Blood Glucose Regulation Flashcards
diabetes mellitus
a disorder of carbohydrate metabolism and results in high levels of blood glucose
carbohydrate metabolism
- insulin supported process of facilitated diffusion moves glucose from blood into cells
- after eating: synchronous rise and fall of glucose and insulin
glucose
energy, stored as glycogen, or component or of lipid molecules
insulin
- produced by beta cells
- facilitated diffusion moves glucose from blood into cells
glycogenesis
glycogen formation in the liver
glycogenolysis
- glycogen breakdown into glucose
- occurs when blood glucose falls and body needs energy
hypoglycemia
- BG less than 70 mg/dL
- compensatory response by the liver and hypothalamus to raise BG
- epinephrine, glucagon, activation of SNS
- need to administer fast acting carbs
- avoid fats bc they delay glucose absorption
- IV glucose can be provided
- glucagon by subq injection
- hypoglycemia is a MEDICAL EMERGENCY
hyperglycemia
blood glucose greater than 100 mg/dL
Diabetic Ketoacidosis
occurs when there isnt enough insulin in the body
- think strenuous exercise
- fatigue
- weakness
Somogyi effect
- nighttime BG normal —> hypoglycemia —> BG doubles by morning
- epinephrine, cortisol, and hormones are released and BG levels double
s/s type 1 diabetes
- polydipsia
- polyuria
- polyphagia
- fatigue
- possible infection
patho type 1 diabetes
- T cell mediated attack of beta cells
- blood sugar goes up while insulin goes down (0)
- genetic influence
- autoimmune
- insulin deficient/ not enough to do its job
presenting sign of type 1 diabetes
DKA- because the early signs are not recognized
- will develop in people with no insulin reserves and the liver starts to mobilize fats
tx for type 1 diabetes
insulin replacement
s/s type 2 diabetes
- polydipsia
- polyphagia
- polyuria
- blurred vision
- electrolyte imbalance- hyperkalemia
- glycogenolysis
- gluconeogenesis
diagnostic testing type 2 diabetes
- blood and urine tests
- fasting BG greater than 126 on 2 separate occasions
- random BG greater than 200 more than 1 time
- OGTT(oral glucose tolerance test) greater than 200
- A1c above 6.5%
- glucosuria (sugar in urine, dipstick test)
- ketonuria (ketones in urine, dipstick test)
what foods are appropriate for the glycemic index diet
- foods low in carbohydrates!
- dried beans
- legumes
- whole grains
- some fruits- watermelon, apple, nectarines
- avocado
- dates
tx type 2 diabetes
- exercise, maintain ideal body weight, reduce insulin before physical activity (exercise before administering insulin)
- diet changes: 40-50% carbs, 25-30% fats, low fat/low salt diet
- self monitor glucose levels
examples of fast acting carbs in the event of hypoglycemia
- 4 glucose tablets
- glucose gel
- 4 oz fruit juice
- 4 oz regular soda
- 8 oz milk
- 5-6 pieces hard candy
- 1-2 tsp honey or sugar
- 2 tbsp raisins
causes of hypoglycemia
- too much insulin use
- excessive physical activity
- surgery
- antibiotics
risk factors for diabetes
- obesity
- sedentary lifestyle
- polygenic disorder (T1)
- environmental triggers: diet, infection
role of insulin
- facilitates glucose uptake by cells
- facilitates glucose storage in the liver (glucose cannot get into the liver without insulin)
- promotes glycogen formation
- decreases utilization of fat
- anabolic hormone- muscle building function
patho of type 2 diabetes
- insulin resistance
- increased insulin levels
- metabolic syndrome
- blood sugar up, insulin up
- can go undiagnosed for years
diabetic foot complications
- most common cause of nontraumatic lower extremity amputation
- peripheral neuropathy, poor circulation, suppressed immune response
- increase infection susceptibility
- can lead to gangrene and amputation
- osteomyelitis can occur
- postprandial hyperglycemia puts pts at risk for these issues
dermatology complications of DM
- prolonged wound healing and ulcer formations
- poor circulation
- diabetic skin spots
- lipoatrophy can occur at injection sites
what disorders are included in metabolic syndrome
- hypertension
- dyslipidemia
- hyperinsulinism
- central obesity
- glucose intolerance
- predisposition to DM2
diagnostics for metabolic syndrome
- pt must have the presence of 3 OR MORE these components
what must the waist circumference for men be to diagnose metabolic syndrome
greater than 40 in
what must the waist circumference for women be to diagnose metabolic syndrome
greater than 35 in
what must triglycerides be to diagnose metabolic syndrome
greater than 150 mg/dL
what must HDL be lower than for men to diagnose metabolic syndrome
less than 40 mg/dL
what must HDL be lower than for women to diagnose metabolic syndrome
less than 50 mg/dL
what must blood pressure be higher than to diagnose metabolic syndrome
greater than 130/85 mmHg
what must fasting blood glucose be higher than to diagnose metabolic syndrome
greater than 100 mg/dL
