Diabetes (Diabetes Week 9) Flashcards
Types of diabetes
- type 1
- type 2
- gestational
- secondary: latrogenic - usually type 2
What is latrogenic?
Getting diabetes (or other disease) from another disease process
* e.g. critical care patients have problem with glycemic control due to inflammatory environment they experience
* may experience with medications
Prevalence of diabetes mellitus
5% - 9% of Canadian population
* Incidence is rising (obesity rising)
* Incidence increases with age
* Many people with the disease are not diagnosed
* Seek medical attention for complications and then diagnosed (i.e. eyes, kidney)
Characteristics of T2D
- Slow onset
- β cell dysfunction and/or relative insulin resistance: insulin levels may be normal or above normal, insulin does not function adequately
- Increased hepatic glucose output
- Increased incidence with obesity: adipose tissue is more insulin resistant, weight loss usually diminishes symptoms
- Genetic link (more than 1 gene involved)
- PA is important and if caught early wt loss can help with remission
Characteristics of gestational diabetes
Any degree of glucose intolerance with onset during pregnancy
* Associated with weight gain
* increased risk for larger size delivery which can increase birthing complication
* increased risk for diabetes in offspring
* potential impaired liver function
At six weeks post-partum reclassify
* diabetic
* impaired fasting glucose
* impaired glucose tolerance
* normoglycemia
Usually resolves after delivery if you have normal post partum weight loss but there is still risk of disease later in life
Metabolic syndrome risk factors and defining levels
Describe secondary diabetes
As a result of another disease/treatment
* e.g. corticosteroids, cystic fibrosis; patients receiving organ tx on corticosteroids. Not that common for patients with IBD but still possible if on long term steroids
* Need to treat it as the same risk for long term complications
Prevalence of T2D
more common in adults - usually diagnosed after 40 yrs (but becoming younger)
* 10-30 fold increase in children (10-15 yrs)
Major symptom of diabetes mellitus
hyperglycemia - biggest culprit before other symptoms appear and associated with beta cell dysfunction
* Lack of insulin production
* Lack of insulin secretion
* Insulin resistance
Symptoms of diabetes
Nurses check urine via dipstick
* above renal trheshold of 10-12 mmol
* sugars in urine may be because of infection
fatigue causing changes in metabolism
* Want to eat more because they arent getting enough delivered to tissues (polyphagia)
excess ketones will impact blood and can cause issues with breathing
delayed gastric emptying
Diagnosis of diabetes mellitus
OGTT - 75 grams. Pregnant women will do this to see if they are at risk for gestational diabetes
Signs and symptoms of diabetes
- Polyphagia
- Polyuria
- Polydypsia
- weight loss (unintentional)
- fatigue/ weakness
- poor wound healing/ ↑ infections
- blurred vision
- tinging/numbness in extremities
polyphagia
body feels as though it is starving; lack of insulin
function prevents transfer of glucose from blood
polyuria
- hyperglycemia above renal threshold of ~13.5mmol/L causes glucose to be lost in urine
- ↑ glucose in urine ↑ urine production
polydypsia
↑ urine production ↑ water loss ↑ thirst
