Diabetes Flashcards
___ million people have diabetes
Thats about 1 out of every 11 people
1 out of 4 do not know they have diabetes
29.1
What happens when we eat?
Energy
Most food is turned into blood glucose, the body’s main source of energy
Glucose is a sugar that is taken up into the cell by insulin and used as energy
Insulin is a hormone made and secreted by the beta cells of the islet of Langerhans in the panrease
In people with diabetes, glucose stays in a healthy range because insulin is released at the ……
right times and in the right amounts
3 Possible Reasons for Diabetes??
- Too little insulin is made
- Liver releases too much glucose
- Cells cant use insulin well
In diabetes, blood glucose builds up for several possible reasons…
Hyperglycemia
- Too little insulin is made
- Cells cant use insulin well
- liver relases too much gucose
what are the 2 types of diabetes
- Type 1 Diabetes
- Pancreas makes too little insulin or non at all - Type 2 Diabetes
- Cells do not use insulin well
- Ability for pancreas to make insulin decreases over time
•1 in 10 people with diabetes have Type 1 •Most people are under the age of 20 when
diagnosed •Body can no longer make insulin
Insulin is always needed for treatment of Type 1
Ty pe 1 Diabetes (formally known as insulin dependant)
What is needed with TYPE 1 DIABETES
Insulin is always needed for treatment of type 1
Type 1 diabetes is an ____ disorder
autoimmune
Type 1 Diabetes: Hyperglycemia is secondary to __ deficiency
Insulin
Insulin is not being produced as needed to help glucose enter the cells due to destruction of pancreatic beta cells.
Type 1 Diabetes
Type 1 Diabetes : At diagnosis, ___% of the beta cells have already been destroyed.
80-90
Symptoms of Type 1 Diabetes
- Symptoms start suddenly
- Weight loss
- Loss of energy
- Increased thirst
- Frequent urination
- Hunger
- Blurred vision
9 in 10 people with Diabetes have type 2 Most people are over age 40 when diagnosed but type 2 is becoming more common in children and teens
Ty pe 2 Diabetes (formally known as Adult-Onset)
Type 2 more likely effects people who are:
- Overweight • Belong to a specific Ethnic Group
* Have a history of Type 2 Diabetes
Type 2 diabetes occurs mainly in adults- and more ____ are being diagnosed
children
Diabetes is 2-4 times higher in __ populations
• American Indians/Alaska Natives
• African Americans
• Hispanic Americans
• Asian/Pacific Islanders Educational level affects rate of diagnosis (higher education has less incidence).
minority
Type 2 Diabetes: Hyperglycemia is secondary to insulin resistance
Insulin production is ____, but is not used correctly to facilitate glucose entering the cells.
Insulin resistance occurs when cells have a decrease sensitivity to insulin.
sufficient
Symptoms of Type 2 Diabetes
Symptoms appear gradually usually subtle of no symptoms in early stages - Increased thirst - Increased urination - Felling tired - Blurred VIsion - More Frequent infections
Symtpoms may be mistaken for other situations or problems again or summer heat
Type 2 Diabetes
Overtime hyperglycemia can lead to :
long term complications of diabetes
Diabetes increases the risk of ____ blood vessel damage.
Over time __ deposits can clog large blood vessels
What are the macrovascular complications:
large
Fatty
Stroke, heart attack, poor circulation
Diabetes can lead to __ and __ blood vessel damage. Microvascular complications
nerve and small
Nerve Damage
Neuropathy
Neuropathy can cause problems in
- Feet and hands
- Heart and circulation
- Stomach, bladder, and sex organs
Small blood vessel damage can cause
blindness
kidney disease
3 bricks to diabetes management plan
- education
- healthy food choices
- medications and monitoring
What Can You Do if Diabetes or Uncontrolled Diabetes is Suspected?
•Check blood glucose if at risk for diabetes or has diabetes •Refer patient to his/her physician •Refer to Diabetes Educators •Encourage patient to care for their diabetes •Teach risk of periodontal disease and diabetes
What affects blood glucose
Increase Glucose?
Decrease glucose?
INCREASE:
- Physcial stress-illness
- Emotional stress
- Carbohydrates
- Medications
DECREASES GlUCOSE
- EXERCISE
- MEDICATIONS
Insulin major side effects : Too much glucose in cell
Hypoglycemia COnfused pale sweating shaking
Lispro Speed of Action
Rapid
Aspart speed of action
Rapid
Glulisine
rapid
regular insulin
short
NPH
intermediate
Detemir
long
Insulin glargine
long
In sulin Sensitizers Major Side Effects
•Fluid Retention
•Weight gain
•Headaches and muscle pain
•Elevated liver enzymes (should have liver
function tests prior to taking medication) •Should not take if history of Congestive Heart
Failure •Increased chance of ovulation in menopausal
women and decreases effectiveness of birth
control pills
Oral Medications for Type 2 Diabetes:
Insulin Sensitizers
Avandia
Actos
What do
Avandia
Actos improve?
Improve insulin senstiivity, helping cells use blood glucose for energy
Oral Medications for type 2 diabetes:
Sulfonylureas Amaryl DiaBeta, Glynase, Microname Glucotrol, Gluctotrol XL Diabinese
Sulfonylureas cause the pancreas to
produce more insulin, which lowers blood glucose
Glycosated hemoglobin levels-red blood cells that are bound to glucose for the life of that cell.
Test monitors how well patient is controlling the disease by taking an average of blood glucose levels over 3 months.
HbA1c Levels
eAG
estimated average glucose
Type 1
a. May need: Oral medication or oral medication and insulin alone
b. Insulin is always needed
b.
Type 2
a. May need: Oral medication or oral medication and insulin alone
b. Insulin is always needed
a
*** Biguanides Major side effects
Nausea Diarrhea Vimitting Sometiems weight loss * To decrease side effects, start with low dose and take with food, often side effects subsdie over time.
