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pt management 3 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is Diabetes?

A

Chronic, systemic disorder characterized by HYPERglycemia and disruption of the metabolism / utilization of carbohydrates, proteins, and fats

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2
Q

Type 1 risk factors

A

Family history, presence of autoantibodies, environmental factors

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3
Q

Type 2 risk factors

A

obesity, sedentary lifestyle, age, race, family history, etc

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4
Q

Weight risk factor

A

the more fatty tissue you have, the more resistant your cells become to insulin.

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5
Q

Inactivity risk factor

A

The less active you are, the greater your risk.

Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin.

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6
Q

Family history risk factors

A

Your risk increases if a parent or sibling has type 2 diabetes.

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7
Q

Race or ethnicity risks factor

A

Although it’s unclear why, certain people — including Black, Hispanic, American Indian and Asian American people — are at higher risk.

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8
Q

Type 1

A

5%

absolute deficiency in production and secretion of insulin

autoimmune disease

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9
Q

Type 2

A

95%)- (NIDDM)

cellular resistance to insulin action and inadequate compensatory insulin secretory response

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10
Q

Signs and symptoms type 1

A

Polyuria, polydipsia, weight loss with polyphagia, blurred vision, ketonuria, weakness/fatigue

May initially present as diabetic ketoacidosis (DKA).

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11
Q

Signs and Symptoms type 2

A

Polyuria and polydipsia

Blurred vision, fatigue, paresthesias, skin infections, foot pain, high blood lipid levels

Obesity is often seen versus weight loss

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12
Q

Pre-Diabetes

A

Hyperglycemia classification that falls between “normal” and true diagnosis of DM

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13
Q

Gestational Diabetes

A

Glucose intolerance detected during pregnancy

Monitor diet and occasionally insulin therapy

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14
Q

HbA1C

A

bA1c is a test that measures the amount of glycated hemoglobin in
your blood. Glycated hemoglobin is a substance in red blood cells
formed when blood sugar (glucose) attaches to hemoglobin.

  • Indicates blood sugar control over a 2–3 month period
  • Normal value is 6% or less. Goal for DM is around 6-7%
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15
Q

Type 1 meds

A

Diet

Injectable Insulin

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16
Q

type 2 meds

A

Diet
Exercise
Oral Medications
Injectable Insulin

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17
Q

Atherosclerosis - Macrovascular

A

Cerebrovascular Disease
CAD
PVD
Renal artery stenosis

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18
Q

Atherosclerosis - Microvascular

A

Nephropathy
Retinopathy

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19
Q

Infection/Impaired wound healing

A

Diabetic Foot Ulcers/Amputations

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20
Q

Orthopedic

A

Periarthritis

Hand stiffness

Limited joint mobility

Flexor tenosynovitis

Dupuytren’s contracture
RSD

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21
Q

Neuropathic

A

Autonomic
Peripheral
Diabetic Amyotrophy
Carpal Tunnel
Charcot’s Joint

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22
Q

Heart disease and stroke - diabetes

A

Heart disease and stroke account for about 65% of deaths in people with diabetes.

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23
Q

Retinopathy (microvascular) - diabetes

A

Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year making diabetes the leading cause of new cases of blindness in adults 20-74 years of age

24
Q

type 1 diabetes - Retinopathy (microvascular) - diabetes

A

therapy that keeps blood sugar WNL as reduces damage to the eyes by 76%

25
Q

Nephropathy (microvascular)

A

Diabetes is the leading cause of kidney failure, accounting for 44% of new cases.

26
Q

type 1 diabetes - Nephropathy (microvascular)

A

therapy that keeps blood sugar levels as close to normal as possible reduces damage to the kidneys by 35% to 56%

27
Q

Neuropathy

A

About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage.

28
Q

Neuropathy - NS damage

A

impaired sensation or pain in the feet or hands - peripheral neuropathy

slowed digestion - gastropathy

carpal tunnel syndrome – ischemia of the median nerve

29
Q

look at what causes neuropathy

A

x

30
Q

Impaired Wound Healing - rule of 15

A

15% of diabetics develop foot ulcers

15% of those ulcers lead to osteomyelitis

15% of all ulcers lead to amputation

31
Q

Impaired Wound Healing

A

Influenced by the macro-and microvascular effects and neuropathic effects of DM

32
Q

Charcot Foot Deformity contributing factors

A

peripheral neuropathy and microvascular effects.

33
Q

Charcot Foot Deformity - result in what

A

Results in microfracture and eventual collapse of the midfoot

Resultant deformity unequally distributes plantar pressures during gait, placing person at even greater risk for ulceration

34
Q

Charcot Foot Deformity - idiopatheic or sudden

A

Resultant deformity unequally distributes plantar pressures during gait, placing person at even greater risk for ulceration

35
Q

when should you refer for a diabetic foot

A

Any warm, swollen diabetic foot should be taken very seriously and NWB recommended until dx of Charcot Foot can be confirmed with x-ray.

36
Q

what is the treatment of choice for charcots foot

A

NWB protection

37
Q

Treatment for diabetes charcot foot

A

Total Contact Cast

Patellar Tendon-bearing brace

38
Q

Hypoglycemial

A

<70mg/d

39
Q

Hypoglycemial in what type

A

type 1

40
Q

Hypoglycemial signs and

A

Perspiration
Nervousness
Weakness
Pallor
Tachycardia
Palpitations
Shakiness/trembling
Blurred vision
Confusion
Emotional lability

41
Q

Treating Low Blood Glucose

A

first check their blood sugar if possible

Treatment is to ingest some form of sugar, preferably not combined with fats

42
Q

sugar - examples

A

Glucose tablets
Sugar packet
Candy
Orange juice

43
Q

treating Low Blood Glucose
- patient passes out

A

it is an emergency and 911 should be called

44
Q

Hyperglycemia

A

(>250mg/dl)

45
Q

Hyperglycemia - sign and sym

A

Lethargic
Confusion
Thirst
Polyuria
Flushed/dry skin
Dry mucous membranes
Rapid but weak HR
Fruity/acetone breath
Diminished reflexes

46
Q

Acute hyperglycemia most commonly occurs in what Type

A

Type 2 diabetics as a response to infection or poor glycemic control.

47
Q

what can hyperglycemia develope into

A

ketoacidosis or HHNK - if so call 911

48
Q

Carbohydrate-Containing Foods

A

Starchy foods like bread, cereal, rice, and crackers

Fruit and juice

Milk and yogurt

Dried beans like pinto beans and soy products like veggie burgers

Starchy vegetables like potatoes and corn

Sweets and snack foods like sodas, juice drinks, cake, cookies, candy, and chips

49
Q

how many grams fo carbs per meal

A

45-60 grams per meal.

this can be adjusted based on the indivduals needs

50
Q

lowLow glycemic index-

A

vegetables, berries, peanuts

51
Q

High glycemic index

A

white bread, Rice Krispies, mashed potato, pretzels > table sugar

52
Q

metabolic syndrome and diabetes

A

Some studies have shown that exercise is more beneficial than medication (metformin) in treating metabolic syndrome, a precursor to diabetes.

53
Q

Overall Benefits of Exercise for persons with Type 2 DM

A

Lowers blood sugar
Increases insulin sensitivity
Improves lipid profile
Promotes weight loss/maintenance
Reduces dose/overall need for insulin or oral meds

54
Q

ACSM Guidelines for Exercise for Individuals with Type 2 DM - Aerobic Exercise

A

At least 3x/week (preferred 5x/week) with no more than 2 consecutive

40-60% VO2 max

150min/week

55
Q

ACSM Guidelines for Exercise for Individuals with Type 2 DM - resistance

A

2x/week on non-consecutive days

50-80% 1RM

include all major muscle groups; 10-15 reps progressing to higher weight, less reps

56
Q

Exercise for Type 1 DM for Type 1 DM

A

Exercise has not been proven to aid in glycemic control in type 1 diabetics.

Benefit of exercise is primarily protective cardiovascular effects.

prevent the complication of hypoglycemia

pt management 3 (10 decks)

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