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Diet Therapy 2380 > Ch. 26 Diabetes Mellitus > Flashcards

Ch. 26 Diabetes Mellitus Flashcards

1
Q

In 2014, how many people in the US had diabetes?

A

29 million (9.3% of population)

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2
Q

What is the most common type of diabetes?

A

Type 2 (associated with obesity)

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3
Q

Which states have higher rates of diabetes in the US?

A

Southern states

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4
Q

Diabetes Insipidus

A

Fairly rare

Caused by hormone (anti-diuretic hormone)

Seen with very increased thirst and urine output

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5
Q

Diabetes Mellitus

A

Metabolic disorder caused by altered glucose regulation and utilization

Unable to secrete enough insulin, use insulin effectively, or both

Results in elevated glucose in blood

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6
Q

Type 1 Diabetes: Prevalence in diabetic population

A

5-10% of cases

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7
Q

Type 1 Diabetes: Age of onset

A

less than 30 years

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8
Q

Type 1 Diabetes: Associated conditions

A

Autoimmune disease, viral infection, inherited factors

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9
Q

Type 1 Diabetes: Major defect

A

Destruction of pancreatic beta cells; insulin deficiency

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10
Q

Type 1 Diabetes: Insulin Secretion

A

Little or none

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11
Q

Type 1 Diabetes: Requirement for insulin therapy

A

Always

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12
Q

Type 1 Diabetes: Former names

A

Juvenile-onset diabetes

Insulin-dependent diabetes (IDDM)

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13
Q

Type 2 Diabetes: Prevalence in diabetic population

A

90-95%

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14
Q

Type 2 Diabetes: Age of onset

A

older than 40 years

Seeing Type II in children because of obesity

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15
Q

Type 2: Associated conditions

A

Obesity, aging, inactivity, inherited factors

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16
Q

Type 2: Major defect

A

Insulin resistance; insulin deficiency relative to needs

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17
Q

Type 2: Insulin secretion

A

Varies; may be normal, increased, or decreased

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18
Q

Type 2: Requirement for insulin therapy

A

Sometimes

19
Q

Type 2: Former Names

A

Adult-onset diabetes

Non-insulin dependent diabetes (NIDDM)

20
Q

Risk factors for pre-diabetes/Type II

A
  1. Ages older/equal to 45
  2. Overweight (BMI greater than/equal to 25)
  3. Family history
  4. Race/ethnicity: African American, Hispanic American, Native American, American Indian
  5. Glucose levels
  6. History gestational diabetes
  7. History of giving birth to baby weighing greater than 9lbs
21
Q

Diagnosis: A1c

A

Measures amount of glycated hemoglobin

Normal: less than 5.7%
Pre-diabetes: 5.7-6.4%
Diabetes: 6.5% +

22
Q

Diagnosis: Fasting Plasma Glucose (FPG) [mg/dL]

A

fast for 8-12 hours, blood drawn, measure glucose level

Normal: less than 100
Pre-diabetes: greater than or equal to 100-125
Diabetes: 126+

23
Q

Diagnosis: Oral Glucose Tolerance Test (OGTT) [mg/dL]

A

glucose challenge, drink liquid, measure glucose levels 2 hours after

Normal: less than 140
Prediabetes: 140-199
Diabetes: 200+

24
Q

Glycated Hemoglobin

A

The more glucose you have, the more it’s glycated with hemoglobin
Assists healthcare providers to evaluate long-term glycemic control
Measure of glycemic control during previous 2-3 months

HbA1c: less than 6% for non-diabetic persons
HbA1c: less than 7% for DM patients

25
Q

What are the 2 diseases of long term complications?

A

Macrovascular Disease

Microvascular Disease

26
Q

Macrovascular Disease

A

Damage to heart, brain, periphery (larger blood vessels)

Perhaps more closely related to hyperglycemia

27
Q

Microvascular Disease

A

Damage to nerve, eyes, kidneys (smaller blood vessels affected)

28
Q

Result of Macrovascular Disease

A 
MI = myocardial infarction
Stroke (CVA)
Peripheral Vascular Disease
--decrease circulation to arms and legs
--can be a contributing factor to foot ulcers
29
Q

Result of Microvascular Disease: Eyes

A

Retinopathy

Diabetes is leading cause of blindness in US

30
Q

Result of Microvascular Disease: Nerves

A

Neuropathy

Peripheral Neuropathy:
–watch for gastroparesis

31
Q

Gastroparesis

A

Delayed stomach emptying

–person can experience nausea, discomfort, vomiting…

32
Q

Result of Microvascular Disease: Kidneys

A

Nephropathy

Diabetes is leading cause of kidney disease in US

Usually takes about 10-15 years before signs of kidney disease occur

33
Q

S/S Hyperglycemia

A

*Polydipsia (increased thirst)
*Polyuria (increased urine)
*Polyphagia (increased hunger)
Weight loss
Blurred vision
Fatigue
Glycosuria (glucose in urine)
Acetone breath
Labored breathing (lungs have to work extremely hard to restore pH balance)

*Main S/S of hyperglycemia

34
Q

S/S Hypoglycemia

A 
Shakes
Sweats
Blurred vision
Confusion
Headaches
35
Q

Nutrient Recommendations: CHO

A

~50% total kcalories

  • -high fiber, whole grain
  • -AMDR range: 45-65% for healthy population
36
Q

Nutrient Recommendations: Fiber

A

Same as general population

  • -women: 25 g/d
  • -men: 38 g/d
37
Q

Nutrient Recommendations: Sugar

A

Minimize foods and drinks with added sugars

38
Q

Nutrient Recommendations: Fat

A

Same as general population

39
Q

Nutrient Recommendations: PRO

A

~15-20% kcalories

40
Q

Nutrient Recommendations: Alcohol

A

General population BUT effect on glucose-depends on amount of ETOH and food consumed

S/S hypoglycemia similar to inebriation

kcal
Increased triglycerides (TG)
41
Q

Nutrient Recommendations: Micronutrients

A

Same as general population

42
Q

Primary Sources of CHO

A 
Breads, crackers, cereal
NOT just starches
Pasta, rice, grains
Starchy vegetables
Non-starchy vegetables
Milk, yogurt
Fruits and juices
Sweets and desserts

–>15g CHO in one serving

43
Q

Meal Planning: Basic CHO Counting

A

Basic CHO concepts:

  • -teaches client to focus mainly on CHO content of foods
  • -use tables, exchange lists, food labels, etc. to determine amount of CHO consumed
  • -consistent CHO intake
  • -portion control
  • -still need to watch total kcals if Type II and trying to lose weight
  • -key: education on CHO and CHO sources

Diet Therapy 2380 (28 decks)

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