Diabetes 1st PPT Flashcards
What is diabetes?
-Metabolic disorder which results in hyperglycemia
-Disturbance of carbohydrate, fat and protein
-Relative or complete lack of Insulin
-Common chronic disease
-Increases risk of other diseases
What does Insulin stimulate?
Stimulates skeletal muscle fibers: to convert
Glucose to glycogen
Amino acid to protein
allows glucose uptake into cells with K+
DM is the leading cause of
End-stage renal disease (ESRD), non-traumatic lower extremity amputations, and adult blindness
Hyperglycemia is caused by
Excessive Glucose Production and impaired glucose clearance.. leading to tissue injury
Type 1 Diabetes sx
-Unexplained weight loss and easy fatigability
-Ketoacidosis*
-Irritability, drowsiness, and loss of consciousness
-Dehydration, electrolyte abnormalities, osmolality, and acid-base disturbances
-Honeymoon remission*
Type 2 Diabetes
-Often asymptomatic
-Weight loss initially
-Hyperosmolar nonketotic coma, severe dehydration: Secondary to osmotic diuresis
PMH:*uncontrolled hyperglycemia
- Frequent/recurrent infections
- poor wound healing
- blurring of vision
- numbness or tingling in the extremities
3 Cardinal symptoms of diabetes
Polyuria Polydipsia Polyphagia
Diagnosis of Pre-diabetes
A1C
FPG
OGTT
Random Glucose
A1C: 5.7–6.4% (39 mmol/L)
FPG: 100–125 mg/dL (5.6 mmol/L)
OGTT: 140–199 mg/dL (7.8 mmol/L)
Fasting is defined as
no caloric intake for at least 8 hours
Diagnosis of Diabetes
A1C
FPG
OGTT
Random Glucose
A1C: Over 6.5% (48 mmol/L)
FPG: Over 126 mg/dL(7 mmol/L)
OGTT: Over 200 mg/dL (11.1 mmol/L)
Random Glucose: Over 200 mg/dL
For OGTT the test should be performed using
a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water.
The A1C test should be performed in
A laboratory using a metho that is NGSP certified and standardized to the DCCT assay.
When would you take a random plasma glucose. In what kind of pt?
In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis
Criteria for Screening for Diabetes or Pre-diabetes in Asymptomatic Adults
Adults with overweight or obesity (BMI ≥25 kg/m2 or ≥23 kg/m2 in Asian American individuals) 1+
- First-degree relative with diabetes
- High-risk race/ethnicity
- History of CVD
- Hypertension (≥130/80 mmHg or on therapy for hypertension)
- HDL <35 mg/dL ,triglyceride level >250 mg/dL
- Individuals with pcos
- Physical inactivity
- Other clinical conditions associated with insulin resistance (e.g., severe obesity, acanthosis nigricans)
- People with prediabetes should be tested yearly.
- People who were diagnosed with GDM should have lifelong testing at least every 3 years.
- People with HIV.
For all other people, testing should begin at age ___ years.
35
-if normal repeat every 3 years
- increase frequency with initial results and risk status
Interpretation of OGTT
