DMT2 Flashcards
What ethnic groups are type 2 diabetes more prevalent in
All ethnic groups but a higher risk in non-whites
Is type 2 diabetes a rapid or slow onset
Slower onset
How long will one have type 2 diabetes before actually being diagnosed
Typically 6-7 yrs
What happens to the cells in a type 2 diabetic
They become insulin resistant
What are the four leading factors to type 2 diabetes
Insulin resistance
Pre-diabetes
Metabolic syndrome
Gestational diabetes
What is the pre-diabetes glucose tolerance test level
140-199
What is the pre-diabetes fasting blood glucose level
100-125
What is the Hgb H1C level in a person with pre-diabetics
5.7 - 6.4
How does metabolic syndrome increase risk for type 2 diabetes
Elevated glucose levels
Abdominal obesity
Elevated bp
High levels of triglycerides
Decreased levels of hdls
What level do we want our total cholesterol level to be under
Under 200
What level do we want our LDL to be under
Under 100
What level do we want our triglycerides under
Under 150
What level should our HDL be over for women
Higher than 50
What level should HDL be over for men
Higher than 40 for men
What are risk factors that could be changed before a diabetes diagnoses (4)
BMI greater than 26
Physical inactivity
HDL less than 35
Metabolic syndrome
What are non-modifiable rich factors for getting diabetes (7)
First-degree relative with dm
Members of high risk ethnic population
Women who delivered a baby greater than 9 lbs or greater or had GDM
HTN
Women with PCOS
HgA1C of 5.7% or greater
History of CVD
Signs & symptoms of type 2 diabetes (10)
Polyuria, nocturia
Polydipsia
Polyphagia
Recurrent infections
Prolonged wound healing
Vision changes
Fatigue
HgA1C 6.5% or more
FPG 126 or more
Metabolic syndrome
How can we medically manage type 2 diabetes (7)
Education
Monitoring glycemic control
Diet
Exercise
Monitoring for complications
Oral glucose control agents
Insulin if needed
What type of medication is metformin
An oral glucose medication
What class is metformin
Biguanides
Why is metformin used and what does it do
Reduces glucose production by liver
When is metformin started
Started immediately after the diagnosis of type 2 diabetes
What side effects may metformin cause (2)
Gi upset
Lactic acidosis
When can metformin not be administered
When dye in CT or MRI scans is going to be used
How long should we hold metformin when a pt will go for a scan with diagnostic dye
Hold for 48hrs before test and 48hrs after test
Why do we hold metformin for these tests that use dyes
Because the pt could go into renal failure or lactic acidosis
What is the first step in treatment of type 2 diabetes
Diet and exercise
What is the second step to treat type 2 diabetes
Lifestyle changes plus taking metformin
What is the third step in the treatment of type 2 diabetes
Lifestyle changes plus metformin and add a second drug
What is the fourth step in treatment for type 2 diabetes
Lifestyle changes plus metformin and insulin therapy
What do sulfonylureas do for a type 2 diabetic
Increase insulin production from pancreas
What are the side effects from sulfonylureas
Hypoglycemia and weight gain
What second-generation sulfonylureas are commonly used (3)
Glipizide
Glyburide
Glimepride
What can alcohol potential the effects of
Hypoglycemia
What are other medications that are not directly related to diabetes (6)
Statin drugs
Ace inhibitors
Calcium channel blockers
Angiotensen II receptor blockers
Diuretics
Beta blockers
What do statin drugs treat
Treat cholesterol and hyperlipidemia
What do ace inhibitors, calcium channel blockers, angiotensin II receptor blockers treat
HTN
Renal insufficiency
What do diuretics treat
Fluid overload and hypertension control
Why do we not put diabetics on beta blockers
It masks warning signs of hypoglycemia
What do beta blockers treat
Used for hypertension and decrease cardiovasculardisease
What should we teach a type 2 diabetic
Diet
Exercise
Wt loss
Drug therapy
Nutritional therapy
Exercise
Self-monitoring of bs
What are the long term effects of hyperglycemia
Major CVD: ischemic heart disease, stroke
Lower-extremity amputation
Dka,hhs
Skin & soft tissue infections
Pneumonia
Influenza
Bacteremia / sepsis
Tb
