urine and high blood glucose, since both draw water from the cells, thus making the person thirsty. Increased thirst and drinking is known as polydipsia.

Which degenerative condition is associated with the development of a leg ulcer in a person with diabetes? A. Microangiopathy B. Macroangiopathy C. Diabetic nephropathy D. Autonomic neuropathy

B. Macroangiopathy Macroangiopathy is a condition that affects the large blood vessels and can lead to conditions like leg ulcers, intermittent claudication, and delayed healing of infections.

Which population groups are at increased risk for developing type 2 diabetes? Select all that apply. A. Asian Americans B. Native Americans C. African Americans D. Hispanic Americans E. Non-Hispanic white Americans

B. Native Americans Native Americans are at risk of developing type 2 diabetes, because there is a higher prevalence of type 2 diabetes among this ethnicity. C. African Americans African Americans are at risk of developing type 2 diabetes, because there is a higher prevalence of type 2 diabetes among this ethnicity. D. Hispanic Americans Hispanic Americans are at risk of developing type 2 diabetes, because there is a higher prevalence of type 2 diabetes among this ethnicity.

Which should be avoided as a means to prevent hypoglycemia? Select all that apply. A. Eating carbohydrates B. Performing strenuous exercise C. Drinking too much water D. Taking too much exogenous insulin E. Skipping meals after taking insulin

B. Performing strenuous exercise Strenuous exercise can cause hypoglycemia because it allows glucose to enter the cells too quickly, so it should be avoided. D. Taking too much exogenous insulin Taking too much exogenous insulin is a risk factor for hypoglycemia and should be avoided. E. Skipping meals after taking insulin Skipping meals after taking insulin can cause hypoglycemia because it creates a lack of exogenous glucose and should be avoided.

Which is accurate regarding how the liver responds in a person with type 2 diabetes? A. The liver is where insulin is produced B. The liver is where increased glucose synthesis occurs C. The liver causes decreased sensitivity of cellular insulin receptors D. The liver is affected by autoimmune reactions, destroying its beta cells

B. The liver is where increased glucose synthesis occurs Synthesis of glucose in the liver increases when pancreatic islet cells experience dysfunction, leading to elevated blood sugar levels.

Which statement is accurate regarding the prevalence of type 2 diabetes in children? A. "One out of every 400 children will develop type 2 diabetes." B. "About 9% of children in the United States have type 2 diabetes." C. "People are more likely to get type 2 diabetes with age, but children can still be affected." D. "Type 2 diabetes is primarily prevalent among children who were diagnosed with type 1 diabetes."

C. "People are more likely to get type 2 diabetes with age, but children can still be affected." Age is a risk factor for type 2 diabetes, and there are an estimated 18 million people with type 2 diabetes who are older than 20 years of age. However, type 2 diabetes is still prevalent among children and adolescents.

Which person is most at risk for type 2 diabetes? A. An underweight toddler B. A 22-year-old female who exercises regularly C. A person of Native American descent who is obese D. A new father who is sleep deprived and under a lot of stress

C. A person of Native American descent who is obese There is a higher prevalence of type 2 diabetes in people who are obese as well as those of Native American descent (as well as African Americans and Hispanic Americans). Therefore, this patient is at risk for type 2 diabetes.

Which is an accurate description of insulin resistance? A. Insulin is made by the body B. Insulin is added to the body from an external source C. Cellular insulin receptors have a decreased sensitivity D. Amounts of insulin are insufficient for the body's needs

C. Cellular insulin receptors have a decreased sensitivity This describes insulin resistance. Insulin resistance is when the cells of the body do not react appropriately to the insulin that is present, and it takes more insulin to get the glucose into the cells.

Which is accurate regarding the clinical manifestation of increased hunger in a person with type 1 diabetes? A. Increased hunger is a direct result of increased thirst B. Increased hunger is due to the osmotic pressure of glucose on the filtrate C. Increased hunger is a result of the cells in the body being unable to use glucose D. Increased hunger is due to immune system impairment caused by glucose in the blood

C. Increased hunger is a result of the cells in the body being unable to use glucose The cells in the body are starved of nutrients when a person has diabetes, which makes the cells hungry and stimulates the individual's appetite. Increased appetite is known as polyphagia.

Which degenerative condition is associated with impaired sensation in the form of numbness and tingling in the legs and feet in a person with diabetes? A. Microangiopathy B. Macroangiopathy C. Peripheral neuropathy D. Autonomic neuropathy

C. Peripheral neuropathy Peripheral neuropathy results in impaired sensation such as numbness and tingling, burning pain, or reduced perception of pain.

Which is a clinical manifestation of type 2 diabetes? A. Weight loss B. Hearing changes C. Recurrent yeast infections D. Negative for blood glucose

C. Recurrent yeast infections Recurrent infections, particularly yeast infections, is a clinical manifestation of type 2 diabetes because the excess glucose in the blood reduces the body's immunity and makes it a good breeding ground for yeast.

Which is the rationale for the lack of ketones in the urine of a person with hyperosmotic hyperglycemic nonketotic state (HHNS)? A. Neurologic complications affect the kidneys B. Blood flow decreases and depresses the nervous system C. The body still produces enough insulin to stop lipids from breaking down D. Fats and proteins are catabolized as a result of insufficient glucose in the cells

C. The body still produces enough insulin to stop lipids from breaking down A person with HHNS would test negative for serum and urine ketones. This is because the body produces just enough endogenous (self-made) insulin to prevent the breakdown of lipids and fats.

Which statement is accurate regarding the difference between type 1 and type 2 diabetes? A. Type 1 diabetes can be prevented, and type 2 cannot B. Type 1 diabetes is more prevalent than type 2 diabetes C. Type 1 diabetes is a more severe form of the disease than type 2 D. Type 1 diabetes is more likely to develop later in life than type 2

C. Type 1 diabetes is a more severe form of the disease than type 2 Type 1 diabetes is more severe than type 2 diabetes, because with type 1 diabetes, the body does not produce any insulin, which is required for regulating blood glucose. Type 2 diabetes produces some insulin.

Which are predisposing factors for type 1 diabetes? Select all that apply. A. Obesity B. Prediabetes C. Viral infection D. Family history E. Genetic factors

C. Viral infection A viral infection that affects pancreatic beta cells can cause a child to develop type 1 diabetes. D. Family history Family history is a predisposing factor for type 1 diabetes. E. Genetic factors Genetic factors, such as abnormalities that affect pancreatic beta cell production, can cause a child to develop type 1 diabetes.

Which child is most at risk for developing type 1 diabetes? A. A child who has prediabetes B. A child who is older than 5 years of age C. A child who is considered obese and has excess adipose tissue D. A child with a physical condition that destroys pancreatic beta cells

D. A child with a physical condition that destroys pancreatic beta cells Any physical condition that destroys or damages pancreatic beta cells predisposes a person to type 1 diabetes, because the cells are not able to properly produce insulin.

Which degenerative condition is associated with urinary retention in a person with diabetes? A. Microangiopathy B. Macroangiopathy C. Peripheral neuropathy D. Autonomic neuropathy

D. Autonomic neuropathy Autonomic neuropathy affects the nerves that control everyday processes, such as digestion, urination, and sweating. Therefore, the person with urinary retention has autonomic neuropathy.

Which patient with diabetes is at risk for developing hypoglycemia? A. Patient who is calm and restful B. Patient who gets regular exercise daily C. Patient who takes oral antidiabetic medications and then eats D. Patient who takes exogenous insulin and then skips eating

D. Patient who takes exogenous insulin and then skips eating Taking exogenous insulin and then not eating is a risk factor for hypoglycemia.