Treating Patients with Diabetes Flashcards

1
Q

List the four types of diabetes

A

Type 1
Type 2
Gestational diabetes
Pre- diabetes

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2
Q

Describe type 1 diabetes

A

Antibodies attack insulin making cells in the pancreas, thus, cells cannot uptake sugar to use as energy
• As a result the body burns its own fats as a substitute
• Using fat as energy can result in of ketoacidosis
• Patients with type 1 diabetes depend on insulin injections daily

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3
Q

Describe type 2 diabetes

A
  • In type 2 diabetes, the pancreas cannot make enough insulin/ the body is resistant to it
  • Diabetes medications or insulin injections may also be required to control blood sugar levels
  • Associated with lifestyle risk factors including poor diet, high blood pressure insufficient physical activity and overweight or obesity
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4
Q

List the signs and symptoms of type 1 diabetes

A
  • Excessive thirst and dehydration
  • Frequent urination
  • Hunger, accompanied by weight loss
  • Blurred vision
  • Weakness, tiredness, or sleepiness
  • Vomiting or nausea
  • Sudden irritability
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5
Q

List the signs and symptoms of type 2 diabetes

A
  • Fatigue
  • Excessive thirst
  • Frequent urination
  • Blurred vision
  • Mood changes
  • High rate of infections
  • Slow healing process
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6
Q

Describe gestational diabetes

A
  • The demand for insulin increases in pregnancy. If the body is unable to keep up with this demand, gestational diabetes develops.
  • Also, the placenta produces hormones which can block the action of the mother’s insulin (insulin resistance)
  • The condition usually disappears once the baby is born
  • Increased risk of developing Type 2 Diabetes in the future for mother and baby
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7
Q

Describe pre-diabetes

A
  • Impaired fasting glucose: too much glucose released from the liver overnight into the bloodstream
  • Impaired glucose tolerance Not enough insulin produces or does not work properly or a combination of both
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8
Q

List long term complications of diabetes

A

Retinopathy- damage to the retina can lead to blindness
• Nephropathy-kidney disease-damage to the kidneys
• Neuropathy- injury to blood vessels supplying the nerves-inability to feel pain
• Muscle weakness
• Cholesterol (heart failure, stroke)

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9
Q

List oral manifestations of diabetes.

Describe the link between diabetes and periodontitis

A
Candidiasis/ Infection
• Caries
• Xerostomia
• Burning mouth syndrome
• Impaired wound healing
• Increased glucose in saliva
• Dysgeusia
• Increased risk for periodontitis and periodontitis has a negative effect on glycaemic control
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10
Q

Describe the types of medications used by diabetics and their physiology

A
  • In the form of tablets and injections
  • They work by reducing the amount of glucose released by the liver, slowing the absorption of glucose and making the body more sensitive to the insulin
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11
Q

List the ranges of BGL

A
  • 4.0 and 10.0 = treatment proceeds as normal
  • If BGL exceeds 10.0 or monitor gives abnormal result, repeat test
  • If on second test BGL exceeds 14.0 (within 2 hours of taking a meal), your patient may need to be reappointed- consult with your Clinical Educator or DO
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12
Q

Describe the histological effect of diabetes and the periodontium

A
  • Increased glucose levels in blood and GCF which causes selection of periodontal pathogens
  • Degenerative vascular changes (decreased oxygen utilisation, waste elimination and PMN migration)
  • Decreased fibroblast function
  • Altered collagen (altered metabolism, decreased synthesis, increased collagenase activity)
  • PMN function (decreased chemotaxis, adherence, phagocytosis & oxidative killing)
  • Increased pro-inflammatory cytokines (IL-1β & TNF-α)
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13
Q

Discuss the impacts of diabetes on vascular TISSUES and talk about HbA1c

A
  • High BGL cause the endothelial cells lining the blood vessels to take in more glucose
  • These cells form more glycoproteins on their surface and the basement membrane becomes thicker and weaker
  • The walls of the vessels become thick but weak and results in bleeding, leaked protein and a slow flow of blood through the body
  • Some cells therefore do not get enough blood and may be damaged. e.g. diabetic retinopathy, diabetic nephropathy and diabetic neuropathy
  • HbA1c: refers to glycated haemoglobin (glucose attached to the haemoglobin)
  • The higher the HbA1c, the greater the risk of developing diabetes-related complications
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14
Q

Describe hypoglycemia and hyperglycemia and patient management

A

Hypoglycemia
• Low blood sugar
• Give sweets (glucose gel under tongue)

Hyperglycemia
• Excess blood sugar
• Call 000 or 2222

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15
Q

Discuss the management of diabetes during treatment

A

Medical history:
• Need to determine whether Type 1 or Type 2
• Determine if meds have been taken

• Determine when patient has last eaten

Vital signs
• Determine when BGL was last checked, and value measured
• Check BG prior to treatment
• Record the BGL in patient file

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16
Q

List the target levels for type 1 diabetes

A

Before meals: 4 - 6 mmol

2 hrs after meals: 4- 8 mmol

17
Q

List the target levels for type 2 diabetes

A

Before meals: 6 - 8 mmol

2 hrs after meals: 6- 10 mmol

18
Q

List things that affect glucose levels

A
  • Medication
  • Food
  • Exercise or physical activity
  • Illness or pain
  • Emotional stress
  • Testing techniques used
  • Periodontal diease
19
Q

list risk factors for gestational diabetes

A
  • > 30 years of age
  • family history of diabetes
  • overweight
  • ATSI
  • gestational diabetes during other pregnancies
  • difficulty carry a pregnancy full term
  • certain ethic groups
20
Q

state weather diabetes can cause dental caries

A
  • no clear identification has been clarified
  • however, people with diabetes often have xerostomia, periodontal issue, and experience salivary dysfunction which are all risks for dental caries
21
Q

Describe histological effects of chronic hyperglycemia on the periodontium

A
  • stimulates macrophages= iL-1 & TFNa= tissue destruction
  • Impaired Chemotaxis= increased collegenses= tissue destruction
  • causes glycation of capillaries= thickening/weakening= promotes poor healing
  • Altered fibroblast activity= poor healing
22
Q

what is Hba1c? describe is significants to diabetes including its target range

A
  • known as the amount of glucose attached to haemaglobin in red blood cells
  • measuring Hba1c gives an overall picture of what an average blood sugar levels has been over a period of weeks/ months
  • this is important as the higher the Hba1c, the greater risk of developing diabetes-related complications
  • The usual target for Hba1c is less then 7%