Ch. 3 - Diabetes Flashcards
What are the most common forms of diabetes?
Type 1 (insulin dependent diabetes mellitus or juvenile diabetes) and Type 2 (non-insulin dependent diabetes or adult-onset diabetes)
What type of diabetes results when the beta cells in the pancreas have been either damaged or destroyed, and the pancreas is no longer able to produce insulin
Type 1 DM
What are symptoms of Type 1 DM?
Symptoms can include hunger and weight loss, increased thirst (i.e., polydipsia) and urination (i.e., polyuria), blurred vision, and fatigue. Onset of Type 1 DM is usually in childhood or early adulthood, but it can occur at any age
What is the treatment of Type 1 DM?
Daily injections of insulin
What is the primary difference regarding the pancreas when comparing Type 1 and Type 2 Diabetes?
In Type 2 DM, the pancreas of a person usually still produces some insulin, perhaps at a decreased level, but the body’s cells are not able to effectively use the insulin, a condition known as insulin resistance
What are symptoms of Type 2 DM?
Symptoms of Type 2 DM are like those of Type 1 DM, except the onset is more gradual, and symptoms often are unnoticed or attributed to other causes. Up to one-third of those with Type 2 DM are unaware that they have it. Worldwide, up to half of those with diabetes are undiagnosed. The vast majority (around 90%) of individuals with diabetes have Type 2.
What is diagnosed when at least three of the following five factors are present: Abdominal obesity, elevated triglycerides, low HDL cholesterol, elevated blood pressure, and elevated fasting blood sugar.
Metabolic syndrome (Note: this is not a disease, but instead a group of cardiometabolic risk factors). Individuals with metabolic syndrome have an increased risk of developing type 2 diabetes and cardiovascular disease
What form of diabetes develops in some females during pregnancy and generally resolves after delivery?
Gestational diabetes mellitus (GDM). GDM affects approximately 2-10% of pregnancies
The combination of type 1 and type 2 diabetes was noted in research that discovered the relationship between obesity and autoantibodies. What are terms for this combination?
LADA (i.e., latent autoimmune diabetes of adults), type 1.5 diabetes, and double diabetes. An individual with these types of diabetes tends to show more rapid decline in beta cell function and tends to need insulin treatment earlier
What test is often done instead of the oral glucose tolerance test due to its ease, cost, and relatively quick results?
Fasting blood glucose test (i.e., fasting blood sugar, or FBS). Fasting blood glucose of 126 mg/dl or more on two separate occasions is diagnostic of diabetes. Fasting blood glucose between 110 and 125 mg/dl is considered impaired fasting glucose (IFG)
Over the past several years, what test have many medical organizations moved toward using to diagnose diabetes?
Glycohemoglobin test, also called hemoglobin A1c. The A1c reading represents the average blood glucose level over the prior three months. This is the best test for monitoring blood sugar control
What treatment is needed for most type 2 diabetics?
Medication to maintain the blood glucose level within an acceptable range. Oral medications work by either increasing the production of insulin in the pancreas, decreasing the insulin resistance of the body’s cells, decreasing glucose production, or decreased the body’s ability to absorb glucose from the intestine when food is digested. Some new oral medications work by helping the kidneys remove excess glucose through urination.
Some type 2 diabetics require insulin
What is one treatment that some have considered a cure for type 1 diabetes?
A pancreas transplant. This procedure has allowed a few individuals to reduce or eliminate their dependence on insulin, but the risks of tissue rejection and immunosuppression are still a concern, and the long-term benefits are uncertain
Why is frequent self-monitoring of blood sugar levels especially important for Type 1 diabetics?
To enable them to adjust their insulin dosages throughout the day to avoid hypoglycemia and hyperglycemia
What device automatically tracks blood glucose levels around the clock?
Continuous glucose monitor (CGM)
What is a relatively frequent complication of Type 1 diabetes?
Hypoglycemia, a state of low blood sugar that can occur if a higher dose of insulin than is necessary is taken or if caloric intake is inadequate. An acute hypoglycemia episode can result in seizures or loss of consciousness, which can cause injury and occasionally death
What occurs when the body does not get enough insulin?
Ketosis, or ketoacidosis (also known as diabetic ketoacidosis or DKA). The body is unable to use the glucose in the bloodstream and instead begins to use fat for energy
What is hyperosmolar hyperglycemia nonketotic syndrome (HHS)?
An acute complication for diabetes. This is a serious and potentially fatal complication usually seen in patients with type 2 diabetes with a mortality rate as high as 20%
Regarding diabetes complications, coronary artery disease, cerebrovascular disease, and peripheral arterial disease are classified as what?
Macrovascular complications
Regarding diabetes complications, nephropathy (i.e., kidney disease) and retinopathy, a disorder of the blood vessels in the retina of the eye are classified as what?
Microvascular complications. In addition to serving as a marker for advanced atherosclerosis, both nephropathy and retinopathy each have significant mortality and/or morbidity implications
How can the presence of nephropathy be detected?
By checking the serum creatinine level on the blood profile, or by testing for the presence of protein and/or microalbumin on a urinalysis
What is the leading cause of blindness?
Retinopathy, which can be described either as mild background retinopathy, which is mild damage to the retina, or as proliferative retinopathy, which is more advanced condition involving the growth of new blood vessels in the retina
What is the treatment for proliferative retinopathy?
Laser therapy, which can prevent or delay blindness
What is a disorder of the nerves that often presents as a painful sensation, or lack of sensation, in the toes and feet?
Diabetic neuropathy, which can result in and lead to amputation and disability
