Bed Diabetes Flashcards
What is T2DM
Insufficient insulin production
And/or insulin rsoh esistance
Leading to hyperglycemia
What is T2DM
Insufficient insulin production
And/or insulin rsoh esistance
Leading to hyperglycemia
Risk factors
Advanced age
Obesity
Inactive lifestyle
Family hx
Certain k fections
Glucose intolerance
Gestational diabetes
Pancreatitits or pancreatic cancer
Alcohol
Smoking
Signs and symptoms0
Glucosuria
Polyuria
Polyphagia..increased appetite
Polydipsia..increased thirst
Ketoacidosis
Weight loss
Prolonged wound healing
Fatigue
Recurrent infections
Ben’s signs and symptoms
Polydipsia
Polyuria
Glycosuria
Ketoacidosis
Retinopathy
Vascular glycosylation
Increased permeability…leakage
Macula oedema
Vascular proliferation
Micro aneurysm
Micro hemorrhage
Both lead to blurred vision and blindness
Micro vascular complications due to glycosylation
Macro vascular proliferation…New weak vessels
Hyperglycemia can lead to glycosylation of business where glucose get deposited onto the basement membranes of the capillaries. Thus decreases effective exchange of gas waste and nutrients and can lead to localized damage including microbadcular damage.
The capillaries are particularly susceptible to.this as they are very delicate.
With Ben the vascular damage allowed leakage kf fluid into the Macula causing Macula oedema.
Nephropathy
Micro vascular damage can also affect the glomeruli leading to kidney disease.
Diabetes is the leading cause of kidney disease.
Nephropathy
Micro vascular damage can also affect the glomeruli leading to kidney disease.
Diabetes is the leading cause of kidney disease.
Patho of diabetes
Glucose renal threshold
Normally glucose is reabsorbed back into blood in the tubeless.
When levels are too high the cells can’t absorb the extra
As BSL rises more glucose enters the renal filtration. The excess exceeds the reabsorbative capacity of thr proximal convoluted tubular
The excess unabsorbed glucose remains in the tubule fluid creating an osmosis effect that draws water into the urine this leads to Polyuria to get the glucose out…via pee
The loss of water leads to dehydration and can result in imbalances of electrolytes
The presence of glucose in urine is the direct result on the excess glucose filtered by the kidneys
Patho of T2DM in short
Glucose renal threshold
Increases glucose filtration
Osmotic duiresis
Dehydration and electrolyte imbalances
Glucosuria
Neuropathy
Glycosylation effects a/p conduction in neurons in Ben’s case it is somatasensory neurons in the periphery..mostly limbs..that are effected.
He had no feeling in lower legs
Peripheral neuropathy leads to
Increased susceptibility to tissue damage
Decreased wound healing
Increased risk of infection
Can result in Hypoxia and ischemia.
Ben so experiences bloating due to gastroparersis
Ben as erectile issues due to decrease in a/p conduction along the nerves to the punishment.
Neuropathy
Glycosylation effects a/p conduction in neurons in Ben’s case it is somatasensory neurons in the periphery..mostly limbs..that are effected.
He had no feeling in lower legs
Peripheral neuropathy leads to
Increased susceptibility to tissue damage
Decreased wound healing
Increased risk of infection
Can result in Hypoxia and ischemia.
Ben so experiences bloating due to gastroparersis
Ben as erectile issues due to decrease in a/p conduction along the nerves to the punishment.
Diabetic foot pathology
Edema
Infection
Ischemia
Ulcers
Charcot joints
Hammer toes
Fallen arches
Diabetic foot pathology
Edema
Infection
Ischemia
Ulcers
Charcot joints
Hammer toes
Fallen arches
Ben’s foot patho
Sensorial loss
Skin alterations
Ischmia and ulcers
Poor wound healing
Charcot joints
Fallen arches Gail alterations
Dry feet
Evaluation and management of diabetes
Glycemic control
Normal bsl 3 to 8
Ben was initially on insulin then stopped
Now on Humalin NPH (isophane insulin)
Humalog rapid onset short acting
Am 20 units
Pm 18 units
What is the HbA1c test
The “Hg test” for glucose likely refers to the “hemoglobin A1c” (HbA1c) test. This test measures the average blood glucose levels over the past two to three months.
- Diagnosis: It helps diagnose diabetes and prediabetes.
- Monitoring: It assesses how well blood sugar levels are being managed over time.
- A blood sample is taken, usually from a vein in your arm.
- The results are expressed as a percentage; a higher percentage indicates poorer blood sugar control.
- Normal: Below 5.7%6
- Prediabetes: 5.7% to 6.4%
- Diabetes: 6.5% or higher
The HbA1c test is a crucial tool for managing diabetes and assessing the risk of complications.
The test is done every 3 months which is the life span of a RBC. It measure the amount of glucose in hemaglobin
