Diabetes Flashcards by Maggie Berger

Type of DM that is autoimmune destruction of pancreatic beta islet cells

Type 1 DM

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Type of DM that is lack of insulin production

Type 1 DM

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Type of DM that is due to cellular resistance to insulin with insufficient insulin secretion

Type 2 DM

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Type of DM that is abnormal islet cell function

Type 2 DM

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Any degree of glucose in tolerance during pregnancy

Gestational diabetes

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What is one long term effect of having gestational diabetes

60% will develop type 2 DM within 5-10 years

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People can get DM secondary to disease in the _____

pancreas

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fasting blood glucose is showing what

your glucose in that one moment of time

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Diagnosing DM: fasting blood glucose ____

> 126mg/dL

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Diagnosing DM: HbA1c ___

Greater than or equal to 6.5

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What is HbA1c mesuring

blood glucose over a period of time
tells us about organ function

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If you wanted to know how someone is managing their DM what test shows us that

HbA1c

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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

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What symptoms and random blood glucose is indicative of DM

polyuria, polydipsia, weight loss, blurred vision
random BG of >200

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What is optimal BG preprandial and when fasting

70-90mg/dL

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What is the typical age of onset for type 1 and 2

1: < 35yrs
2: >40yrs

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in type 1 DM they have ___ or ___ blood insulin

decreased or absent

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in type 2 DM they have ___ or ___ blood glucose

normal or increased

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Who has insulin resistance, T1DM or T2DM?

type 2 DM

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Who is positive for ketosis, type 1 or 2

type 1 DM

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What is the treatment for type 1 DM

insulin, diet, exercise

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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