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Clinical health midterm2 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Motivational Enhancement Therapy (MET)

A

is a method that enhances motivation to change behavior by inducing ambivalence (cognitive dissonance) and resolving it.

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2
Q

Type 1 diabetes (t1DM)

A

B-cell destruction, usually leading to absolute insulin deficiency

Previously called insulin-dependent

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3
Q

Two types of T1DM

A

(Auto)immune and idiopathic (unknown) origin

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4
Q

Type 2 diabetes (T2DM)

A

is a long term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin.

Previously called non-isuline-dependent

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5
Q

Gestational (pregnancy diabetes)

A

3-20% of all pregnancies

  • The disease ends at the end of pregnancy
  • but increases the risk of alter T2DM
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6
Q

Epidemiology of Diabetes

A

number of people has risen from 108 mill (1980) to 422 million (2010).

  • in 2015: 1.6 mill death were directly caused by diabetes.
  • WHO: leading death cause > 7th place.
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7
Q

Normal blood sugar level

A

Fasting: <6.0

2h: <7.8

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8
Q

Diabetes blood sugar level

A

Fastin: >7.0

after 2h: >11

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9
Q

Hypoglycemia

A

Low blood sugar

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10
Q

Hyperglycemia

A

High blood sugar

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11
Q

Symptoms of diabetes

A
  • always tired
  • Frequent urination
  • Sudden weight loss
  • Wounds that won’t heal
  • Sexual problems
  • Always hungry
  • Blurry vision
  • Numb og tingling hands or feet
  • Always thirsty
  • Vaginal infections
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12
Q

Symptoms of T1DM

A
  • sudden
  • increased thrust, urine, hunger
  • Decrease in body weight
  • Sadness
  • feeling tired
  • severe dehydration
  • Consequential rapid and deep breathing
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13
Q

Symptoms of T2DM

A
  • slow development
  • abdominal localized obesity
  • increased fluid consumption
  • dry mouth
  • the first symptom can be the visual impariment
  • frequent symptoms are: skin infections, body itching
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14
Q

Differences between T1DM and T2DM

A

1:
- muscle unable to use glucose due to low incline
- increased glucose due to low insulin

2:

  • muscle unable to use glucose do tu insulin resistance
  • Increased glucose in the blood stream
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15
Q

Keto-acidosis

A

potentially life-threatening complication

A type of metabolic acidosis which is caused by high concentration of ketone bodies, formed by the breakdown of fatty acids.

Include vomitting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness.

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16
Q

Diabetic encephalopathy

A

dementia due to diabetes

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17
Q

Diaebtic neuropathy

A

abnormal and decreased sensation due to diabetes

18
Q

Diabetic neprhopathy

A

Damage to kidney due to diabetes.

19
Q

Keto-acidosis is typically in..?

A

T1DM, not common or rare in T2DM

20
Q

Early theories about the cause of T1DM (WEISS and ENGLISH)

A

early trauma leads to permanent unconscious anxiety

21
Q

Early theories about the cause of T1DM (DUNBAR)

A

characteristic of people living with DM: clumsy, messy, geek

22
Q

Early theories about the cause of T1DM (ALEXANDER)

A

love and loss –> eating –> obesity –> diabetes

23
Q

Etiology of T1DM

A

Autoimmune processes:

  • hereditary factors (tendency can be inherited, not the disease)
  • Then triggers: infections, viruses; mumps, rubella; toxins; early feeding with cows milk
  • The destruction of B-cells -> insulin is needed
24
Q

Etiology of T1DM (background factor?)

A

In the background of T1DM, there is often an abnormal immune response triggered by childhood viral infection. As a result antibodies are produced against insulin-producing beta cells in the pancreas.

25
Q

The treatment of T1DM

A
  • medication and insulin therapy
  • nutrition: aim to avoid the high increase of blood sugar level due to meals
  • exercise reduce our body’s insulin requirement
26
Q

The etiology of T2DM

A

Predisposing factors:

  • obesity
  • age over 45
  • dm in family
  • hypertension
  • woman giving birth to a big fetus
  • having cardiovascular disease
  • prolonged stress or traumatic events
  • excessive energy input
27
Q

The treatment of T2DM

A
  • Losing weight > can be enough
  • Glucose lowering pills
  • lifestyle regulations

Main goals:

  • the reduction of blood glucose levels to normal or near normal levels
  • the elimination of symptoms
  • reduce the chance of complications
  • development of an appropriate quality
28
Q

Diabetic diet

A

Main goal: stable blood glucose level

No sugar!
30% fat
20% protein
No alcohol!

Eat 5-7 times, small amount

Eat carbs in every meal!

29
Q

The glycemic index (GI)

A

Is a relative ranking of carbohydrate in foods according to how they affect blood glucose levels

30
Q

Diabetics + physical excerise T2DM

A

The training helps the release of glucose into muscle cells and the insulin-sensitivity

regular physical exercise

5-10% weight loss is significant

31
Q

Psicho-somatic effect (development of T2DM)

A

Chronic activation of the physiologic stress response increase the risk of developing T2DM.

A study found that low emotional support increased the impact of job strain on T2DM in woman, but not in men.

32
Q

Traumatic life events (T2DM)

A

Childhood abuse, childhood neglect; parents who experienced the death of a child were at increased risk of developing diabetes for up to 18 years after the bereavement.

33
Q

Depression + T2DM

A

studies have found a significant association between T2DM and a previous diagnosis of depression or depressive symptoms.

34
Q

Schizophrenia & affective psychosis + T2DM

A

nonsignificant increase in t2DM for shizo.

Statistically significant increase in T2D in patient diagnosed with affective psychoses.

35
Q

Type 2 behavior pattern + T2DM

A

A Japanese study found that the risk of t2D increased with increased levels of type A behavior in women but not in men.

36
Q

A high sense of coherence (SOC) + different diseases

A

SOC is a measure of positive orientation towards life, and has been associated with lower mortality from all causes, CVD, and cancer.

A low SOC score (poorer mental health) has also been associated with an increased incidence of T2DM .

37
Q

Psychosocial factors related to diabetes self-management

A
  • High self-efficacy (confident in ability to implement their diabetes)
  • Perceived control (believe that these efforts will affect outcomes)
  • Education/knowledge
  • problem solving and coping
38
Q

Comorbid mental health problems in diabetes

A
  • Depression 30% (antidepressants could be dangerous)
  • Anxiety;
    > fear of complications in diabetes (improper education like internet)
    > OR fear of hyperglycemia
  • eating disorder: stress eating is often
  • bad cycle: stress eating > disapproval of the doctor > feeling of guilt > lower self esteem > depression > eating.
39
Q

The relevance of health psychologist in treatment of diabetes

A
  • Facilitate to accept the disease
  • Life style change
  • Emotional change
  • psychosocial factors are taken into account (education, the role of SES)
40
Q

health psychologist role in treatment of DM

A

Should identify the main areas which may affect the treatment of the disease:

  • Risk behavior: binge-eating, physical inactivity, smoking, alcohol
  • Intrapersonal factor: motivation, self-efficacy, disease related beliefs, cognitive functionalization
  • Interpersonal factors: family and social support, working conditions, connection with health workers
41
Q

Task of the health psychologist in DM treatment

A
  • behavior changing interventions: developing specific behavior, quit smoking etc.
  • motivation interview: raising motivation to promote beh. change.
  • raising the social support: improve family relationships, reduce conflicts
  • stress management training
  • Coping with the medical complications:
  • comorbid depression treatment:

Clinical health midterm2 (8 decks)

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