Endocrine & Metabolic 3 Flashcards
what is hypoglycemia characterized by
- shaky, hungry, weak, headache, dizziness, pallor, sweating, tachycardia
- difficulty concentrating, seizure, loss of consciousness
if hypoglycemic, blood is
- glucose <70 mg/dL
- ketones negative
- pH normal
if hypoglycemic, urine is
- glucose negative
- acetone negative
- normal output
if hypoglycemic what do you give
*15 grams of rapid acting glucose
examples of 15 g rapid acting glucose
- 1/2 cup orange juice or sugar sweetened carbonated beverage
- 1 small box raisins
- 3 or 4 glucose tablets
- **if unconscious… GLUCAGON
what is hypergylcemia characterized by
-thirsty, weak, flushed, abdominal pain, blurred vision, irritable, N/V, dehydration, kussmaul resp, fruity breath, decreased LOC
if hyperglycemic, blood is
- glucose 200 mg/dL or higher
- ketones high, large
- low pH
if hyperglycemic, urine is
- high glucose
- high acetone
- increased output
describe type 2
- associated with insulin resistance
- risk factors: obesity, low levels of physical activity, diet high in fat and family hx of diabetes
- several genes on chromosomes have been associated with predisposition for development of type 2
etiology and incidence of type 2
- family hx
- insulin resistance, glucose toxicity and eventual inadequate insulin secretion
- usually in teens over 12 (overweight) and adults >45 yrs
- gradual onset without ketosis
type 2 clinical manifestations
- obese, little to no wt loss
- Acanthosis nigricans
- Polyuria, polydipsia, may be mild or absent
- Glycosuria without ketonuria in 1/3 of cases on initial presentation
- Ketoacidosis may be present
- Fatigue
type 2 diagnostic tests
- Blood glucose levels of 200 mg/dL or greater without fasting
- Fasting glucose level of 126 mg/dL or greater
clinical therapy of type 2
- Normalizing blood glucose and Hemoglobin A1C
- Decrease weight
- Increase exercise
- Normalize lipid profile and blood pressure
- Prevent complications
describe the initial med treatment for type 2
- When the child or adolescent presents with severe hyperglycemia or diabetic ketoacidosis, insulin is usually required to gain the initial glycemic control
- Then once metabolic control has been achieved metformin is initiated and the child is weaned off insulin
describe metformin
- Metformin has been used when diet and exercise efforts are inadequate
- Metformin helps control hyperglycemia
- Metformin improves the sensitivity of target cells to insulin, slows the gastrointestinal absorption of glucose, and reduces hepatic and renal glucose production.
- So used when there is normal liver and kidney functioning and no ketosis
An autosomal recessive inherited disorder of amino acid metabolism the impacts the body’s use of protein
Phenylketonuria (PKU)
if left untreated what can PKU lead to
leads to irreversible brain damage and severe intellectual disability
what is the PKU screening
Newborn screening for PKU is required in all 50 states
PKU treatment
- Phenylketonuria is treated with special formulas and diet low in phenylalanine
- A low-phenylalanine diet is rigid and strict, families must be educated about sources of phenylalanine and a registered dietician can help with meal planning
