Chapter 29: Medical Nutrition Therapy for Diabetes Mellitus and Hypoglycemia of Nondiabetic Origin Flashcards
hyperglycemia
High blood glucose
insulin
A hormone produced by the beta-cells of the pancreas, is necessary for the use or storage of macronutrients
impaired fasting glucose (IFG)
Individuals with this are referred to as having prediabetes, indicating a relatively high risk for the development of diabetes and CVD
impaired glucose tolerance (IGT)
Individuals with this are referred to as having prediabetes, indicating a relatively high risk for the development of diabetes and CVD
prediabetes
A diagnosis of prediabetes indicates a relatively high risk for the development of diabetes and CVD
type 1 diabetes mellitus (T1DM)
The primary defect is pancreatic beta-cell destruction, usually leading to absolute insulin deficiency and resulting in hyperglycemia, polyuria, polydispia, polyphagia, unexpected weight loss, dehydration, electrolyte disturbance and diabetic ketoacidosis
insulin deficiency
When insulin-producing cells are damaged or destroyed and stop producing insulin
polyuria
excessive urination
polydipsia
excessive thirst
polyphagia
excessive hunger
diabetic ketoacidosis (DKA)
A serious complication of diabetes characterized by extreme hyperglycemia and a buildup of ketones in the blood and urine
immune-mediated diabetes mellitus
Results from an autoimmune destruction of the beta-cells of the pancreas, the only cells in the body that make the hormone insulin
honeymoon phase
The time after diagnosis of diabetes and the correction of hyperglycemia, metabolic acidosis, and ketoacidosis, endogenous insulin secretion recovers and exogenous insulin requirements drastically decrease for up to 1 year or longer
latent autoimmune diabetes of the adult (LADA)
An autoimmune diabetes that occurs in adulthood. AKA type 1.5 diabetes.
type 2 diabetes mellitus (T2DM)
A progressive disease that, in many cases, is present long before it is diagnosed.
insulin resistance
Decreased tissue sensitivity or responsiveness to insulin
postprandial blood glucose
Blood glucose level after a meal
preprandial blood glucose
Also known as fasting blood glucose. Blood glucose level before a meal
glucagon
A hormone formed in the pancreas which promotes the breakdown of glycogen to glucose in the liver
glucotoxicity
The deleterious effect of hyperglycemia on insulin sensitivity and insulin secretion
lipotoxicity
Increased fatty acid levels
C-peptide
Byproduct of insulin production. Can be used to determine type of diabetes, T1DM or T2DM
gestational diabetes mellitus (GDM)
A type of diabetes that occurs during pregnancy
macrosomia
A larger than normal baby
maturity onset diabetes of youth (MODY)
A group of several conditions characterized by abnormally high blood sugar levels. These forms of diabetes typically begin before age 30, although they can occur later in life
acanthosis nigricans
A condition in which dark raised areas appear on the sides of the neck and in the body folds and creases
fasting plasma glucose (FPG)
The simplest and fastest way to measure blood glucose and diagnose diabetes. Fasting means that you have had nothing to eat or drink (except water) for 8 to 12 hours before the test
glycosylated hemoglobin (A1C) test
A test that measures the amount of blood sugar (glucose) attached to hemoglobin. An HbA1c test shows what the average amount of glucose attached to hemoglobin has been over the past three months. It’s a three-month average because that’s typically how long a red blood cell lives
normoglycemia
A normal concentration of sugar in the blood (as contrasted with hyper- or hypoglycemia)
counterregulatory (stress) hormones
Have the opposite effect of insulin. These include glucagon, growth hormone, cortisol, epinephrine, and norepinephrine
self-monitoring of blood glucose (SMBG)
Measuring blood glucose of oneself to assess day-to-day glycemic control
carbohydrate counting
An eating plan method based on the principle that all types of carbohydrate (except fiber) are digested, and that the majority of carbohydrates are absorbed into the bloodstream as molecules of glucose
glycemic index (GI)
Developed to compare the physiologic effects of carbohydrates on glucose. The GI ranks carbohydrate foods according to how they affect the blood glucose level. The GI of glucose = 100
glycemic load (GL)
An estimate of the glycemic index of all foods, meals consumed. The GL is calculated by multiplying the GI by the amount of available carbohydrate in each food and then totaling the values for all foods in a meal or dietary pattern.
insulin secretagogues
Medications that increase insulin production
incretins
Hormones made by the GI tract and include GLP-1. GLP-1 is released during nutrient absorption, which increases glucose-dependent insulin secretion, slows gastric emptying, decreases glucagon production, and enhances satiety
basal or background insulin dose
Amount of insulin required in the postabsorptive state to restrain endogenous glucose output primarily from the liver, which helps maintain normal glucose levels between meals
insulin to carbohydrate ratio
The amount of insulin required per gram of carbohydrate
continuous glucose monitoring
Used on a day to day basis to manage diabetes effectively and safely.
correction factor (CF)
Defines how much milligrams per deciliter a unit of rapid-insulin will lower blood glucose levels over a 2- to 4- hour period
hyperglycemic hyperosmolar state (HHS)
A high blood glucose level without ketones. Patients are markedly dehydrated, and mental alterations range from mild confusion to hallucinations or coma
hypoglycemia (or insulin reaction)
A low blood glucose is a common side effect of insulin therapy, although individuals taking insulin secretagogues also can be affected
autonomic symptoms
Arise from the action of the autonomic nervous system and are often the first signs of mild hypoglycemia
neuroglycopenic symptoms
Related to insufficient supply of glucose to the brain, also can occur at similar glucose levels as autonomic symptoms but with different manifestations
dawn phenomenon
The increased need for insulin at dawn causes a rise in fasting blood glucose levels
Somogyi effect
Hypoglycemia followed by rebound hyperglycemia. This phenomenon originates during hypoglycemia with the secretion of counterregulatory hormones and usually is caused by excessive exogenous insulin doses
macrovascular disease
Involves diseases of large blood vessels
microvascular disease
Associated with diabetes involve the small blood vessels and include nephropathy and retinopathy
metabolic syndrome
Characterized by intraabdominal obesity or the android distribution of adipose tissue and is associated with dyslipidemia, hypertension, glucose intolerance, and increased prevalence of macrovascular complications
gastroparesis
Characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach
hypoglycemia of nondiabetic origin
Defined as a clinical syndrome of diverse causes in which low levels of plasma glucose eventually lead to neuroglycopenia
Whipple’s triad
- A low plasma or blood glucose, 2. symptoms of hypoglycemia at the same time, and 3. resolution of the symptoms once the blood glucose returns to normal
postprandial (reactive) hypoglycemia
If blood glucose levels fall below normal limits within 2 to 5 hours after eating
fasting hypoglycemia
Often is related to an underlying disease
