Endocrine - Diabetes (Type 1, Type 2, Gestational, Prediabetes) Flashcards
Type 1 diabetics have ______ or ____ insulin ?
Little or no
When is Type 1 diabetes typically diagnosed ?
Childhood
What is the cause of Type 1 diabetes ?
- Auto-immune response (Type 1A)
- Idiopathic (Type 1B)
________ may be the first sign of Type 1 diabetes ?
DKA
Type 1 diabetes presents how ?
Abruptly
despite years of beta cell destruction
What are the Classic 3P’s of Diabetes (Type 1) ?
- Polyuria
- Polydipsia
- Polyphagia
What is considered a normal blood glucose in someone WITHOUT diabetes ?
70-99mg/dL (3.9 - 5.5 mol/L)
What is considered a normal blood glucose in someone WITH diabetes ?
< 140mg/dL (7.8 mol/L)
80 - 130 mg/dL (4.4 - 7.2 mol/L)
Pathophysiology of Type 1 Diabetes
- you have to have __1._______ to carry ______2.___ out of the blood and into the cell
- Since there is no ____3._____, the ______4.____ just build up in the blood
- The blood becomes ______5.______ as a result, and pulls ____6.____ into the vascular space
- The kidneys then filter excess _____7._____ and ____8.______
( _________9._____ and ___10.__________ ) - The cells are starving and therefore start breaking down _____11.____ and ____12.___ for energy (Polyphagia)
- When you break down fat you get ___13._________ (acids), which now causes the client to become _______14.______ (specifically–> _____15.____ ________)
Resulting in ____16___ ? (?)
- Insulin
- Glucose
- Insulin
- Glucose
- Hypertonic
- fluid
- Glucose
- fluids
- Polyuria
- Polydispisa
- Protein
- Fats
- Ketones
- Acidotic
- Metabolic acidosis
- Kussmal respirations
In Type 1 diabetes how does the body compensate for the metabolic acidosis as a result from little to no insulin production ?
Kussmaul Respirations
- to get rid of the excess acid by breather faster and getting rid of the excess CO2 (acid)
When you hear Polyuria, what should you think of FIRST?
Shock
What symptoms should you think of when you hear Hyperglycemia ?
3 P’s
What are the s/s of Type 1 Diabetes ?
Polyuria
Polydipsia
Polyphagia
Will oral hypoglycemics work for a client with Type 1 Diabetes ?
No!
They have to have insulin
Clients with Type 2 Diabetes have what type(s) of insulin ?
Either…
- Not enough insulin
- Or resistant insulin
Type 2 Diabetics have just enough insulin, that they don’t do what ?
Don’t break down fats into ketones
& thus, don’t get acidotic like Type 1
Type 2 Diabetics are usually what ?
Overweight
Client’s with Type 2 Diabetes Can’t do what to keep up with the glucose load the client is taking in ?
Can’t make enough insulin
The onset of type 2 Diabetics is not as _________ as type 1 ?
Abrupt
True or False: Type 2 Diabetes is usually found by accident ?
Or why ?
True
B/c the client keeps coming back to the PHCP for things like wounds that won’t heal or repeated vaginal infections (Bacteria loves glucose), etc.
Individuals with Type 2 Diabetes should be evaluated for what ?
Metabolic Syndrome (Syndrome x)
What are the features of Metabolic Syndrome ?
- Waist circumference
> 40in in men
> 35in in females - Triglycerides > 150mg/dL
HDL
< 40mg/dL for males
< 50mg/dL for females - BP > 130/85
- FBS > 100mg/dL
Individuals are considered at increased risk for Type 2 Diabetes if they have what ?
3 or more features of Metabolic Syndrome present
Metabolic Syndrome is known to increase the risk for developing what 2 things ?
Type 2 Diabetes & Cardiovascular Disease
Treatment for Type 2 Diabetes should START with what ?
Diet and exercise
What are other Treatment modalities if diet and exercise don’t work for Type 2 Diabetes ?
- Adding oral agents
- Some clients may need insulin
What type of Diabetes resembles Type 2 ?
Gestational Diabetes
What do the insulin requirements look like in a mom with Gestational Diabetes ?
Mom needs 2-3x more insulin than normal
If a mom is at high risk for gestational diabetes when should they be screened at ? and re-tested at ?
The 1st prenatal visit & re-test at 24-28 weeks
ALL moms should be screened for gestational diabetes when ?
At 24-28 weeks gestation
What are complications seen in babies of moms who have gestational diabetes ?
- Increased birth weight
- Hypoglycemia
Why do babies born to mothers with gestational diabetes develop hypoglycemia ?
B/c the baby is removed from the mom’s sugary environment & it takes baby some time to stop producing extra insulin
A diagnosis of Diabetes requires what ?
2 abnormal tests
A1C in a normal person ?
About 5
A1C in a prediabetes ?
5.7 to 6.4
A1C in Diabetes ?
6.5 or higher
What is prediabetes defined as ?
Blood sugar levels that are higher than normal, but not high enough to diagnose diabetes
Are there clinical symptoms associated with Prediabetes ?
No
find out when the client is screened
What does Prediabetes put a client at greater risk for ?
Type 2 diabetes & Cardiovascular disease
How often should prediabetics be screened for Diabetes ?
yearly
