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NBCD > Chapter 27: MNT IN Diabetes Mellitus > Flashcards

Chapter 27: MNT IN Diabetes Mellitus Flashcards

1
Q

a chronic disease that occurs either when the pancreas do not produce enough insulin or when the body cannot effectively use the insulin it produces

A

diabetes mellitus

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2
Q

organ that produce insulin (beta cells of the langerhans of this organ)

A

pancreas

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3
Q

hormone that regulates blood sugar

an anabolic hormone synthesized by the beta cells of Langerhans of the pancreas, which facilitates the entry of glucose into the cells

A

insuin

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4
Q

or raised blood sugar

a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, esp. the nerves and blood vessels

A

hyperlgycemia

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5
Q

diabetes - types

previously known as insulin-dependent, juvenile or childhood onset

A

type 1 diabetes

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6
Q

characterized by deficient insulin production and requires daily administration of insulin

cause: unknown and it not preventable with current knowledge

A

type 1 diabetes

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7
Q

symptoms include excessive excretion of urine (polyuria), excessive thirst or drinking (polydipsia), constant hunger (polyphagia), weight loss, vision changes, and fatigue

*symptoms may occur suddenly

A

type 1 diabetes

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8
Q

diabetes - types

formerly non-insulin dependent or adult-onset

A

type 2 diabetes

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9
Q

results from the body’s ineffective use of insulin

comprises 90% of people with diabetes around the world and is largely the result of excess boy weight and PA

A

type 2 diabetes

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10
Q

symptoms may be similar to T1DM, but are often less marked

the disease may be diagnosed several years after onset once complication have already arisen

this type of diabetes was seen only in adults, but it is now also occurring in children

A

type 2 diabetes mellitus

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11
Q

is hyperglycemia with onset or first recognition during pregnancy

A

gestational diabetes

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12
Q

symptoms are similar to type 1 and 2 diabetes

most often diagnosed thru prenatal screening rather than reported symptoms

A

gestational diabetes

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13
Q

are intermediate conditions in the transition between normoglycemia and diabetes

people with IGT or IFG are at high risk of progressing to type 2 dm, although this is not predictable

this may cause large gestational-aged infants and hypertension

A

impaired glucose tolerance (IGT)
impaired fasting glycemia (IFG)

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14
Q

features of T1DM

characteristics: age, onset

type #: viral infection, onset

A

type 1

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15
Q

features of T1DM

characteristics: insulin required?

type #: yes

A

type 1

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16
Q

features of T1DM

characteristics: cell response to insulin

type #: normal

A

type 1

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17
Q

features of T1DM

characteristics: acute complications

type #: hyperglycemia with ketoacidosis

A

type 1

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18
Q

features of T1DM

characteristics: prevalence in diabetic population

type #: 5-10%

A

type 1

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19
Q

other names

IDDM
Juvenile-onset diabetes
ketosis-prone diabetes
brittle diabetes

A

type 1 diabetes

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20
Q

IDDM meaning for type 1 diabetes

A

insulin-dependent diabetes mellitus

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21
Q

features of T1DM

characteristics: age, onset

type #: obesity, hereditary, onset

A

type 2

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22
Q

features of T1DM

characteristics: insulin required?

type #: sometimes

A

type 2

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23
Q

features of T1DM

characteristics: cell response to insulin

type #: resistant

A

type 2

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24
Q

features of T1DM

characteristics: acute complications

type #: hyperglycemia without ketoacidosis

A

type 2

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25
Q

features of T1DM

characteristics: prevalence in diabetic population

type #: 90-95%

A

type 2

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26
Q

other names

NIDDM
adult-onset diabetes
ketosis-resistant
diabetes
stable diabetes

A

type 2

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27
Q

NIDDM meaning for type 2 diabetes

A

non-insulin dependent diabetes mellitus

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28
Q

diabetes - risk factors

blood uric acid: >7.0 mmol

A

hyperuricemia

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29
Q

diabetes - risk factors

urine albumin: >50 mg albumin/24 hrs

A

microalbuminuria

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30
Q

diabetes - risk factors

high density lipoprotein (HDL): <35 mg/dL or 0.90 mmol/l

A

dyslipidemia

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31
Q

diabetes - risk factors

triglyceride: 150 mg/dL (2.8 mmol/L)

A

dyslipidemia

32
Q

diabetes - risk factors

total cholesterol: >200 mg/dL

A

dyslipidemia

33
Q

diabetes - risk factors

previous IGT with oral glucose tolerance test 2-hr value _____ (7.7-11.0 mmol/l)

A

140-199 mg/dl

34
Q

diabetes - risk factors

previous gestational diabetes, macrosomic, or large-for-gestational-age infant (_____/8kg lb birth weight); poor obstetrical history

A

3.7 kg

35
Q

diabetes - risk factors

bmi of _____ (especially waist-to-hip ratio >1), or waist circumference >80cm for females and >90cm for males

A

> 23 kg/m2

36
Q

diabetes - etiology

-beta-cell destruction usually leading to absolute insulin deficiency
-autoimmune
-idiopathic

A

type 1 diabetes

37
Q

diabetes - etiology

may range from relative insulin deficiency to a predominantly secretory defect with or without insulin resistance

A

type 2 diabetes

38
Q

diabetes - etiology

pregnancy hormones (placental lactogen, cortisol, prolactin, and progesterone) oppose the action of insulin

A

gastrointestinal diabetes

39
Q

diabetes - diagnosis

plasma blood glucose _____ mg/dL both casual (random) or postprandial

A

> 200 mg/dL

40
Q

diabetes - diagnosis

fasting blood sugar of _____ mg/dL

A

> 126 mg/dL

41
Q

diabetes - complications

damage to the large blood vessels

A

macroangiopathies

42
Q

diabetes - complications (macroangiopathies)

diabetes can increase the risk of _____ (CHD) by 300%

A

coronary heart disease

43
Q

diabetes - complications (macroangiopathies)

_____ among diabetic starts early, progresses faster and is more widespread

A

atherosclerosis

44
Q

diabetes - complications (macroangiopathies)

15% of diabetics will develop _____, and 50% will have recurrence within 2 years; 20% of people with ulcers will undergo amputation

A

foot ulceration

45
Q

diabetes - complications

damage to the small blood vessels

A

microangiopathies

46
Q

diabetes - complications (microangiopathies)

the damage to the blood vessel supplying blood to the eyes, causing impaired vision and, eventually, blindness

symptoms: blurred vision, black spots on vision, and fluctuating vision

A

diabetic retinopathy

47
Q

diabetes - complications (microangiopathies)

deterioration of the nerve tissues; includes damage to the blood vessel, supply of blood to the hands and feet resulting in numbness, loss of sensation or “pins and needles,” carpal tunnel syndrome, and gastroparesis

A

neuropathy

48
Q

diabetes - complications (microangiopathies)

damage to the blood vessel supplying blood to the kidneys, leading to impairment of kidney function, and eventually, kidney failure

A

diabetic nephropathy

49
Q

results to uncontrolled production of ketones by the liver that leads to acidosis due to increased glucose production

A

diabetic ketoacidosis (DKA)

50
Q

diabetes - characteristics (DKA)

hypoglycemia, metabolic acidosis (blood pH <_____), and positive ketones in the urine and blood

A

pH <7.35

51
Q

diabetes - characteristics (DKA)

DKA is often associated with type 1 diabetes, but it may also occur in type 2 diabetes, particularly when associated with a major intercurrent illness

A

-

52
Q

diabetes - signs and symptoms (DKA)

-acetone odor of the breath
-nausea and vomiting
-diffuse abdominal pain (seen in 30% of patients)
-rapid breathing
-blurred vision

A

-

53
Q

a syndrome of marked diabetic stupor, hyperglycemia, and hyperosmolarity in the absence of ketosis due to dehydration of brain cell

this is due to the osmotic pressure exerted by the significant amount of glucose in the blood, causing the withdrawing out the water from the cell; insufficient insulin, defective insulin in the cell

A

nonketotic hyperosmolar coma

54
Q

nonketotic hyperosmolar coma - characteristics

occurs in elderly patients w/ or w/o history of t2dm and is always associated with severe _____

A

dehydration

55
Q

nonketotic hyperosmolar coma - characteristics

_____ (2) often occur days to weeks prior to the presentation of the syndrome

A

polyuria and polydipsia

56
Q

nonketotic hyperosmolar coma - characteristics

impaired _____ function, which prevents clearance of excess glucose in the liver

A

renal function

57
Q

nonketotic hyperosmolar coma - characteristics

there is no metabolic acidosis due to the presence of circulating insulin and lower levels of counterregulatory hormones

A

-

58
Q

death of tissue due to loss of blood supply, with or without bacterial infection

A

gangrene

59
Q

nonketotic hyperosmolar coma - characteristics

overdose of insulin

A

insulin shock

60
Q

nonketotic hyperosmolar coma - characteristics

depressed immune function

A

infection

61
Q

diabetes - mgmt (medical)

medical drugs: 2 drugs for glucose control

A

insulin and/or hypoglycemic drugs

62
Q

these drugs are more convenient, require lower insulin dose, have higher compliance, and show less weight gain

sometimes, are best taken with insulin

A

oral hypoglycemic drugs

63
Q

oral hypoglycemic drugs - types

stimulate insulin secretion once or twice a day; may cause disulfiram reactions (nausea, vomiting, headache, and cramps associated with intake of alcohol); contraindicated against pregnancy, liver, and renal insufficiency

A

sulfonylurea drugs

64
Q

oral hypoglycemic drugs - types

site of action of sufonylurea drugs

A

pancreas

65
Q

oral hypoglycemic drugs - types

suppress glucose production, increase glucose uptake in the peripheral tissues

A

biguanides

66
Q

site of action of biguanides

A

liver

67
Q

oral hypoglycemic drugs - types

lessen insulin resistance; may cause dry mouth, contraindicated against tissue hypoxia (shock), acute blood loss, myocardial infarction, heart failure, pulmonary embolism, arterial circulatory disorders, consumptive diseases, severe generalized infection, and fasting states (less than 1kcal/day)

A

metformin and pioglitazone

68
Q

metformin and pioglitazone site of action

A

fats and muscles as insulin synthesizer

69
Q

oral hypoglycemic drugs - types

delay absorption of CHOs; hypoglycemic drug taken at the start of a meal; may cause diarrhea and abdominal pains

A

alpha-glucosidase inhibitors

70
Q

alpha-glucosidase inhibitors site of action

A

gut

71
Q

gestational diabetes - dietary mgmt

20% CHO at _____; no concentrated sugars, with snacks (including bedtime)

A

breakfast

72
Q

_____ kcal.kg for pregnant women with BMI of 20 to 26 kg/m2

A

30 kcal/g

73
Q

_____ kcal/kg for pregnant women who are obese prior to pregnancy

A

<30 kcal/g

74
Q

gestational diabetes - dietary mgmt

_____ kcal/kg actual weight

A

24 kcal/kg

75
Q

gestational diabetes - dietary mgmt

CHO: 35-45%
CHON: 20-25%
Fat: 35-40%

A

-

NBCD (89 decks)

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