Chapter 15 - Diabetes Mellitus Flashcards
What is Diabetes Mellitus?
Relative or complete lack of insulin secretion by beta cells
OR
defects of insulin receptors
Diabetes Mellitus results in what?
disturbances of carbohydrate, protein, and lipid metabolism, and in elevated blood glucose levels
In Diabetes Mellitus, __________ and ____________ damage results in disability and premature death?
Macrovascular and Microvascular
Macrovascular complications?
- coronary artery disease
- peripheral vascular disease
- cerebrovascular disease
Microvascular complications?
- nephropathy
- retinopathy
- neuropathy
- impaired healing leading to gangrene and amputation
Autonomic effects of Diabetes Mellitus?
- orthostatic hypotension
- gastroparesis
- neurogenic bladder
- impotence
Classifications of Diabetes Mellitus?
Type 1 (T1DM) : 5% to 10% of patients Type 2 (T2DM) : more than 90% of patients
Symptoms of Type 1 Diabetes Mellitus?
- polydipsia
- polyuria
- polyphasic
- weight loss
Type 1 Diabetes Mellitus is caused by what?
destruction of pancreatic beta cells
- Autoimmune disorder
- Idiopathic diabetes
Symptoms of Diabetes Mellitus?
- gradual onset of polyuria and polydipsia
- easily fatigues
- frequent infections (especially UTIs)
- May have condition for many years before complications lead to diagnosis
What is Type 2 Diabetes Mellitus caused by?
Insulin resistance - failure of cells to respond to insulin
OR
- defects in insulin secretion
Type 2 Diabetes Mellitus Risk Factors?
- family history
- obesity
- gestational diabetes
________ produces an insulin-resistant state; causes cells to produce excess insulin
Obesity
What is A1C called?
Glycosylated hemoglobin
What does A1C reflect?
Reflects blood glucose control for 100 to 120 days
What is used for Type 2 Diabetes Mellitus when diet and physical activity do not control hyperglycemia?
Oral glucose-lowering medications
Type 1 Diabetes Mellitus requires what type of insulin?
exogenous insulin (to maintain blood glucose level WNL)
Some patients with T2DM require _________ to optimize glucose control?
Insulin
what is the goal of Insulin use?
To maintain the glucose level as close to physiologic normal as possible.
What are benefits of Exercise?
- lowers blood glucose levels
- assists in maintaining normal lipid levels
- Increases circulation
People with diabetes should not exercise when?
When insulin is at its peak
When is exercise ideal for people with Diabetes?
Exercise when blood glucose level is 100 to 200mg/dLl
(30 to 60 minutes after meals)
When should exercise be avoided in individuals with diabetes?
When blood glucose level is greater than 250mg/dL and when ketones are in the urine
Causes of Hypoglycemia?
- too much insulin
- skipping meals
- too much exercise without food replacement
When do symptoms of Hypoglycemia occur?
Occur when blood glucose level falls below 50mg/dL
Symptoms of Hypoglycemia?
- Hunger
- Erratic behavior
- Confusion
- Trembling/shaking
- Cool, Clammy, Pale skin
Hypoglycemia–> Food to raise blood sugar quickly?
- 5 to 6 pieces of hard candy
- 4oz of fruit juice or regular soda (not diet)
- 1Tbsp of sugar, jelly, or honey
- 3 glucose tablets
(available without a prescription at most pharmacies)
What effect does an illness have on blood glucose concentrations?
Elevates
What effect does an illness have on the appetite?
Decreases
Women with Pre-existing diabetes are vulnerable to what?
Vulnerable to fetal complications
Gestational Diabetes (GDM)?
Begins in pregnancy and is resolved at parturition
Increased insulin in Gestational Diabetes causes __________?
macrosomia
Gestational Diabetes makes up what percentage of pregnancies?
5% to 6% of pregnancies
Gestational Diabetes is associated with what?
Obesity - but weight loss is not recommended during pregnancy
In individuals with Gestational Diabetes they are at a greater risk for what?
Increased risk for later development of Type 2 DM
(occurs in 20% to 50% of women with GDM
Postpartium recommendations?
- Screening for 6 or more weeks after delivery
- Maintaining ideal body weight
- Eating a low-fat diet
- Exercising regularly
- Breastfeeding
Type 2 diabetes in the young is related to what?
Related to increase in childhood obesity
Other signs and symptoms that may indicate a risk for Type 2 DM include what?
- acanthuses
- nigricans
- polycystic ovarian syndrome
- hypertension
(Girls more susceptible than boys)
