Diabetes & Hypo glycermia Flashcards
What is PKU?
Phenylketonuria.
Genetic disability to break down Phenylalanine (an essential amino acid)
seen in infants (if not diagnosed early will lead to death)
What are the S/S of PKU?
Skin rash
(3-6 months) irritability, franticness, sleeplessness
(1 y/o) irreversible brain damage
What is the treatment for infants diagnosed with PKU?
Strict diet while young. Low Phe. Formula (phenylalanine is an essential amino acid and almost impossible for you to eliminate Phe. entirely b/c it’s in a lot of food). Usually diet becomes less strict with age and most PKU babies are able to live normally w/o watching everything they eat
What is Galactosemia?
genetic inability to convert galactose into glucose.
Diet restriction: Milk
What are the complications of Galactosemia?
vomiting, diarrhea, liver enlargement, nervous system damage, coma, death
Galactose is in ________ found in _____ milk.
Lactose. Cow.
What is Diabetes Mellitus characterized by?
elevated blood glucose concentrations, disordered insulin metabolism, inability to secrete sufficient insulin, use insulin effectively, or both
Type 1 and Type 2
Which is the most common type of DM?
Type 2
What is IDDM?
Insulin Dependent DM - Type 1
produces little or no insulin: AUTOIMMUNE destruction of pancreatic beta cells
occurs in young people
SEVERE symptoms
What is NIDDM?
Non Insulin Dependent DM - Type 2
Overweight people over 40, obese kids can develop this
moderate symptoms
Can Type 2 diabetes lead to Type 1?
yes
What are the acute complications of Diabetes?
Hyperglycemia
Glycosuria
Diabetic Ketoacidosis
Hypoglycemia
What is Hyperglycemia?
high blood glucose
can cause damage to the blood vessels, nerves, and tissues
S/S
thirst, fatigue, acetone breath, labored breathing, hunger, blurry vision, increased urination
What is Glycosuria?
glucose in the urine.
-plasma glucose concentration exceeds renal threshold, passes to urine
Glucose draws additional water leading to POLYURIA (excessive urination) and POLYDIPSIA (excessive thirst)
What is Diabetic Ketoacidosis?
increased activity of glucagon.
- breakdown of triglyceride and protein
- fatty acid oxidation and gluconeogenesis (gluconeogenesis further increased blood glucose)
- excessive amount of ketones (acid) in the blood, low pH (ketoacidosis), spill into the urine (ketonuria - presence of ketones in the blood)
Hypoglycemia
low blood glucose
inappropriate management of diabetes (too much insulin, skipping meals, excessive insulin)
s/s
Hunger, shakiness, headache, nervousness, sweating, confusion, heart palpitations, slurred speech, double vision
Chronic Macrovasuclar Complication of Diabetes
- damage to the blood vessels
- development of atherosclerosis
- increased tendencies for thrombosis
- impaired blood flow in the arteries will give you claudication, foot ulcers, and gangrene
What is claudication?
pain while walking
Macrovascular complications are especially common in what form of Diabetes? what are the risk factors?
DM II
multiple risk factors: obesity, HTN, abnormal blood lipids
Is claudication an early or late stage of diabetes?
late sign
What are the 3 types of Chronic Microvascular Complication of Diabetes
Diabetic retinopathy
Diabetic nephropathy
Diabetic neuropathy
What is Diabetic Retinopathy?
EYES
- damage to the small vessels in the retina
- Defective blood flow: damage and scaring of the retina
- can result in blindness
What is Diabetic Nephropathy?
KIDNEY
-damage to small vessels in the glomeruli —- contributes to — abnormal protein losses in the urine (Microalbuminuria)—will experience —decrease in urine production due to kidney damage
What is Microalbuminuria?
abnormal protein losses in the urine
What id Diabetic Neuropathy?
NERVE
- nerve degeneration in 50% of the cases
- will have pain, numbness, tingling sensation, loss of sensation
- contributes to the development of foot ulcers
- other abnormalities: sweating abnormalities, sexual dysfunction, constipation, and delayed stomach emptying (gastroparesis)
What is Gastroparesis?
delayed stomach emptying
What is the treatment for diabetes?
- carbohydrate-controlled diet
- the importance of a low glycemic index diet
- HbA1c levels under control
Describe the Glycemic Index?
an indicator of the effect carbohydrates have on sugar levels in the blood after ingestion (how fast a carb is broken down and raises the blood sugar)
ranges from 1-100
High Glycemic Index
carbohydrates turns into glucose quickly, rapid rise in blood glucose
Low Glycemic Index
carbohydrates break down more slowly, releases into the blood stream at a gradual pace
Below 55
What is HbA1c?
- a parameter for monitoring diabetes
- Glycated Hb or glycosylated Hb: Hb with glucose attached to an amino acid, does not carry oxygen well
What is a normal Hb1Ac ?
less than 6% (person w/o diabetes)
What Hb1Ac range is indicative of poorly controlled diabetes?
6-14%
What is the Target Hb1Ac for DM patients?
below 7%
