Exam 3 - Diabetes part 1 Flashcards
What is Diabetes Mellitus?
A group of diseases characterized by high blood glucose. Due to defects in:
* Insulin secretion
* Insulin action
* Both
What are the types of DM?
- Prediabetes
- Type I
- Type I: LADA in older adults
- Type II - T2DM
- gestational diabetes
there is an 80% reversal of type II diabetes w/ bariatric surgery
What is considered pre-diabetes?
- impaired glucose homeostasis: IFG, IGT: 140-199, Hgb A1c: 5.7-6.7
- lifestyle interventions can descrease risk for type 2 diabetes
- medical management: metformin, lifestyle changes
MNT goals for prediabetes
- weight loss
- med diet style eating pattern - whole grains, fibers, moderate to no alcohol, avoid SSB
- stop smoking
Type I Diabetes
- slow or abrubp destruction of B-cells
- Smptioms when > 90% B-cells destroyed
- considered immune-mediated and idiopathic
- common characteristics: lean, polydipsia, polyuria, weight loss, ketosis
- ages 4-7 and 10-14 are really common ages to diagnose due to hormonal growth surge leading to autoimmune response
- risk factors: genetics, family history, lack of vit D, age, early exposure to cows milk (< 1 y/o), virus exposure inutero, stress
Type II diabetes risk factors
- family history of diabetes
- age 45+
- ethnicity
- physical inactivity
- overweight or obese
- high blood pressure
- high cholesterol
- smoking
Gestational diabetes
- 7% of all preganancies
- 90% are back to normal glycemic levels post delivery
- higher risk of developing T2DM
- preventing excess weight gain is important
When is gestational diabetes screened for?
- at 24-28 weeks
- diagnostic criteria are any of the following: fasting > 92 mg/dl, 1 hr > 180 mg/dl, 2 hr > 153 mg/dl
What is acanthosis nigricans?
a skin condition characterized by a dark marking (hyperpigmentation) caused by hyperinsulinemia
appears on: nape of neck, knuckles, elbows, axillae, knees, abdomen, thighs, soles of feet
What are the levels of A1c?
normal: less than 5.7%
pre-diabetes: 5.7-6.4%
diabetes: > 6.5%
What are the fasting plasma glucose diagnostic ranges?
Normal: < 100 mg/dl
pre-diabetes: 100-125 mg/dl
diabetes: > 126 mg/dl
What is hypoglycemia?
- low blood sugar
- Autonomic symptoms – shakiness, sweating, palpitations, anxiety, hunger
- Neuroglycopenic symptoms –reduced performance, difficulty concentrating and reading, mental confusion, slurred/rambling speech, bizarre behavior, fatigue, lethargy, seizure, unconsciousness
- Treatment: typically 15g simple CHO or glucagon if not able to swallow – but must be individualized
40g CHO too low, cut off is around 70g
What is diabetic ketoacidosis?
- Inadequate insulin – body uses fat
- BG >250 <600 mg/dL
- Ketones in blood and urine
- Polydipsia, polyuria, hyperventilation, dehydration, acetone breath, fatigue
- Coma and death if untreated
- Treatment: insulin, fluid/electrolyte replacement, medical monitoring
Which type of diabetes is diabetic ketoacidosis more common?
Type 1 diabetes, because they cannot make insulin
What is the symogi effect?
hypoglycemia followed by “rebound” hyperglycemia
* Often originates from ill timed insulin or excess insulin dosing before bedtime
