living with diabetes Flashcards

1
Q

define diabetes

A

Diabetes is defined as a blood glucose that is increased to a point that it could cause microvascular disease: 1. Kidneys: proteinuria, progressing to end stage renal failure requiring dialysis. 2. Eyes: proliferative retinopathy, bleeding, potentially progressing to blindness. 3. Nerves: pain, numbness, propensity to injury, potentially leading to amputation.

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2
Q

diabetes fasting glucose

A

Fasting (no caloric intake for >8hrs) glucose: >126 mg/dl

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3
Q

diabetes 2 hr plasma glucose during oral glucose tolerance test

A

2-hr plasma glucose >200 mg/dl during a 75 gram oral glucose tolerance test

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4
Q

A1C levels in diabetes

A

> 6.5% on 2 occassions in absence of medical illness

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5
Q

What is pre-diabetes

A

peopl have increased risk for macrovascular dz (coronary artery dz, cerebrovascular dz, etc) but not microvascular.

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6
Q

Pre-diabetes fasting glucose, glucose tolerance and A1C

A
  1. Impaired fasting glucose (IFG): 100-125 mg/dl. 2. Impaired glucose tolerance (IGT): 2-hr glucose 140-199 mg/dl during an OGTT. 3. An HbA1C: 5.7-6.4% is also indicative of “pre-diabetes” or “at risk for diabetes”
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7
Q

List the signs and symptoms that a person with new onset diabetes might experience.

A
  1. Polyuria: frequent urination, and nocturia: urination at night. 2. Polydipsia: the osmotic diuresis caused by hyperglycemia produces excessive thirst and drinking. 3. Blurry vision: osmotic shifts cause swelling of the lens of the eye. 4. Weight loss: increased gluconeogenesis produces loss of muscle mass, increased lipolysis causes loss of fat mass.
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8
Q

List 4 types of diabetes

A

type 1, type 2, gestational and pancreatic

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9
Q

What causes type 1 diabetes and how is insulin affected

A

autoimmune destruction of beta cells in the pancreas. The result is insulin deficiency, but presumed normal insulin sensitivity

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10
Q

Features of type 1 diabetes

A

Childhood dz, low C peptide (insulin deficiency), genetic contribution low, positive GAD antibodies against islet antigens, normal weight, predisposed to ketoacidosis, insulin sensitive

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11
Q

What causes type 2 diabetes

A

Insulin resistance then a reduction in insulin secretion

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12
Q

type 2 diabetes features

A

More common in adults, hispanics, african americans, native americans and pacific islanders, usually overweight, strong genetic component, usually no ketoacidosis, no autoimmunity

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13
Q

treatment of type 1 vs type 2 diabetes

A

type 1: insulin always necessary and not responsive to oral hypoglycemic drugs. Type 2: responsive to oral hypoglycemic drugs, diet, exercise, insulin may or may not be necessary

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14
Q

what causes gestational diabetes

A

Hormone changes and weight gain cause insulin resistance

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15
Q

Gestational diabetes adverse outcomes

A

Macrosomia (big babies), complications for mother at birth, child and mother are at risk for type 2 diabetes later in life

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16
Q

what causes pancreatic diabetes

A

surgical removal of the pancreas or injury to the pancreas from pancreatitis- glucose levels are high b/c insulin deficiency from beta cell destruction. Similar to type 1 diabetes

17
Q

Pancreatic diabetes symptoms

A

pancreatic malabsorption causing diarrhea and steatorrhea (fat in the stool), and fat soluble vitamin deficiency, Underweight, predisposed to hypoglycemia b/c lack of glucagon

18
Q

What dz is associated with pancreatic diabetes

A

alcoholism- predisposes to hypoglycemia b/c alcohol also impaires gluconeogenesis and peripheral neuropathy b/c combined neurotoxicity of alcohol and diabetes