Obesity, Diabetes, and Infectious Diseases Flashcards
Diabetes mellitus
8% of Americans have it, this number has tripled since 1980
The result of insufficient or inadequate use of insulin (produced in Islets of Lanerhans, pancreas)
Can lead to high deposits of waste (ketones) in the blood and over metabolism and proteins (diabetic ketoacidosis), which destroys tissue
Types of diabetes mellitus
Type I
- Usually diagnosed before 30
- Formally called insulin dependent (IDDM)
- Complete lack of insulin (most difficult to regulate and treat)
- Cause is unknown
* Autoimmune-triggering event (infection, toxin)
* Genetic
Type II
- On the increase in US (especially in Children)
* Can often be managed with diet, activity
- Formally called non-insulin dependent (NIDDM)
- Obesity and inactivity, genetics, advanced age and race (AI, AA, His, C)
Gestational Diabetes (GDM)
- Occurs during pregnancy
* Increase risk of type I
- Symptoms for all types
* Malfunction in the bodies ability to make or use insulin
* Polyuria, glucose in urine, excessive thirst, weight loss, excessive eating, hard to heal, blurred vision, eventually weakness and fatigue
* Type I-fast sudden onset
* Type II- slow onset, often don’t have symptoms
Problems with diabetes mellitus
Acute: (emergency situation)
- Diabetic Coma
* Intense thirst, confusion, fruity breath, shallow breathing-coma
- Insulin Shock
* Shaky, faint, perspiration, confusion,
* Give juice
Chronic
- Slow healing- amputation
* DFU-diabetic foot ulcers
- Vascular system-organs and muscular system
* Renal failure, kidney disease - nephropathy
* Retinopathy
- Neurological-neuropathy
- Other:
* Periodontal disease
* Diabetic distress
* Autonomic Neuropathies
Common language of diabetes
Insulin - hormone produced by the pancreas that transports glucose to the body’s cells
- Needed for energy and growth and healing
Ketoacidosis - when a patient is hyperglycemic, the body breaks down it’s self, leaving ketones behind, this can be deadly, or damaging
Polydipsia - sweat a lot
Polyuria - pee a lot
Polyphagia - constant hunger/thirst
Hyperlipidemia - excessive fat and lipids in the blood stream
- Better with better treatments but still decreases life expectations
Hypoglycemia - insulin shock (too much insulin-not enough glucose)
- Trembling, seating, hunger, anxiety, confusion, death
- Give Sugar
Hyperglycemia -to little insulin
- Untreated-diabetic coma
- Major issues with vascular structures-ultimately amputation
- Hypertension over 140/90
- CVD and CVA, PAD
- Retinopathy
- Nephropathy (ESRD)
- Peripheral neuropathy
- Neurodegeneration
- Periodontal disease
OT with diabetes mellitus
Life long
- Every age group
Impact to treatment
Part of treatment
OT
- Symptom management
- Medication routines
- Foot checks
- Weight/health maintenance
- Amputation
Obesity
Public Health Crisis
On the increase in the US
Complex problem influenced by:
- Genetics
- Thryoid - metabolic issues
- Neurological links
- Vitamin D deficiency
- Stress
- Depression
- Social determinates
Obesity in children
5x more likely to be obese in adulthood
Musculoskeletal issues in adolescence
Depression
Cardiac effect
Diabetes type II
Diabetes in elderly
Changes in activity and food
Transfers and movement
Obesity impacts all ages
Depression
Cardiac disease
Diabetes and limb loss
Lymphedema
Osteoarthritis
Sleep apnea or obesity hypoventilation syndrome
Impact to ADLs, travel, social isolation, adaptive equipment
Interventions for obesity
Bariatric Surgery
- Gastric Band
- Bypass
* Of the small intestines with a small “stomach” pouch
* Permanent, non reversible
- Obera Ballon
Issues with surgery
- Overeating
- Nutritional issues
Medications
- No quick fix
- Address the psychological of eating
- Side effects
* CVA and other Cardiac issues
* Liver issues
Role of OT with obesity
Evaluation as to occupational impact
Children
- Is it impacting developmental milestones
Health Promotion
Increasing involvement in physical activity or occupations
- psychosocial and physical connection
Modifying the environment or task
Modifying dietary intake
Reducing impact of obesity
Education of client and family
Consideration in safety with adaptive equipment
Infectious diseases
Disorders that can be passed from one individual to another
- TB
- HIV
- Meningitis
- E.coli
- Hepatitis
- Flu/COVID/strep
How can we avoid infectious diseases?
Vaccinations
Universal precautions
- hand hygiene
- PPE
- respiratory hygiene and cough etiquette
- aseptic technique
- use and dispose of sharps properly
- clean and reprocess reusable patient equipment
- perform routine environmental cleaning
- handle and store waste safely
- handle and store linen safely
Precautions for contact diseases
Tuberculosis
Airborne pathogen
Cross species
- Cows, dogs
Opportunistic infection
- Areas of poverty and illness
Nearly irradiated in US until 1970s
Cough, chest pain, bloody sputum
- Can go dormant (not contagious)
- Effects multiple organs, death
Medication - resistant TB
- By law
- 6-12 months
Hepatitis
