living with diabetes Flashcards
define diabetes
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.
diabetes fasting glucose
Fasting (no caloric intake for >8hrs) glucose: >126 mg/dl
diabetes 2 hr plasma glucose during oral glucose tolerance test
2-hr plasma glucose >200 mg/dl during a 75 gram oral glucose tolerance test
A1C levels in diabetes
> 6.5% on 2 occassions in absence of medical illness
What is pre-diabetes
peopl have increased risk for macrovascular dz (coronary artery dz, cerebrovascular dz, etc) but not microvascular.
Pre-diabetes fasting glucose, glucose tolerance and A1C
- 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”
List the signs and symptoms that a person with new onset diabetes might experience.
- 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.
List 4 types of diabetes
type 1, type 2, gestational and pancreatic
What causes type 1 diabetes and how is insulin affected
autoimmune destruction of beta cells in the pancreas. The result is insulin deficiency, but presumed normal insulin sensitivity
Features of type 1 diabetes
Childhood dz, low C peptide (insulin deficiency), genetic contribution low, positive GAD antibodies against islet antigens, normal weight, predisposed to ketoacidosis, insulin sensitive
What causes type 2 diabetes
Insulin resistance then a reduction in insulin secretion
type 2 diabetes features
More common in adults, hispanics, african americans, native americans and pacific islanders, usually overweight, strong genetic component, usually no ketoacidosis, no autoimmunity
treatment of type 1 vs type 2 diabetes
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
what causes gestational diabetes
Hormone changes and weight gain cause insulin resistance
Gestational diabetes adverse outcomes
Macrosomia (big babies), complications for mother at birth, child and mother are at risk for type 2 diabetes later in life