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Diet Therapy > CH. 21 Diabetes > Flashcards

CH. 21 Diabetes Flashcards

1
Q

Symptoms of Type 1 diabetes?

A
  • Glycosuria
  • Polyuria
  • Dehydration
  • Polydipsia
  • Polyphagia
  • Blurred vision
  • Fatigue
  • Irritability
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2
Q

What is a healthy glucose blood range?

A

70-110 mg/dL

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3
Q

Diagnostic criteria for diabetes?

A

*2 positive tests on different days: Start with random

  1. Random glucose: 200 mg/dL or higher + Classic
    symptoms
  2. Fasting glucose: 126 mg/dL or higher after 8 hour fast
  3. Plasma glucose: 2 hours after 75 gram glucose load
    - Oral Glucose Tolerance Test (OGTT): 200 mg/dL or higher
  4. Hemoglobin A1c: Measure of %hemoglobin that has a glucose attached to it. Good test to monitor over time.
    - 6.5% or higher
    - Only used to diagnose type 2
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4
Q

At risk numbers for diabetes? Fasting and HbA1c

A

Fasting glucose: 100-125 mg/dL

HbA1c: 5.7-6.4%

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5
Q

HbA1c ranges?

A
  • HbA1c 4-6%: Non diabetic
  • HbA1c equal to or greater 6.5%: Diabetes diagnosis
  • HbA1c 5.7-6.4%: prediabetes
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6
Q

Acute complication of Type 1?

A

Diabetic Ketoacidosis (DKA)

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7
Q

Bodys response to DKA?

A
  1. elevated blood glucose worsens
  2. glycosuria
  3. Dehydration
  4. electrolyte imbalances
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8
Q

Medical treatment of Type 1?

A

Insulin therapy

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9
Q

Types of insulin?

A

Rapid acting, short acting, intermediate acting, long acting, mixtures

*There is a basal rate and then right before someone eats they will take an insulin bolus amount

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10
Q

How much insulin?

A

15 g. of Carb/ 1 unit fast acting insulin

  • Half given as back ground basal dose
  • Half given as bolus dose before eating
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11
Q

What does bolus depend on?

A
  1. pre meal glucose levels
  2. carb content of the meal
  3. body weight
  4. insulin sensitivity
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12
Q

Symptoms for Type 2 diabetes?

A
  1. Asymptomatic
  2. any symptom of type 1 + the following
  3. Tingling in hands and feet
  4. slow weight gain
  5. slow healing wounds
  6. frequent infection
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13
Q

Complications of type 2?

A

Hyperosmolar hyperglycemic syndrome (HHS)

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14
Q

characteristics of HHS?

A
  1. severe hyperglycemia
  2. severe dehydration
  3. electrolyte imbalances
  4. NO KETOSIS
  5. evolves slowly
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15
Q

Symptoms of HHS?

A
  1. glucose levels 600-1000 mg/dL
  2. severe dehydration
  3. neurological abnormalities
    - Abnormal reflexes
    - Motor impairment
    - seizure
    - coma
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16
Q

Treatment of HHS?

A
  1. insulin therapy (not as effective so used with meds)
  2. medications to decrease cellular resistance to insulin
  3. fluid and elec. replacement
17
Q

General complication of both types?

A

Hypoglycemia: Low blood glucose (below 50 mg/dL)

  • most frequent cause of diabetic coma
  • accounts for 3-5% of diabetes related deaths
18
Q

Cause of hypoglycemia?

A

*anything that decreases glucose levels in the blood

  1. excess insulin
  2. antidiabetic drugs
  3. prolonged exercise
  4. skipped meals
  5. inadequate food intake
  6. alcohol consumed without food
19
Q

Symptoms of hypoglycemia?

A
  1. hunger
  2. shakiness and dizziness
  3. sweating
  4. heart palpitations
  5. mental confusion
  6. coma
20
Q

Treatment for hypoglycemia?

A
  1. give 15-20 g. of glucose
    - tabs
    - 4 oz. juice
    - 4-5 saltines
21
Q

What if someone passes out?

A
  • do not give food
  • inject glucagon
  • call for help
22
Q

Chronic diabetes complications for both types?

A
  • macrovascular
  • microvascular
  • nervous system
23
Q

Macrovascular complications?

A

*Damage to large blood vessels

  1. cardiovascular disease
  2. Peripheral vascular disease (blood in limbs)
    - claudication: pain while walking from inadequate oxygen transport
    - Foot ulcers
    - Gangrene
    - Amputation
24
Q

Microvascular complications?

A

*Damage to small blood vessels

  1. retinopathy: damage to capillaries in retina
  2. nephropathy: damaged to specialized capillaries in the kidneys
  3. neuropathy:
    - deep pain or burning in legs and feet
    - numbness and tingling in hands and feet
    - weakness and cramping in legs and hands
    - disturbances in bladder and bowel function
    - sexual dysfunction
    - Constipation
    - gastroparesis: delayed stomach emptying
25
Q

Medical treatment for type 2?

A

Oral anti-diabetic drugs: Make cells more sensitive

  • inhibit liver glucose production (Metformin)
  • improve insulin secretion
  • delay carb digestion
  • Suppress appetite
  • suppress glucagon secretion
26
Q

Dietary treatment of all diabetes?

A
  1. Carb counting
    - 45-65% total calories…45% for diabetics
  2. Minimize sugar intake to population recommendations
  3. Sat. Fats below 7% (@ risk for CVD)
  4. Protein: 20% of calories or more
  5. Fiber greater than 50 g/day may improve glycemic control but hard to tolerate
27
Q

Dietary treatment for non macronutrients?

A
  1. Alcohol: Limit 1 drink for women and 2 for men. Consume with food to avoid hypoglycemia.
  2. Avoid fructose (affects blood lipid levels)
  3. Consider artificial sweeteners

Diet Therapy (9 decks)

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