Diabetes Flashcards
Types of DM
Type 1
Type 2
Gestational
type of DM majority of people have
Type 2
DM leading cause of
adult blindness
End- stage kidney disease
Non-traumatic amputations
DM major contributing factors to
heart disease
stroke
hypertension
Etiology & Pathophysiology of DM
- Genetic/hereditary
- autoimmune
- environmental
- lifestyle
insulin
released from beta cells of pancreas to lower glucose levels
counter regulatory hormones
glucagon, epinephrine, growth hormone, cortisol
Gestational Diabetes
during pregnancy. baby weighs > 9 lb
Pathophysiology of Type 1 DM
complete destruction of the pancreatic cells. Progresses to lack of insulin production
Type 1 DM
usually affects younger population, does to have to be genetic, rarely overweight, usually compliant
Risk factors for T1DM
autoimmune, viral, environmental, medically induced
S/S of T1DM
polyuria
polydipsia
polyphagia
weight loss
fatigue
increase freq. of infections
rapid onset
insulin dependent
familial tendency
peak incidence from 10 to 15 years
Why do you lose weight with T1DM
can’t use glucose to feed their cells so they are wasting away
Most common Infections for T1DM & why
bacterial & yeast infections because they love a moist, sugary, environment
Diagnosis of DM
hemoglobin A1C, Fasting Blood Glucose, 2 hr postprandial or oral glucose tolerance test, random blood glucose
1 way to test for diabetes & check progression for treatment
HGB-A1C
HGB-A1C
measures the avg. BG levels over the past 2-3 months.
does not give acute/hr to hr changes.
reported as the percentage of total blood.
Things that scew HGB-A1C results
anemia, pregnancy, CKD, thalassemia, recent acute blood loss or transfusion
Good HGB-A1C results
anything below 6.5
Bad HGB-A1C results
anything above 6.5= diabetes
Fasting Blood Glucose
No caloric intake for at least 8 hours
Normal Range for fasting blood glucose test
70-110 mg/dl
Positive DM diagnosis for fasting blood glucose test
Greater than or equal to 126 mg/dl
2 hr postprandial oral glucose tolerance test
the patient drinks beverages with glucose load after fasting 8-12 hours.
When is blood sample taken with the OGTT
prior to consumption then again 1 hr and 2 hrs after consumption
Value based on the level at what time after OGTT
2 hour mark
Positive DM results for OGTT
greater than or equal to 200 mg/dl
Continuous Glucose Monitoring
Good for patients with erratic and unpredictable drops. Good for kids
Insulin pump therapy
continuous subcutaneous insulin infusion via an external device.
Provides continuous infusion of basal insulin
insulin pump therapy
Key to working with a pt. on the pump
motivation
Bolus determined by…
pre meal blood sugar and CHO content of meal
Pump therapy indicators
HBA1C greater than 6.5.
freq hypoglycemia
shift work
type 2 w/ gastroparesis
dawn phenomenon
pediatrics
exercise
hectic lifestyle
Pump candidates
motivated
adequate vision & fine motor skills
strong support system
insurance coverage
Insulin pump benefits
improved glycemic control
better pharmacokinetic delivery of insulin
increased flexibility
variable & individualized basal rates
does NOT eliminate SMBG
DM causative factors
-genetic
-autoimmune
-environmental
