DIABETES MELLITUS Flashcards
a chronic multisystem disease characterized by hyperglycemia from abnormal insulin production, impaired insulin use, or both
Diabetes mellitus
what is diabetes mellitus?
a chronic multisystem disease characterized by hyperglycemia from abnormal insulin production, impaired insulin use, or both
Role of insulin
-normally released slowly in small amounts to the bloodstream
- lowers and normalizes glucose levels
-
What does mmol/l mean?
millimoles per litre
normal insulin
74-106 (4.1 to 5.9)
etiology of diabetes mellitus
-genetic
- autoimmune
- environmental factors
-absence or insufficiency of insulin supply
Insulin Dependent DM
Type 1 diabetes
what is type 1 dm?
an autoimmune disorder in which the body develops antibodies against insulin and/or the pancreatic B cells
etiology of type 1 dm
-genetic disposition (B cell destruction to exposure of virus)
-heredity
-autoimmune
clinical manifestations of type 1 dm
classical symptoms
- polydipsia
- polyuria
- polyphagia
- ketoacidosis
- recent and sudden weight loss
complications of type 1 dm is
diabetic ketoacidosis
non-insulin dependent DM
Type 2 DM
what is the characteristics of type 2 dm
-most common type
- diminished response to insulin
- characterized by a combination of inadequate insulin secretion and insulin resistance
etiology of type 2 DM
-genetic (those with 1st degree relative have 10 times more likely)
- Metabolic anomalies (insulin resistance, insulin receptors are unresponsive , insufficient in number, or both)
-Anomalies of the liver (inappropriate glucose production)
the 5 components of metabolic syndrome
- increased glucose level
- abdominal obesity
- high BP
- high triglyceride levels
- decrease high-density lipoprotein (HDL) levels
Diagnostic criteria of DM
- A1C of 6.5% or higher
- Fasting plasma glucose (FPG) level of 126 mg/dl (7.0 mmol/L) or greater.
- A 2 hour plasma glucose level of 200 mg/dl (11.1 mmol/L) or greater during an OGTT, using a glucose load of 75 g
- In a person with classic symptoms of hyperglycemia (polyuria, polydipsia, unexplained weight loss) or hyperglycemic crisis, a random plasma glucose level of 200 mg/dl (11.1 mmol/L) or greater.
what is hemoglobin A1C test
measures the amount of glycosylated hemoglobin as a percentage of total Hgb
In-range of AIC percentage
<5.7%
Prediabetes of AIC precentage
5.7-6.4%
Diabetes of AIC percentage
> 6.4%
The abcs of diabetes
A-A1c
B- blood pressure
C- cholesterol
Example of rapid-acting insulin
aspart
Apidra
lispro (humalog)
Example of short acting insulin
Regular (Humulin R)
Example of intermediate-acting insulin
NPH (Humulin N)
Example of long-acting insulin
Glargine (Toujeo)
Insulin glargine (Basaglar)
Degludec
Detemir
Onset of rapid-acting
10-30 mins
onset of short-acting
30-1 hr
onset of intermediate
1.5-4 hr
onset of long-acting
0.8-4
peak of rapid-acting
30 mins- 3 hr
peak of short acting
2-5 hr
peak of intermediate acting
4-12 hr
peak of long-acting
less defined or no peak at all
duration of rapid-acting
3-5 hr
duration of short-acting
2-5 hr
duration of intermediate acting
12-18 hr
duration of long-acting
16-24 hr
onset of inhaled insulin
12-15 min
peak of inhaled insulin
60 min
duration of inhaled insulin
2.5 -3 hr
Steps in mixing insulins
- wash hands
- gently rotate NPH insulin bottle
- Wipe off tops of insulin vials with alcohol sponge
- Draw back amount of air into the syringe that equals total dose t
