Diabetes Flashcards
Type of DM that is autoimmune destruction of pancreatic beta islet cells
Type 1 DM
Type of DM that is lack of insulin production
Type 1 DM
Type of DM that is due to cellular resistance to insulin with insufficient insulin secretion
Type 2 DM
Type of DM that is abnormal islet cell function
Type 2 DM
Any degree of glucose in tolerance during pregnancy
Gestational diabetes
What is one long term effect of having gestational diabetes
60% will develop type 2 DM within 5-10 years
People can get DM secondary to disease in the _____
pancreas
fasting blood glucose is showing what
your glucose in that one moment of time
Diagnosing DM: fasting blood glucose ____
> 126mg/dL
Diagnosing DM: HbA1c ___
Greater than or equal to 6.5
What is HbA1c mesuring
blood glucose over a period of time
tells us about organ function
If you wanted to know how someone is managing their DM what test shows us that
HbA1c
Oral glucose test: how is it done and what is the diagnostic value
come in fasting, drink sugar, wait 2 hours
> or equal to 200
What symptoms and random blood glucose is indicative of DM
polyuria, polydipsia, weight loss, blurred vision
random BG of >200
What is optimal BG preprandial and when fasting
70-90mg/dL
What is the typical age of onset for type 1 and 2
1: < 35yrs
2: >40yrs
in type 1 DM they have ___ or ___ blood insulin
decreased or absent
in type 2 DM they have ___ or ___ blood glucose
normal or increased
Who has insulin resistance, T1DM or T2DM?
type 2 DM
Who is positive for ketosis, type 1 or 2
type 1 DM
What is the treatment for type 1 DM
insulin, diet, exercise
what is the treatment for type 2 DM
weight loss
oral hypoglycemics or insulin
diet
exercise
What is the presenting symptom for type 1?
diabetic ketoacidosis
If someone is presenting with healing issues, what might this look like and what type do they most likely have?
recurrent yeast infections
chronic skin infections
DM2
Someone with ketoacidosis will present with
__glycemia
P__
P__
Breath__
__skin and mough
__ respirations
hyperglycemia
polyuria
polydipsia
fruity smelling breath
dry skin and mouth
kussmauls (rapid and deep)
Goals of therapy:
HbA1c __
fasting glucose __
postprandial __
< 7
< 130 mg/dl
< 180 mg/dL
We want to keep BP __
< 140/90
Lipids values:
LDL__
total cholesterol __
HDL __
< 100
< 150
> 40
Diabetic autonomic neuropathy s/s:
cardiovascular:
resting tachycardia, exercise intolerance, orthostatic hypotension, silent MI
Diabetic autonomic neuropathy s/s:
GI:
GU:
GI: esophageal dysmotility, gastopareisis, constipation, diarrhea
GU: neruogenic bladder, erectile dysfunction, female sex dysfunction
Diabetic autonomic neuropathy s/s:
Metabolic:
hypoglycemia unawareness, abnormal response to hypoglycemia
Diabetic autonomic neuropathy s/s:
Pseudomotor:
anhidrosis. heat intolerance, dry skin, gustatory sweating
What are the goals of therapy for someone with diabetes
alleviate symptoms, achieve BG BP and lipid targets, prevent complications
What value of HbA1c yields a significant decreased risk of MI and CVA, and renal/eye problems
decrease by 1
is it worse off to be hyperglycemic or hypoglycemic? what are the effects of being hypo
hypo: risk fractures, MI, CVA, death
what are s/s of hypoglycemia
tremor
nervous/anxiety
tachycardia
sweating
irritable
dizzy
tingly lips
nauseous/vomit
what are s/s of hyperglycemia
frequent urination
dry mouth/inc thirst
increase hunger
headache
blurred vision
flu-like achyness
face-flushing
kussmaulis breathing
fruity smelling breath
how do you treat mild hypoglycemia
15g carbs
if BG is 70 or less what do you do
give 15g of cards and retest in 15min
if BG is 70 or less what do you do
give 15g of cards and retest in 15min
if BG is still less that 70 after given them 15g of carbs what do you do
eat another 15g of carbs and contact MD
in poorly controlled DM, pts with hyperglycemia who exercise might __ BG (what type can this happen to?)
increase BG
type 1
what are some impacts of exercise in someone with DM
inc blood flow –> inc glucose and insulin delivery
stimulates glucose transport via muscle contraction
enhances whole body sensitivity to insulin
dec BG levels
if BG is between 70-100:
give snack and then 15g of carbs for every hour of mod intensity exercsie
if BG is >300 and pt is on oral hypoglycemics:
10-15min exercise and check BG
if rises –> stop
if drops –> continue and recheck every 15min
if BG is >300 and pt is on insulin:
check ketones in urine
if (+ )don’t exercise
if (-) exercise with close monitoring of BG
how long should you check BG after exercise
6-12hrs
what is a common insulin injection site? why is this relevant to us?
abdomen
don’t inject over area you are exercising (ex: dont inject in thigh if you are running or in abs if you are crunching)
FITT for diabetics
f: 3-5x/week
i: low to mod (40-70%) VO2max
t: 150 min/week
type: both aerobic and resistance
what exercises to avoid for non-proliferative retinopathy
ones that elevate BP, valsalva, powerlifting, jarring ones
what exercises to avoid for proliferative retinopathy
strenuous, pounding/jarring, ones that elevate BP, weight lifting, jogging, high-impact aerobics, racquet sports, palyin wing/brass instruments
what 3 kinds of insulin on diabetics usually on
basal (taken 1-2x daily)
pre-meal insulin (to cover calorie intake of meals)
correction factor (combines with pre-meal to adjust based on fingerstick)
what are the 4 kinds of inslin
ultra-short acting (5min before meal)
intermediate acting
regular
long acting
