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NURO 504 - Module 2 Endocrine Exam Study Guide
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NURO 504 - Module 2 EndocrineExam Study Guide
Diabetes mellitus type 1 - Answer autoimmune beta cell destruction
Diagnosis (two or more abnormal results, unless random plasma glucose >/= 200)
- A1C >/= 6.5 OR
- FBG >/= 200 during OGTT OR
- FBG > 126
Islet antibodies frequently present
- Test for overweight/obese folks
BMI >/= 25 OR 23 in Asian Americans and one or more risk factor
DM risk factors - Answer 1st degree relative with diabetes
· High risk race: AA, NA, Asian Americans, Hispanic
· History of CVD
· HTN > 149/90 or on anti-HTN meds
· Triglyceride level > 250
· PCOS
· Physical inactivity
· Conditions with insulin resistance (severe obesity/acanthosis nigricans)
· Waist circumference > 34.8 inches
Testing begins at age 45 no matter what and repeat test in minimum of 3 years if original
test is normal
DM II treatment - Answer - Physical activity
- Address psychosocial issues
- Goal: weight loss 7%
- Screen/treat modifiable risk factors
, Consider metformin = can decrease Vitamin B12
DM therapy goals - Answer - A1c < 7%, PG 150-160
- Pre-prandial PB: 80-130
- Post-prandial: < 180
Individualize:
Tighter targets (A1C 6.0-6.5%) for younger, healthier patients
Looser targets (A1C 7.5-8.0%) for older patients, those with comorbidities, or those
prone to hypoglycemia
Avoid hypoglycemia
DM type 2 - Answer most common form of diabetes - results from resistance to insulin
and the inability of the pancreases to increase insulin production to compensate for this
resistance.
Risk factors - persons age, obesity, first degree family members, lack of physical
activity, smoking. Diet high in red meat, high-fat dairy, processed carbs, and sweets
increases the risk of developing diabetes.
Hypoglycemia - Answer - Give 15-20 g of glucose for a conscious person with a blood
glucose <70 mg/dl
Repeat SMBG 15 mins after treatment and repeat treatment as needed
- Once SMBG is normal consume a meal or snack
- Prescribe glucagon if at risk of level 2 hypoglycemia (<54 mg/dl)
- Caregivers, school personnel, or family members should know how to administer it
- Hypoglycemia unawareness or one or more episodes of level 3 hypoglycemia should
trigger reevaluation of the treatment regimen Ask about symptomatic/asymptomatic
hypoglycemia at every visit
Physical activity recommendations - Answer Children - 60 min at least 3 days a week
Adults - 150min at lease three days a week - no more than 2 days without activitiy in a
row
Older adults - Flexibility/balance (yoga) training 2-3 times/week
Prolonged sitting should be interrupted every 30 min for blood glucose benefits
Pre-diabetic clients - Answer target wt loss - 7%, increase physical activity to 150min
per week of moderate activity (walking counts), monitor for development of DM
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