NP Exam: Endocrine Study Guide.
Diabetes Mellitus Type I pathology - CORRECT ANSWER -May occur from childhood to early adulthood
-pancreas makes no insulin
-Strongly associated with human leukocyte antigens HLA-DR3 and HLA-DR4
-Islet cell antibodies found in approx 90% of patients within 1...
Somogyi Effect in DM 1 - CORRECT ANSWER -Nocturnal hypoclycemia stimulates hormones which raise
blood sugar.
-Patient will be HYPOGLYCEMIC at 3 am and rebound with hyperglycemia at 7 am
Treatment: REDUCE or OMIT the bedtime insulin dose
sOmOgyi - Omit bedtime dose
Dawn Phenomenon in DM 1 - CORRECT ANSWER Tissues become desensitized to insulin at night.
Blood glucose progressively rises through the night, resulting in elevated glucose at 0700.
Treatment: Add or increase the bedtime dose of insulin
Dawn is rising
Type 2 DM pathology - CORRECT ANSWER -Most common type of diabetes. >90% of DM is type 2
-Circulating insulin exists to prevent DKA, but is inadequate
-Either tissue is insensitive to insulin or insulin secretory defect results in insulin resistance or impaired
production
-Not linked to HLA or islet cell antibodies
-Associated with obesity and metabolic syndrome (low HDLs and high triglycerides)
-Slow onset of hyperglycemia, pt may be asymptomatic
-Polyuria, polydipsia
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