Beetus 5 Flashcards
What is a major growing problem with young people?
Childhood DM
Prevalence of DM II in youth
21% of American youth
Group with highest risk for DM II
- american indian
- non-hispanic black youth
Childhood DM II: More likely to have this in the urine than DM I
Protein
Childhood DM: Why is protein in the urine worrisome?
- suggests kidney pathology has already begun
- at increased risk of kidney failure
Childhood DM: cardiovascular
- Early indications of cardiovascular autonomic neuropathy
- increased risk for future cardiovascular disease
Monitoring equipment for blood glucose
- lance
- test strips
- electronic monitor
Monitoring blood glucose: testing procedure
- wash and dry hand well
- lance fingertip with spring lance
- insert test strip into monitor device
- place drop of blood on test strip and wait for recording
Blood glucose: normal random (casual) test values
70-140 mg/dL
Varies according to time of last meal
Acceptable values for diabetic pts determined by ____ and vary according to:
- physician/PCP
- vary according to age, meds, etc
Fasting glucose: women
Under 40 mg/dL
Fasting glucose: men
Under 50 mg/dL
Low values of fasting glucose (men under 50, women under 40) are accompanied by sx of ________. What does this mean for exercise?
- hypoglycemia
- This is too low, do NOT exercise. Phone the PCP
S/s of hypoglycemia
- pallor
- perspiration
- piloerection
- tachycardia
- nervousness, irritability
- shakiness, trembling
CNS s/s of hypoglycemia
- confusion
- emotionally labile
- thickened speech
- coma
- convulsion
If the body has insufficient insulin, what happens?
- Body can’t use glucose
- Begins to break down fat
What are s/s of DKA?
- High blood sugar
- weak, rapid pulse
- Kussmaul’s breathing
- Stupor progressing to coma
- Polyuria
- Polydipsia
- Acetone breath
What is Kussmaul’s breathing?
Deep, labored
Medical mgmt of DM I: primary tx methods
- insulin
- diet
- exercise
First approach to medical mgmt of DM II
- diet
- exercise
What can often reverse the hyperglycemia of DM II?
- weight loss
- diet
When WL and diet are insufficient to control hyperglycemia, what must be done for DM II pts?
Oral hypoglycemic drugs used to lower blood glucose levels
How many classes of commonly used hypoglycemic drugs?
8
What is the single most prescribed of the antihyperglycemic agents?
Metformin
Used in ~ 80% of cases
Metformin aka
- glucophage
- riomet
Types of insulin are classified by
- speed of absorption
- length of effect
Types of insulin (categories)
- rapid acting
- intermediate acting
- long-acting
- insulin mixtures
Is insulin always used in DM I?
Yes
When is insulin needed for DM II pts?
- if BG levels can’t be adequately controlled by oral anti-diabetic drugs because insulin needs to be injected
- used to supplement oral meds
Insulin pump: what are the types?
- open loop
- closed loop
Open loop insulin pump
Current form where testing of blood is necessary
Closed loop insulin pump
Machine tests blood and doses automatically
Other methods of artificial pancreas
- bioengineering (biocompatible beta cells)
- gene therapy (DNA production of insulin-producing cells)
