Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Conditions > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Diabetes mellitus

A
  • diabetes = a group of metabolic conditions meaning a malfunction in the way the body either produces insulin, uses insulin, or both
    Insulin:
  • pancreas makes insulin
  • insulin is a hormone that helps transport glucose from food into the body’s cells to be used for energy
  • helps regulate glucose levels (used for energy)
    Blood glucose:
  • fluctuates throughout the day
  • diabetes causes the levels to go way above (hyperglycemia) or below normal (hypoglycemia)
  • what we eat, how much we move, how we’re feeling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What happens when having lack of insulin?

A
  • the body breaks down its own fat or lipids to produce an energy source = ketones
  • total lack of insulin can create dangerous and life threatening levels of ketones and a persistent high blood glucose level can lead to complications affecting multiple tissues and organ systems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of diabetes

A

The American Diabetes Association (ADA) classifies diabetes into 4 general categories:
- Type 1 diabetes (autoimmune)
- Type 2 diabetes (risk factors that are non-modifiable like age, ethnicity, and family history and modificable like unhealthy diet, obesity, and lack of physical exercise)
- Gestational diabetes mellitus (GDM) (during pregnancy)
- specific types of diabetes due to other causes (rare single gene mutation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Type 1 diabetes

A
  • your body does not make insulin
  • a condition of complete or absolute insulin deficiency
  • autoimmune beta cell destruction that requires insulin replacement
  • can develop at any age
  • in adults = type 1 diabetes accounts for 5-10% of all diagnosed cases
  • it occurs most frequently in children, with just over 18,000 youth newly diagnosed each year
  • type 1 symptoms can develop in just a few weeks or months
    • once symptoms appear, they can be abruptly severe
    • often individuals present in an acutely ill state, many times with a life-threatening condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Type 1 diabetes diagram (slide 7)

A

Healthy:
- pancreas procures insulin
- insulin moves glucose to the cells
Diabetic:
- immune cells destroy beta cells in the pancreas that produces insulin
- pancreas cannot produce insulin
- more glucose ends up in the blood
- there is no insulin to transport the glucose to the cells and is just hanging out in the bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Etiology of type 1 diabetes

A
  • occurs more in kids
  • an autoimmune reaction that destroys the insulin-producing beta cells in the pancreas
  • genetic susceptibility coupled with other factors
  • environmental factors might precipitate the disease
  • diet may precipitate the disease
  • the relationship between viral infection and type 1 diabetes development is supported by many studies alongside the indication that viruses have the potential to induce beta cells damage and reduce insulin production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Type 2 diabetes

A
  • does produce insulin, but either produces less insulin than it should or it doesn’t know how to use insulin
  • a condition where the body does not use insulin properly due to a progressive loss of adequate beta cell insulin secretion
  • insulin deficiency = doesn’t make adequate insulin
  • insulin resistance = when the body cannot use insulin well
  • body needs more insulin to help glucose enter cells and the pancreas makes more insulin at first
  • 90-95% of all cases of diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Type 2 diabetes diagram (slide 10)

A

Normal:
- pancreas produces insulin
- insulin moves glucose to the cells
Diabetic:
- pancreas produces less insulin
- insulin moves less glucose to the cells

  • test question ex: if somebody’s pancreas is working and it making insulin, it cannot be type 1 diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Etiology of type 2 diabetes

A
  • insulin resistance and beta cells dysfunction are known to be the major factors associated with type 2 diabetes
  • genetics, age, ethnicity, and lifestyle factors such as being overweight or obese and not being physically active
  • body fat location and distribution, in particular the extra-abdominal fat, is associated with insulin resistance
  • although individuals can develop type 2 diabetes at any point in time, even during childhood, it most often occurs in middle-aged and older adults 45 years or older
  • presence of high blood pressure, abnormal cholesterol or triglyceride levels, smoking, and use of certain medicines such as steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Difference between type 1 diabetes and type 2 diabetes

A

Type 1 diabetes:
- body doesn’t make enough insulin
- caused by immune system reaction
- often starts in childhood
- symptoms come on quickly
- treated with insulin injections
Type 2 diabetes:
- body doesn’t respond to insulin
- lifestyle factors and genetics contribute
- more common in middle age
- symptoms develop slowly
- managed with drugs and lifestyle changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Gestational diabetes

A
  • pregnant women go take a glucose tolerance test and then 2 hours later, get bloodwork to see blood sugar level
  • transient in nature
  • typically diagnosed in 2nd or 3rd trimester of pregnancy in women that might not have clearly overt diabetes prior to gestational
  • it is due to either hormones blocking the action of insulin to the body or when the body is not able to make and use all the insulin in needs during pregnancy leading to insulin resistance
  • every year, 2-10% of pregnancies in the U.S. are affected by gestational diabetes
  • postpartum, blood sugar levels usually return to normal; however, about 50% of women with gestational diabetes will eventually develop type 2 diabetes
  • high blood glucose levels in mother
  • brings extra glucose to the baby
  • causes baby to put on extra weight (10-12 pounds)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Other specific types of diabetes

A
  • monogenic diabetes = related to a change or defect in a single gene and include neonatal diabetes mellitus (NDM) and maturity-onset diabetes of the young (MODY)
  • NDM = a rare condition that occurs in up to 1 in 400,000 infants in the first 6-12 months of life and is often mistaken for type 1 diabetes
  • MODY = characterized by onset of hyperglycemia due to impaired insulin secretin at an early age (typically before age 25 and accounts for up to 2% of all cases of diabetes in the United States in people ages 20 and younger
  • other specific types of diabetes include diseases of the exocrine pancreas (ex: cystic fibrosis-related diabetes (CFRD) and pancreatitis) and drugs or chemical-induced diabetes (ex: with glucocorticoid use, in the treatment of HIV/AIDS, or after organ transplantation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Prediabetes

A
  • blood glucose levels within the range of normal to high and meet other diagnostic criteria for diabetes
  • individuals in this intermediate zone present with impaired fasting glucose levels (100-125 mg/dL) and impaired glucose tolerance levels (140-199 mg/dL)
  • prediabetes is associated with obesity, dyslipidemia (high cholesterol), and hypertension (HTN), and those diagnosed are at an increased risk for diabetes and cardiovascular disease (CVD) in the future
  • lifestyle modifications including participation in prevention programs that target increasing physical activity, losing weight, managing stress, problem solving, and eating health can delay or prevent progression to type 2 diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Incidence and prevalence of diabetes in the U.S.

A

Diabetes:
- 38 million people have diabetes
- 1 in every 10 people
- 1 in 5 people don’t know they have it
Prediabetes:
- 98 million American adults have prediabetes
- more than 1 in 3 have prediabetes
- more than 8 in 10 adults with prediabetes don’t know they have it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Risks of diabetes

A
  • blindness
  • kidney failure
  • heart disease
  • stroke
  • loss of toes, feet, or legs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Risk factors for type 2 diabetes

A
  • being overweight
  • having a family history
  • being physically inactive
  • being 45 or older
  • when you have too much insulin, you will have low blood glucose = hypoglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Signs and symptoms of diabetes

A
  • hypoglycemia
  • hyperglycemia
  • diabetic ketoacidosis (DKA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hypoglycemia

A
  • low blood sugar
  • drops below 70 mg/dL
  • need for immediate treatment
    Risk factors:
  • types of diabetes, types of medicines
  • not eating enough carbohydrates, skipping or delaying meals, increasing physical activity, drinking too much alcohol without enough food, or being sick
  • muscles need glucose to contract
  • when people get light headed, give orange juice or something surgery to give glucose
  • people with diabetes have constant fluctuation glucose levels
  • ways to test blood sugar = prick the ginger and get a drop of blood into the glucometer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Symptoms of hypoglycemia

A

Mild to moderate:
- shaky or jittery
- irritability, nervousness, or anxiousness
- sweating, chills, or clam mines
- confusion, disorientation, or troubles concentrating
- fast or irregular heartbeat
- dizzy or lightheaded
- hungry
- nausea
- pallor or pale skin
- weakness, low energy, sleepiness, and tired
- coordination problems or clumsiness
- changed behavior or personality
- blurred or impaired vision
Severe:
- unable to eat or drink
- seizures or convulsions (jerky movements)
- unconsciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hyperglycemia

A
  • high blood sugar
  • above 125 mg/dL while fasting or 180 mg/dL 1-2 hours after eating
  • occurs when the body has too little of insulin or when the body cannot use insulin properly
  • if left untreated, hyperglycemia can lead to complications affecting multiple systems and organs producing further impairments associated with diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hyperglycemia having complications on multiple systems like

A
  • atherosclerosis
  • retinopathy glaucoma cataracts
  • gum disease
  • CVA
  • CVD
  • hypertension
  • nephropathy
  • autonomic neuropathy
  • peripheral neuropathy
  • PAD
  • diabetic foot
  • peripheral neuropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Symptoms of hyperglycemia

A
  • weight loss
  • frequent urination
  • fatigue
  • slow healing
  • being thirsty
  • blurred vision
  • always hungry
  • tingling on hands
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Difference between hypoglycemia and hyperglycemia

A

Hypoglycemia:
- T = tachycardia
- I = irritability
- R = restless
- E = excessive hunger
- D = dizziness
- pallor/clammy
Hyperglycemia:
- polyphagia = more hunger
- polyuria = more urinating
- polydipsia = more thirsty
- dry skin
- blurred vision
- delayed wound healing

24
Q

Diabetic ketoacidosis (DKA)

A
  • life-threatening symptom (happens in type 1 diabetes)
  • a diabetic emergency
  • ketones are made by the body’s liver from the breakdown of fats for energy and formed when there is not enough insulin to use glucose
  • high concentrations or a buildup of these ketones in the bloodstream
  • can develop rapidly and clients present with polyuria, polydipsia, polyphagia, weakness, and a deep rapid breathing pattern
25
Q

Warning signs and symptoms of diabetic ketoacidosis (DKA)

A
  • thirst or dry mouth
  • frequent urination
  • high blood glucose levels
  • high level of ketones in the urine
  • fatigue
  • dry or flushed skin
  • nausea, vomiting or abdominal pain
  • difficulty breathing
  • fruity odor on breath
  • problems with attention or confusion
26
Q

Warning signs of diabetes

A
  • polyuria = frequent urination
  • polydipsia = increased thirst
  • polyphagia = increased hunger
27
Q

Diabetes

A
  • type 1 diabetes often seek medical attention after their first experience of DKA = medical emergency
  • type 2 diabetes may first experience symptoms associated with prediabetes, such as extreme hunger, thirst, and fatigue, slow healing cuts and bruises, and blurred vision
28
Q

Measure glucose levels

A
  • fasting plasma glucose value (FPG)
  • the fasting 2-hour plasma glucose value/Oral glucose tolerance test (2-h PG, OGTT)
  • A1C criteria
29
Q

Course and prognosis of diabetes

A
  • advances in medical management have resulted in improve longevity and quality of life for individuals = developments and innovations in medications, testing, and blood glucose monitoring
  • overall life expectancy for individuals with diabetes remains lower than the general population because of secondary complications
  • type 1 = 12 years less on average
  • type 2 = 10 years less on average
30
Q

Diabetic complications

A

Microvascular complications:
- retinopathy (eye damage)
- nephropathy (kidney damage)
- neuropathy (nerve damage)
Macrovascular complications:
- CVA (stroke)
- CVD (heart)
- PVD (pain in limbs)

31
Q

Diabetic retinopathy (microvascular complication)

A
  • most common complication of diabetes
  • microvascular changes in the retina and can cause blurred vision, impaired peripheral vision, “floaters” in the visual field, or, in more severe cases, blindness
32
Q

Diabetic nephropathy (microvascular complication)

A
  • 30-40% of people diagnosed with type 1 or type 2 diabetes will develop diabetic nephropathy (kidney failure)
  • pathology and structural changes in the kidneys of person with type 1 or type 2 diabetes causing impaired kidney function
  • diabetic nephropathy and diabetic kidney disease are the leading causes of end-stage renal disease in the U.S.
  • requires dialysis treatment of kidney transplant for survival

Normal kidney:
- health function
- proper size
- low urine protein
Kidney disease:
- granular surface
- decreased function
- smaller size
- high urine protein

33
Q

Hemodialysis

A
  • when kidneys stop functioning, you have to go on a dialysis
  • dialysis = a port on somebody’s arm (sometimes in their chest) that takes out the blood into the machine to filter it and then puts the blood back into the body
  • doesn’t urinate if you’re on dialysis
  • if can’t do dialysis on time, you have all this unfiltered blood in your body and you gain weight, have extra fluid
34
Q

Macrovascular complications

A
  • affect the cardiovascular system and include hypertension, CVD, CVA, and PAD
  • poor glycemic control have higher rates of hypertension
  • high blood sugar levels leads to atherosclerosis = CVA
  • aggressive blood pressure and cholesterol management are critical to addressing macrovascular complications with individuals with diabetes
35
Q

Diabetic peripheral neuropathy (neurologic complication)

A
  • affects about half of all persons with diabetes
  • risk factors include poor glucose control duration of diabetes, hypertension, hyperlipidemia (high cholesterol), and smoking
  • symptoms include burning, tingling, pain, numbness, and/or loss of protective sensation (need to do skin checks)
  • typically, symmetrical and occurs in a “stocking and glove” type distribution beginning ideally and progressing proximally
36
Q

Diabetic autonomic neuropathy (neurologic complication)

A
  • affects the autonomic nerves that innervate body organs
    Cardiovascular:
  • arrhythmia, ischemia, myocardial events, or sudden death
  • tachycardia, orthostatic hypotension, faintness, weakness, palpitations, and syncope
    Gastrointestinal:
  • esophageal dysfunction, indigestion, gastroparesis, diarrhea, constipation, or fecal incontinence
  • gastroparesis, or delayed gastric emptying, can cause severe cramping, bloating, nausea, and bowel irregularities
    Genitourinary:
  • sexual dysfunction or bladder dysfunction
  • erectile dysfunction, and women may experience painful intercourse, inadequate lubrication, or decreased sexual arousal
    Sudomotor:
  • dry skin, lack of sweat, and cracks on the skin
37
Q

Neurodegeneration and cognitive dysfunction

A
  • older adults with type 2 diabetes show a higher incidence of neurodegenerative diseases such as Alzheimer’s disease
  • a higher rate of cognitive decline and institutionalization
  • type 3 diabetes is a term used to describe the hypothesis that Alzheimer’s disease is caused by insulin resistance in the brain (not widely accepted by the medical community as a clinical diagnosis)
  • too much blood sugar kills of the blood vessels in the brain, leading to brain fog
38
Q

Diabetes distress

A
  • refers to the psychological impact of living with a chronic and progressive condition and the emotional response to stressors such as medications and dosing schedules, adherence to diet, anxiety about existing or possible complications, guilt for periods of poor self-management, impact of the disease on family or friends, feelings of guilt or shame, or fear of hypoglycemia
  • patient and their partners or families
  • feeling of DM-controlled life
  • feeling of missing support from Healthcare Providers
  • social isolation or feeling a lack of social support
  • life quality of related other issues
  • living with a chronic illness
  • anger of living the entire life with DM
39
Q

Diabetic foot ulcers

A
  • you don’t feel it at all
  • sores or lesions in the soft tissue of the foot caused by a combination of factors such as peripheral neuropathy and vascular complications, weight on the lower extremity, and activity levels
  • smoking increases the risk
40
Q

Periodontal disease

A
  • caused by the presence of bacteria (ex: dental plaque) and results in chronic inflammation to the gums, periodontal ligaments, and oral bones
41
Q

Medical management of diabetes

A
  • blood glucose monitoring
  • glucometer
  • continuous glucose monitoring system (CGM)
42
Q

Blood glucose monitoring

A
  • glucose monitoring has been shown to improve A1C levels and decrease diabetic complications for people with type 1 diabetes
  • identification of hypoglycemia, hyperglycemia, and general glycemic variability allows a person with diabetes to determine how blood glucose levels may be affected by diet, activity level, stress, illness, injury, and/or medications
  • tracking trends or patterns in blood glucose levels provides information used to determine the effectiveness of current management and assists in the modification and tailoring of insulin or medication dosages
43
Q

Glucometer

A
  • a blood sample is taken using a small lancing device and the sample is placed on the test strip for analysis by the glucometer
  • type 1 diabetes test their blood sugar 4-10 times a day
  • before and after meals or snacks
  • before and after exercise
  • before bedtime
  • if there’s a suspicion of hypoglycemia or hyperglycemia
  • before driving or travel
  • while taking a new medication
  • type 2 diabetes should check their blood sugar several times a day if they are using insulin
44
Q

Continuous glucose monitoring system (CGM)

A
  • a reusable transmitter and small subcutaneous catheter inserted into the body to obtain real-time glucose readings from interstitial fluid
  • readings are taken at regular intervals and can be sent to an insulin pump, a smart phone or other receiver with the CGM system app
  • CGM software allows blood glucose results to be shared in real time with others involved with the person’s care, such as a school nurse, coach, or parent
  • helpful in decreasing hypoglycemic fear and diabetes-related stress
45
Q

Medical management for type 1 diabetes

A
  • type 1 diabetes is a lifelong condition that requires significant and vigilant ongoing medical management
  • daily routines must incorporate insulin replacement, frequent blood glucose monitoring, and carbohydrate, protein, and fat counting
  • insulin replacement injections
46
Q

Insulin replacement

A
  • insulin is typically injected subcutaneously in the fat under the skin to reach the bloodstream (cannot be taken orally because its proteins would be destroyed during the digestive process)
  • delivered using a syringe, an insulin pen, or via continuous subcutaneous infusion using an insulin pump
  • Bolus insulins = rapid-acting insulins (ex: NovoLog, Apidra, Humalog) and short-acting insulins (ex: Humulin R, Novolin R) are absorbed quickly into the bloodstream (begins working 5-30 mins after injection, making them a good choice for a mealtime or correction bolus)
  • Basal insulins = intermediate-acting insulins and long-acting insulins are typically used to control glucose using the night and between meals (begins working 2-4 hours after injection and remains in the bloodstream for up to 12-24 hours)
  • may use both = typical insulin protocols require once or twice daily injections of basal insulin and several bolus insulin injections taken with each meal or snack
47
Q

Insulin protocols

A
  • a thorough understanding of portion size, carbohydrate counting, the effects of fats and proteins, glycemic index, and an understanding of dosage ratios is all necessary for effective and safe basal/bolus insulin therapy
48
Q

Insulin pump

A
  • insulin pumps are small devices that are attached to the body on the skin, or by way of a small tube and cannula
  • programmed to work like the pancreas, delivering continuous customized basal doses of insulin and user-directed bolus doses to cover meals, or to correct hyperglycemia
49
Q

Medical management for type 2 diabetes

A
  • lifestyle changes = initially managed with the incorporation of nutritional strategies and regular exercise into daily routines
  • patient education
  • nutrition therapy = must understand the impact of facts, carbohydrates, and proteins in their blood sugar; understand the glycemic index of foods, or how they affect blood glucose levels; foods high in simple sugar have a higher glycemic index and affect blood glucose more significantly and more quickly, while whole foods higher in complex carbohydrates have lower glycemic index and are more slowly digested, absorbed, and metabolized, lessening their immediate impact on blood glucose
50
Q

Regular exercise (lifestyle change)

A
  • improved control of blood glucose, improved cardiovascular health, contributes to weight loss, and increased overall well-being
  • recommends that children or adolescents with type 2 diabetes engage in a minimum of 60 minutes of moderate-intense aerobic activity per day and resistive strengthening exercise at least 3 days per week
  • for adults, the recommendation is 150 minutes or more of moderate-vigorous aerobic activity per week and 2-3 sessions of resistive strengthening exercise per week
  • periods of prolonged sitting should be avoided and it is recommended that older adults with diabetes also engage in flexibility and balance training 2-3 times per week
51
Q

Weight control (lifestyle change)

A
  • beneficial in the treatment of type 2 diabetes and can delay the progression of prediabetes to a diagnosis of diabetes
  • modest and sustained weight loss has been shown to improve insulin sensitive and beta cell function yielding improved blood glucose control
  • decrease the need for glucose lowering medications
52
Q

Pharmacological management

A

Glucose lowering oral medications:
- decreased the release of glucose from the liver
- increases insulin production
- improves insulin sensitivity
- delaying breakdown of sugar
Metformin:
- decreases the release of glucose from the liver
- relatively low incidence of side effects
Injectable medications are also available to treat type 2 diabetes:
- these drugs work to lower the amount of glucose released by the liver, keep the food in the stomach longer, and increase insulin production
Effectiveness may decrease over time:
- insulin replacement via injection or insulin pump to manage blood glucose

53
Q

Occupational implications on health management (diabetes)

A
  • developing, managing, and maintaining routines for health and wellness by engaging in self-care with the goal of improving, or maintains health, including self-management, to allow for participation in occupations
  • adjust eating, exercise, and stress management habits and routines
  • monitor and control symptoms, manage medications, and communicate with the health care system
  • self-management education is critical for implementing and sustaining performance patterns that prevent further complications and support overall health
  • informed decision-making, collaboration with the healthcare team, enhanced problem-solving behaviors, and the development of new self-care skills
  • complete and thorough understanding of blood glucose monitoring, insulin dosage, dietary intake, device care and maintaining, the effects of activity and exercise, and signs and symptoms of hypoglycemia and hyperglycemia is essential
54
Q

Occupational implications on ADLs (diabetes)

A
  • periodontal disease
  • skin care
55
Q

Occupational implications on IADLs (diabetes)

A
  • shop for groceries and prepare health meals
56
Q

Occupational implications on rest and sleep (diabetes)

A
  • poor sleep can affect glycemic control and performance of daily occupations

Clinical Conditions (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions