NSG123-Module 11

Alpha-glucosidase inhibitors

* Delay absorption of complex carbohydrates in the intestine and slow entry of glucose into systemic circulation * Acarbose, miglitol

Second-generation sulfonylureas

* Glipizide, glyburide * Stimulate beta cells of the pancreas to secrete insulin; may improve binding between insulin and insulin receptors or increase the number of insulin receptors

Which of the following are risk factors for diabetes? Select all that apply. Family history of diabetes Anorexia Hypertension (≥140/90 mm Hg) Age equal to or greater than 45 years

*Family history of diabetes *Hypertension (≥140/90 mm Hg) *Age equal to or greater than 45 years Diabetes Family history of diabetes (e.g., parents or siblings with diabetes) Obesity (i.e., ≥20% over desired body weight or body mass index ≥30 kg/m2) Race/ethnicity (e.g., African Americans, Hispanic Americans, Native Americans, Asian Americans, Pacific Islanders) Age equal to or greater than 45 years Previously identified impaired fasting glucose or impaired glucose tolerance Hypertension (≥140/90 mm Hg) High-density lipoprotein (HDL) cholesterol level ≤35 mg/dL (0.90 mmol/L) and/or triglyceride level ≥250 mg/dL (2.8 mmol/L) History of gestational diabetes or delivery of a baby over 9 lb

Thiazolidinediones

*Sensitize body tissue to insulin, stimulate insulin receptor sites to lower blood glucose and improve action of insulin * Pioglitazone, rosiglitazone

Dipeptidyl peptidase-4 inhibitors

*Sitagliptin, vildagliptin, saxagliptin *increase and prolong the action of incretin, a hormone that increases insulin release and decreases glucagon levels, with the results of improved glucose control

Methods of insulin delivery include? Select all that apply. insulin pumps jet injectors traditional subcutaneous injections orally

*insulin pumps *jet injectors *traditional subcutaneous injections

__________g of a fast-acting concentrated source of carbohydrate is recommended for the immediate treatment of hypoglycemia. 5-10 10-15 20-25 15-20

15-20

If these high-risk women do not have gestational diabetes at initial screening, they should be retested between which weeks of gestation? 20 and 24 4 and 8 30 and 38 24 and 28

24 and 28

Severe hypoglycemia is when glucose levels are less than how many mg/dL? 40 mg/dL 80 mg/dL 60 mg/dL 20 mg/dL

40 mg/dL

The ADA now recommends that all patients with diabetes strive for glucose control with an HgbA1c less than which percentage to reduce their risk of complications? 8% 7% 6% 6.5%

7%

Hypoglycemia develops during pregnancy because of the secretion of placental hormones, which causes insulin resistance. False/True

False. Hyperglycemia develops during pregnancy because of the secretion of placental hormones, which causes insulin resistance.

Calorie-controlled diets are nutritional therapy prescribed for the management of diabetes usually given by a registered dietician. False/True

False. Medical nutrition therapy (MNT)—nutritional therapy prescribed for management of diabetes usually given by a registered dietician.

lantus insulin is a short-acting insulin. FalseTrue

False. Regular insulin is a short-acting insulin.

What is the name of the blood glucose determination test obtained in the laboratory after fasting for at least 8 hours? Fasting plasma glucose (FPG) Random blood sugar test Glycated hemoglobin (A1C) test Oral glucose tolerance test

Fasting plasma glucose (FPG)

What is a metabolic disorder of Type 2 diabetes resulting from a relative insulin deficiency initiated by an illness that raises the demand for insulin?

HHS. Hyperglycemic Hyperosmolar Syndrome

The three main clinical features of DKA are what? Hyperglycemia, Dehydration and fluid loss, acidosis Hypoglycemia, Rehydration and fluid gain, alkalosis Hypoglycemia, Dehydration and fluid loss, alkalosis Hypoglycemia, Dehydration and fluid loss, acidosis

Hyperglycemia, Dehydration and fluid loss, acidosis

The therapeutic goal for diabetes management is to achieve normal blood glucose levels (euglycemia) without which of the following while maintaining a high quality of life? Hypoglycemia Hyperglycemia Hyperinsulinemia Normal BS

Hypoglycemia

Biguanides

Inhibit production of glucose by the liver

Which of the following hormones is secreted by beta cells in the islets of Langerhans in the pancreas? Pancreatic polypeptides Insulin somatostatin glucagon

Insulin

Glucagon-like peptide-1 agonist

Liraglutide, dulaglutide

Name the nutritional therapy prescribed for management of diabetes usually given by a registered dietician? Meal Planning Medical nutrition therapy (MNT) Calorie-controlled diets MyPlate Food Guide

Medical nutrition therapy (MNT)

Classic clinical manifestations of diabetes include the "three Ps". Which of the following are included in the "three Ps"? Select all that apply. Polycythemia Polyuremia Polyphagia Polydipsia

Polyphagia Polydipsia Clinical manifestations depend on the patient's level of hyperglycemia. Classic clinical manifestations of diabetes include the "three Ps": polyuria, polydipsia, and polyphagia.

In Type 2 diabetes, if the patient experiences symptoms, they are frequently mild and may include which of the following? Select all that apply. Poor healing of wounds Polyuria Blurred vision Surg of energy

Poor healing of wounds Polyuria Blurred vision

Which of the following is a short-acting insulin? Lisproinsulin Regular insulin NPH insulin Lantus Insulin

Regular insulin

Which of the following are a class of oral antidiabetic medications that reduce insulin resistance in target tissues, enhancing insulin action without directly stimulating insulin secretion? alpha-glucosidase inhibitors thiazolidinedione first- and second-generation sulfonylureas dipeptide peptidase-4

The thiazolidinediones are a class of oral antidiabetic medications that reduce insulin resistance in target tissues, enhancing insulin action without directly stimulating insulin secretion.

Insulin is a hormone secreted by beta cells, which is one of four types of cells in the islets of Langerhans in the pancreas. False/True

True

Patients must understand that oral agents are prescribed as an addition to (not as a substitute for) other treatment modalities, such as MNT and exercise. False/True

True

Rapid-acting insulins produce a more rapid effect that is of shorter duration than regular insulin. FalseTrue

True

Rapid-acting insulins produce a more rapid effect that is of shorter duration than regular insulin. True/False

True

Regular insulin is a short-acting insulin. TrueFalse

True

Before starting a patient with Type 2 diabetes on insulin, the provider should consider a new option for treatment of diabetes. True/False

True.

Medical nutrition therapy (MNT)—nutritional therapy prescribed for management of diabetes and is usually given by a registered dietician. True/False

True.

Hyperglycemic Hyperosmolar Syndrome is a metabolic disorder of Type __________diabetes resulting from a relative insulin deficiency initiated by an illness that raises the demand for insulin.

Type 2 diabetes

For patients who are obese and have diabetes, especially those with Type 2 diabetes, _________________loss is the key to treatment.

Weight

In Type 1 diabetes, when excess________________ is excreted in the urine, it is accompanied by excessive loss of fluids and electrolytes. This is called osmotic diuresis.

glucose

Diabetic ketoacidosis (DKA)

is a metabolic derangement that occurs most commonly in persons with type 1 diabetes and results from a deficiency of insulin