Diabetes Flashcards
Is Type 1 diabetes insulin dependent or resistant?
Pancreas does not produce insulin, = Insulin Dependent
Is Type 2 diabetes insulin dependent or resistant?
Body is resistant to insulin = +Insulin Resistant_
Body is still producing insulin but is not being used by the tissues
Age of diagnosis of Type 1 diabetes?
AKA Juvenile Diabetes
- diagnosed mostly in childhood, can occur at any age
Symptoms of Type 1 Diabetes
3 P’s:
- Polyphagia; increased hunger
- Polydipsia; increased thirst
- Polyuria; increased urination
Also:
- Blurry Vision
- Dehydration
- Weight Loss
- Ketoacidosis
What is the cause of Type 2 Diabetes?
Occurs secondary to other conditions: obesity, hypothyroidism, Cushing’s
What glucose level is indicative of Hypoglycemia?
Glucose < 70 mg/dL
What glucose level is indicative of Hyperglycemia
Glucose > 300 mg/dL
Early Signs of Hypoglycemia?
COLD and CLAMMY get him a CANDY!
- Pallor and Sweating
- Shakiness
- Tachycardia, palpitations
- Dizziness, Fainting
- Excessive Hunger
Late Stages Signs and Symptoms of Hypoglycemia?
Slurred Speech, Drowsiness, Confusion
LOC = Loss of Consciousness
Coma
Early signs of Hyperglycemia?
- Weakness
- Dry mouth
- Frequent, scant amounts of urination
- Deep and Rapid Respirations = Kussmaul Breathing
- Diminished Reflexes
- Excessive Thirst
(Essentially DM 1 symptoms)
Late signs of Hyperglycemia?
- Fruity Breath (Acetone Breath)
- Hyperglycemic Coma
When is appropriate to notify the phycisian/call 911
Incidents of Coma or LOC
What is the most important step to take first in cases of hypoglycemia?
Check Blood Glucose (if that is an answer choice)
When should we avoid exercise after taking insulin?
Peak insulin hours (2-4 hours), can lead to hypoglycemia.
(1 Hour after should be safe)
Where should insulin be injected if exercise is planned?
Usually the abdomen, or any non-active extremity.
Why should insulin not be injected into an active extremity?
Insulin is absorbed more quickly in an extremity that is active.
How should insulin dosage be changed after exercise?
Should reduce insulin dosage immediately after exercise.
What time of day is the best if exercise is planned?
Exercise in the morning, so we can catch if hypoglycemia occurs.
We are unable to monitor signs and symptoms if they are asleep at night.
What are safe blood glucose levels to exercise?
100 - 250 mg/dL
What blood glucose level should we NEVER exercise in?
BG < 70 mg/dL
BG > 300 mg/dL
Presence of Ketoacidosis
Is it safe to exercise between 70 - 100 mg/dL
Yes, first need to provide a carbohydrate snack
Is it safe to exercise between 250 - 300 mg/dL
Yes, only if ketones are not present, but still exercise with caution
When is it not safe to exercise with a patient with a BG > 250 mg/dL
When Ketone bodies are present, notice a fruity odor on breath?
Foot care: washing feet and soaking feet
NO soaking the feet
Foot Care: Moisturizers
Good, but no lotion between the toes
Foot Care: Socks
White Socks preferred to see if there are any cuts
Foot Care: Shoes
Snug fit shoes with laces or velcro
Foot Care: Appropriate time to purchase a new pair of shoes?
Later in the day; afternoon as we experience weight gain as the day progresses. Allows us to get a more accurate shoe size.
Normal reference range for HbA1c?
4% - 6% (< 5.7%)
What HbA1c level indicate immediate insulin therapy?
HbA1c levels above 10%
FITT Principle for Exercising with a patient with DM: Frequency
3-7 days per week
FITT Principle for Exercising with a patient with DM: Intensity
11-13 RPE Scale
FITT Principle for Exercising with a patient with DM: Time/Duration
150 min/week progressed to 300 min/week
FITT Principle for Exercising with a patient with DM: Type
Mod intensity aerobic exercise of the large muscle groups
How does hyperglycemia affect DTRs?
Hyporeflexia = Decreased Reflexes
