Diabetes Mellitus Flashcards
Diabetes
-impairment of glucose metab in which glucose is underutilized and blood glucose levels become abnormally elevated (hyperglycemia)
1 Person Dies from DM every _____
7 Seconds
Insulin
- protein hormone produced by islets of Langerhans cells in pancreas
- stimulates cellular uptake of glucose and suppress production of glucose
in absence of insulin ____
-blood glucose rises to abnormally elevated levels
Cause of diabetes mellitus
- impairment of glucose metabolism
- from defect in insulin production or reduction of insulin potency
DM
-diabetes mellitus
All cells in body require insulin for _____, except _____
- glucose to enter cell
- CNS tissue & working/exercising Mm tissue
Normal Physiology of Insulin/Glucose Relationship
- cells in body need glucose for energy
- glucose too large to pass across cell membrane
- insulin triggers transport proteins (GLUT 4) to go to cell wall
- GLUT 4 transports glucose into cell
Abnormal Physiology
-insulin not present/not sufficient amounts
-glucose collects in blood and can’t enter cells
OR
-insulin present but cell wall/transport proteins resistant to its action
-glucose collects in blood and can’t enter cells
Type 1 Diabetes diagnosed:
-in childhood (under 20 years)
Type 1 Diabetes
- body makes little/no insulin
- insulin injections required
- prone to ketoacidosis & disorders associated hyperglycemia
Type 2 Diabetes
- adulthood (>40)
- pancreas doesn’t make enough insulin for normal blood gluocose levels
- body doesn’t respond well to insulin
Children have a ____chance of developing diabetes
-1/3
Gestational Diabetes
-develops at any time during pregnancy who does not have diabetes
S/Sx Type 1 Diabetes
- polydipsia
- polyuria
- polyphagia
- weight loss
- fatigue
- nausea
- vomiting
S/Sx Type 2 Diabetes
- polydipsia
- polyuria
- polyphagia
- fatigue
- blurred vision
- slow-healing infections
- impotentce
Complications of DM
- brain damage (stroke, dementia)
- cardiovascular disease
- urinary/sexual dysfunction
- neuropathy
- diabetic coma
- retinopathy
- atherosclerosis
- kidney malfunction
- poor wound healing
to decrease risk of stroke:
- physical activity
- no smoking
- moderate alcohol consumption
- normal body weight
- low-fat diet
- high intake fruits/veggies
Neuropathy
- decr perfusion of nerve tissue
- accum of sorbitol, leading to fluid/electrolyte imbalance in nerve tissue
Atherosclerosis
- incr fat metabolism (type I)
- incr blood cholesterol levels (type I and II)
- connection between insulin resistance and atherosclerosis
Osteoporosis
-bone matrix formation inadequate if insufficient circulating insulin levels
Infection
- vascular disease leads to tissue hypoxia, decr healing ability
- pathogens which gain entrance feed on excess glucose in extracellular body tissues
- vascular disease also leads to decr WBC response
Atherosclerosis—>
- CVA
- MI
- PVD
Infection, neuropathy—->
- ulceration
- amputation
Retinopathy—>
blindness
Nephrophathy—>
- ESRD
- dialysis dependence
Osteoporosis—>
- spinal compression fractures
- hip fractures
Management of DM
-Reduce controllable risk factors
- -obesity
- -first degree relatives with DM
- -HTN
- -Hypertriglyceridemia
- -previous evidence of impaired glucose homeostasis
DM Diagnosis
- 2 hour glucose tolerance
- HbA1C (glycosylated Hb)
- fasting blood glucose
Management of DM
- earlier detection
- frequent monitoring
Exercise for DM
-monitor blood glucose levels before and after
Optimal blood glucose range prior to exercise
-100-150mg/dL
Optimal timing of exercise
- 2-3 hours after a meal
- moderate intensity to prevent abrupt changes in blood glucose
Benefits of Exercise for DM
- incr insulin sensitivity for up to 16 hours post ex’s
- improve lipid profile
- decr body fat
- reduce BP
- decr platelet stickiness
- decr stress
- prevent deconditioning
- incr socialization
Guidelines for Exercise
- 150 min/week spread over at least 3 days each week
- resistance ex’s 2-3x/week
Foot Care Instructions
- check feet daily
- wash feet daily (dry thoroughly)
- soften dry skin with lotion/patroleum jelly
- protect feet with comfy, well-fitting shoes
- ex’s daily to promote circulation
- podiatrist
- remove socks and shoes at healthcare provider appts
- stop smoking
