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nutrition > chapter 15 > Flashcards

chapter 15 Flashcards

1
Q

what is diabetes melitus

A

group of serious and chronic disorders affecting metabolism of carb

absence or misuse of insulin = hyperglycemia

precursor is prediabetes (impaired glucose tolerance) - blood glucose levels higher than normal but not high enough to diagnose diabetes + growing insulin resistance

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2
Q

metabolic syndrome (dysmetabolic syndrome)

A
  • constellation of conditions that pose signficiant risk of developing heart disease, stroke, and diabetes
  • abn cholesterol
  • excess body fat around waist
  • increased bp and blood sugar
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3
Q

diabetes insipidus

A

large amt of urine but not sweet (insipid)

caused by damaged pituitary land

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4
Q

___ millino have diabetes in US (___% percent of US pop) with ____ diagnosed and ___ undignosed

A

29.1 millin

9.3%

diagnosed: 18.8 mil
diagnomsed: 8.1 mil

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5
Q

what is t2d major cause for

A

blindness
heart and kidney disease
amputation of toes, feet, and legs
infection
ieath

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6
Q

meaning behind t2d naeme

A

dibates - flow through (large amt of urine)
mellitus - honey (glucose in urine)

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7
Q

what secretes insulin

A

beta cells of sislets of Langerhans in pancreas

inadequate production of insulin or body is unable to use insulin it produces

glocuse cant enter cells and accumulate in blood, = hyperglycemia

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8
Q

glucagon role

A

secreted by alpha cells of islets of langerhans

helps release energy when needed to convert glycogen to glocuse

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9
Q

somatostatin

A

hormone produced by delta cells of islets of langerhans and hypothalamus

inhibits release of insulin and glocagons

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10
Q

glycosuria

A

glocuse excreted in urine when hyperglcemia exceeds renal threshold

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11
Q

what causes polyphagia in diabetes

A

inability to metabolize glucose causes body to break down its own tissue for protein and fat

causes polyphagia and loss of weight, weakness, and fatigue

use of protein from its own tissue causes body to excrete nitrogen

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12
Q

ketones in diabetes

A

excess fat is broken down, thus liver produces ketones from fatty acids

causes ketonemia and ketonuria

ketoacidos : lead to loss of consciousness and possibly death if not treated w fluids and insulin

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13
Q

neuropathy occurs in ____ of clients w diabetes

A

60-70%

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14
Q

what is number one cause of need for kidney dialysis

A

nephropathy

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15
Q

symptoms of diabetes

A

urinating often
feelign v thirsty
feelnig v hungry even though you have been eating
extreme fatigue
blurry vision
cuts or bruises that are slow to heal
weight loss (even though eating more - T1D)
tingling pain or numbness in hands or feet (T2D)

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16
Q

classification of diabetes (types)

A

prediabetes
Type 1 diabetes
type 2 diabetes
gestational diabetes
type of diabetes due to toerh causes like drug or chemical induced diabetes

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17
Q

1 in ___ adults ahve prediabetes

A

3

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18
Q

results indiciate pre-diabetes

A

fasting glucose of 100 and 125 mg/dL
A1C of 5.7-6.4
OGTT 2hr blood glucose of 140-199 mg/dL

start testing at 45 yo w 3 y intervals

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19
Q

risk facotrs for prediabetes

A

physical inactivity
first-degree relative w diabetes
members of high risk race or ethnicity (AA, Latino, native or Asian AMerican, Pacific Islanter)
women who delivered babies ? 9lb or had gestatoin diabetes
hypertension
dyslipidemia
PCOS
elevated labs
clinical conditions associated w insulin resistance (severe obesity, acanthosis, nigricans)
history of CVD

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20
Q

type 1 diabetes

A

juvenile diabetes
body immune system destroys pancraitc beta cells
5% of all diabetes cases
diagnose using blood glucose (over 126 mg/dL)

risk factors include genetics, autoimmune status, environmental factor

treat w exogenous insulin

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21
Q

type 2 diabetes

A

usually occur after 40 yo

diagnose w fasting glucose of 126 mg/dL, 2 our glcusoe of 200 mg/dL during OGTT, A1C of > 6.5

control w diet and exercise and oral diabetes medication

metformin is original medication

goal of nutrition therapy is maintain healthy glucose, blood pressure, and lipid levels

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22
Q

rapid acting insulin

A

Lispro (Humalog)
Aspart (Novolog)
Glulisine (Apidra)

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23
Q

short acting insulin

A

Regular (Humulin R, Novolin R)

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24
Q

intermediate acting insulin

A

NPH (Humulin N, Novolin N)

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25
Q

long actign insulin

A

detemir (Levemir)
Glargine (lantus, Basaglar, Toujeo)

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26
Q

inhaled insulin

A

afrezza

27
Q

premixed insulin

A

Humulin or Novolin 70/30
Novolog 70/30
Humalog 75/25
Humulin 50/50

28
Q

criteria for testing T2D in asymptomaitc children

A

overweight (BMI > 85th percentile) +
amily history of T2D in first or second degree relative; race/ ethnicity at risk; signs of insulin restiance or condition associated w insulin resistance (including small-for-gestational age birth wight)
age of iniaitiion (age 10 year or puberty at younger age)

29
Q

meglitinide

A

repaglinide

30
Q

d-phenylalanines

A

Nateglinide

31
Q

Thiazolidinedione

A

Pioglitazone
rosiglitzaone

32
Q

Nonsulfonylurea

A

Metformin
Metformin and time-released cpntrolling polymer

33
Q

Alpha-glucosidase inhibitor

A

Miglitol

34
Q

Second gen suflonylureas

A

Glyburides
Glipizide
Glimepride

35
Q

Class-bile acid sequestrants (primariyl used to decrease cholesterol)

A

Colesevelam

36
Q

DPP-4 inhibitor

A

Sitagliptin
Saxagliptin
Linagliptin
AlogliptinS

37
Q

SGLTZ inhibitor

A

Canagliflozin
Dapagliflozin
Empagliflozin

38
Q

opamine receptor agonist

A

Bromocriptine Mesylate

39
Q

Combinatio ndrugs

A

Glcuovance, Avandamet, Metaglip

ACTOplus Met, Avandaryl, Duetact, Janumet, Kmobigylze XR, Kazano, Oseni, Juvisync, Jentadueto, Invokamet, Xigduo XT, Glyxambi

40
Q

incretin mimetics

A

injected same as insulin but not insulin

used in conjunction w oral med to lower A1C to less than 7% (American diabetes association prefer outcomes less than 7% for clients w diabetes, American college of endocrinology preers less than 6.5%)

41
Q

Pramlintide

A

used in clients w t1d

lowers blood sugars by assisting insulin injected at meals to lower postmeal blood sugar levels

suppress potmeal glucagon release, slows gastric emptying, and decreasing appetite

act on beta cells in pancreas to increase glucose-dependent insulin secretion

42
Q

gestational diabetes

A

occurs during pregnancy btwn weeks 16 and 28

diagnosed w OGTT

if not responsive to diet, exercise, or oral medication, insulin injection therapy w be used

avoid concentrated sugars

usually disappear after infant is born

women who have had gestational diabetes have 35-60% chance of developing T2D

43
Q

secondary diabetes

A

infrequent

caused by certain drugs or by disease of pancreas like steroid meds can increase blood sugars and client can develop steroid induced diabetes

44
Q

treatments for diabetes

A

lose 7% of body weight

increase mod intensity physical activity to at least 150 min a week

control blood glucose levels

provide optimal nourishment for client

prevent symptoms and thus delay complications

diet alone or diet w insulin or oral guclose lowered medication plus regulated exercise and regular monitoring of clients blood glucose levels

45
Q

dietitan for type 2 diabetes

A

ned to know client diets history, food likes and dislikes, and lifestyle

client cal needs depend on age, activities, lean muscle mass, size, and resting energy expendtirute

46
Q

carb intake for diabetes

A

whole grains
veg
fruits
legumes
dairy products w emphasis on foods higher in fiber and lower in glycemic load should be advised over other sources esp those contain sugars

47
Q

how much should sodium be limited

A

<2300 mg a day

48
Q

treatment for T1D

A

nurtition plan that balances cal and nutrient needs w insulin therapy and exercise

meals and snacks be composed of similar nutrients and cal and eaten at reg time

small meals pus 2 to 3 snacks may be more helpful in maintaining steady blood glucose levels than 3 large meals

49
Q

carb counting for pt w t2d

A

starch and bread category, milk and fruit placed under heading of carb

4 carb breakfast
protein for lunch and dinner
only 1 or 2 fat per meal
2 carb and 1 oz protein for evenignsnacks

given in terms of exchanges rather than as particular foods

50
Q

high fiber

A

25-35 g of dietary fiber daily

increased fiber requires increased water intake

for clients dosing insulin based on g of carb, priotn of fiber may be subtracted (fi fiber content is greater than 5g half the grams of fiber may be subtracted from total carb for which client is doing)

51
Q

sucralose

A

splenda

made from sugar molecule altered so body can t absorb

600x sweter than sugar

linked int to increased leukemia in mice in utero

52
Q

Aspartame

A

equal nutrasweet

2 amino acids: phenylalanine, aspartic acid

200x sweeter than sugar

least desirable sweenter to use bc linked to cancer in rats and mice

53
Q

Saccharin

A

350x sweeter than sugars

linked to bladder cancer in rodents

54
Q

acesulfmae-potassium

A

equal original or equal spoonful

200x sweetre than sugar (used w sucralose or aspartame to cut bitterness )

two studies showed risk for cancer in rats

55
Q

Advantame

A

20,000x sweeter than sugar

safe bc v small amount used in food

56
Q

Neotame

A

8000x sweeter than sugar

no safet concerns by rarely used

57
Q

Stevia Lead Extract

A

high purified
viewed as safe

whole-lead stevia or crude stevia not allowed in foods

58
Q

alchohol and diabetes

A

if cnonsumed on empty stomach, may experiecne hypoglycemia

59
Q

exericse and T2D

A

helps body use glucose by increasing insulin receptor sites and stimulating creation of glucagon

lowers cholesterol and bp and reduces stress and body fat as it toens muscles

helps improve wt control, glucose levels, and CV system

60
Q

exercise and T1d

A

exercise can complicate glucose control

lowers glucose level = hypoglycemia

61
Q

exogenous insulin

A

protein

must be injected bc if swallowed would be digetested

human insulin is most common; synthesized in lab similar to how pancreas makes it

  • animal insulin are rarely used bc contain antibodies

for t1d 2 or more injections daily w more than one type of insulin (rapid vs long acting (for gen use regardless of meal))

62
Q

insulin pump therapy

A

deliver insulin in 2 ways: basal rate and premeal bolus

basal; very rapid acting insulin delivered continuously throughout day (keep gucose in check btwn meals and during night)

premeal bolus; cover food eaten during meal

63
Q
A

nutrition (21 decks)

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