Living with Diabetes

Question 1

Signs/sx of new onset diabetes

Answer 1

• Polyuria: frequent and nocturia
• Polydipsia: excessive thirst and drinking
• Hyperphagia: Eating lots
• Weight loss: as a result of protein catabolism for gluconeogenesis
• Blurry vision: osmotic shift causes lens swelling
• Fatigue
• High blood glucose
• If keto acidosis from hyperglycemia → abdominal pain, nausea, vomiting

Question 2

• Type 1 Diabetes:
  
  • Age of Onset
  • Nutritional Status at time of Disease Onset
  • Prevalence
  • Genetic predisposition

Answer 2

• Usually during childhood or puberty; symptoms develop rapidly
• Frequently undernourished
• 10% of diagnosed diabetics
• Moderate

Question 3

• Type 2 Diabetes:
  
  • Age of Onset
  • Nutritional Status at time of Disease Onset
  • Prevalence
  • Genetic predisposition

Answer 3

• Frequently after age 35; symptoms develop gradually
• Obesity usually present
• 90% of diagnosed diabetics
• Very Strong

Question 4

• Type 1 Diabetes
  
  • Defect or Deficiency
  • Frequency of Ketosis
  • Plasma Insulin
  • Acute Complications
  • Treatment with Hypoglycemic Drugs

Answer 4

• β cells are destroyed by Ab, eliminating production of insulin
• Common
• Low to absent
• Ketoacidosis
• Unresponsive

Question 5

• Type 2 Diabetes
  
  • Defect or Deficiency
  • Frequency of Ketosis
  • Plasma Insulin
  • Acute Complications
  • Treatment with Hypoglycemic Drugs

Answer 5

• Insulin resistance combined with inability of β cells to produce appropriate quantities of insulin
• Rare
• High early in disease; low in disease of long duration
• Hyperosmolar state
• Responsive

Question 6

Type 1 Diabetes tx

Answer 6

• Insulin always necessary

Question 7

Type 2 Diabetes tx

Answer 7

• Diet
• exercise
• oral hypoglycemic drugs
• insulin may or may not be necessary
• Reduction of risk factors: smoking cessation, BP control, treatment of dyslipidemia → essential to therapy

Question 8

Characteristics of gestational diabetes

Answer 8

• Pregnancy
• Positive family history of GD
• Delivery Complications, diagnose with two subsequent blood glucose tests.
• (More info to come in Life Cycles)

Question 9

Characteristics of pancreatic diabetes

Answer 9

• Surgical removal of pancreas or damage due to pancreatitis causes pancreatic diabetes
• High glucose levels due to β cell destruction, so shares many features with type 1 diabetes
• Can have malabsorption
• Individuals can be very underweight
• Glucagon deficiency
• May occur in alcoholics with liver disease
• These individuals are very prone to hypoglycemia
• Worse neuropathy because of combined neurotoxicity of EtOh and diabetes

Question 10

Patient Tools for Blood Glucose Monitoring

Answer 10

• Home glucose monitoring → finger pricking
• Continuous subcutaneous glucose monitoring (CGM)

Question 11

Factors ==> hyperglycemia in diabetics

Answer 11

• Stress (cortisol)
• increased carbohydrate intake
• [occasionally] exercise (due to epi)

Question 12

Factors ==> hypoglycemia in diabetics

Answer 12

• exercise
• glucose lowering medications
• adrenal insufficiency