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Chronic Health Challenges > Week 11- Diabetes > Flashcards

Week 11- Diabetes Flashcards

1
Q

What ethnic groups are at higher risk for diabetes?

A

South Asian, African , Hispanic, Aboriginal

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2
Q

How much will diabetes reduce your life expectancy?

A

5-10 years

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3
Q

What are some risk factors for type 2 diabetes?

A
  • Meds (prednisone)
  • Race (South Asian, African, Hispanic, Aboriginal)
  • Hypertension
  • Stress
  • Age 65+
  • Inactivity
  • High cholesterol
  • obesity
  • Family hx (1st degree relative)
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4
Q

What is more prevalent type 1 or 2 diabetes?

A

Type 2 (90%)

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5
Q

What is the etiology of type 1?

A
  • 5-8% of diabetes
  • occurs before 20or 30
  • environmental factors- autoimmune triggers destruction of beta cells
  • genetic factors
  • hyperglycemia
  • M>F
  • 80-90% of beta cells destroyed by the time it is detected
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6
Q

What is the etiology of type 2?

A
  • 90%
  • Insulin resistance
  • Compensatory hyperinsulinemia
  • increased glucose production in the liver
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7
Q

What are goals for treatment of pt’s with diabetes?

A

Through client/family education for effective self-management:

  • Decrease symptoms
  • prevent acute complications
  • Maintain normal blood glucose levels
  • Prevent or delay chronic complications
  • enable client and career to reach an optimal level of independence
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8
Q

What are the diagnostic test for diabetes?

A

FBG= 7.0 mmol/L

A1C greater than or qual to 6.5%

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9
Q

What is the IGT for pre diabetic?

A

6.1-6.9 impaired glucose tolerance

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10
Q

When should pregnant women be screened for gestational diabetes?

A

24-28 wks

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11
Q

Who gets screened for type 2?

A
  • age 40+ (every 3 yrs)
  • Those with risk factors
  • Hx of IGT, GDM, or infant >4kg
  • CAD, HTN, or other diabetes related complications
  • 1st degree relative with diabetes, member of high risk pop, obesity, low HDLs
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12
Q

What are HDLs?

A

high density lipoproteins “good cholesterol”

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13
Q

Who gets monitored?

A

those at high risk or who have IGT

- treat with weight control and exercise and oral hypoglycemics

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14
Q

How often is A1C checked?

A

every 3 months

- should be 6.5% or under

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15
Q

What should your A1C be

A
  • should be 6.5% or under
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16
Q

What is SMBG?

A

self monitoring blood glucose

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17
Q

What is monitored?

A
  • glucose tolerance
  • risk factors
  • Tight BG control (should be 6.5% or under)
  • Frequent SMBG (best AC
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18
Q

What type of medication management is used for type 1 diabetes?

A

insulin only- multiple (3-4) daily injections or continuous SQ infusion

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19
Q

What type of medication management is used for type 2 diabetes?

A
  • Lifestyle changes
  • First line Metformin
  • Combination therapy (oral agent, bedtime insulin, insulin injections (1-4x daily)
20
Q

What does the education plan include?

A
  • Basic def and patho
  • Target glucose levels
  • How does insulin/oral meds and exercise affect each other?
  • Effect of food and exercise
  • How to give meds, manage diet
  • How to monitor blood glucose
  • Sick day management
  • Prevention and management of complications
  • Foot and eye care
21
Q

What are the benefits of physical activity?

A
  • lower blood glucose
  • helps wt loss
  • increases insulin sensitivity
  • Increased HDL
  • Lowers triglycerides
22
Q

What are the key recommendations regarding physical activity for diabetes?

A
  • Aerobic activity (bicycling, swimming, skiing, dancing, walking, jogging, ensure proper foot wear)
  • min. 3x/wk for 150 mins total (resistance training 2-3 times a week as well)
  • check glucose pre exercise; if
23
Q

What is involved with planning an exercise program for someone with diabetes?

A
  • PRESCREENING: HbA1c, stress test, FBG (fasting blood glucose), foot evaluation.
  • PREVENT COMPLICATIONS FROM EXERCISE: check risk of cardiac problems, joint problems, age; ensure hydration; diabetes ID bracelets; CHO if b.s. 13 hold off
24
Q

What happens to glucose when you exercise?

A

Generally goes down, but if vigorous exercise then it can increase glucose by releasing stored glycogen

25
Q

What are the nutritional recommendations for diabetics?

A
  • Maintain normal glucose levels
  • Balance intake based on medication and activity
  • EAT 3 MEALS/DAY no more that 6HR apart (high fibre, limit salt, eating at reg times,
  • Follow Canada’s food guide (Protein 15-20%, Fat (
26
Q

What is the protein intake recommendation?

A

15-20% of daily intake

27
Q

What is the fat intake recommendation and why?

A

Limit high fat foods (

28
Q

What is the fibre recommendation and why?

A
  • High fibre 5g + helps to have a gradual glucose release instead of rapid)
29
Q

What is glycemic index?

A

Rates food based on how quickly sugars are released:
Low glycemic index means slow sugar absorption
High glycemic index is rapid

30
Q

For pt with diabetes what is intake based on?

A

medication and activity

31
Q

What are the recommendations for alcohol with diabetes?

A

Limited can be incorporated into a meal plan

  • moderate: 1-2 drinks/day
  • taken with meal or snack, not on an empty stomach
  • sip slowly or dilute
32
Q

Intake recommendations when on insulin therapy.

A
  • timing of meals based on insulin becomes crucial (match insulin with CHO intake)
  • balanced CHO taken, adjusted for insulin activity (especially with NPH/Lente)
  • Meals match insulin action
  • Usually breakfast eaten within 1h of am dose
  • CHO snack eaten 2-21/2hrs later
  • lunch within 4-5 hrs of am dose, snack recommended
33
Q

How should diabetics manage sick days?

A
  • stress and illness can increase blood glucose; body needs extra energy to deal with stress of illness
  • continue meds and food intake, may need more insulin, frequent SGBM (q4hr)
  • increase sugar free fluid intake
  • check for sugar-free cough syrup
  • do not take Sudafed with decongestants (increases BP)
  • if frequent vomiting/diarrhea, contact a doctor
  • promote flu and pneumococcal vaccines
34
Q

What happens to blood glucose when you are stress or ill?

A

increases

35
Q

When you are sick what adjustments to intake should you have?

A

none, maintain regular food and med intake; may even need more insulin and more sugar free fluids

36
Q

How often should you monitor your BG when you are sick?

A

q4hr

37
Q

When do you need to keep in mind when taking cough syrup?

A

may contain sugar

38
Q

Do not take ____ with decongestants because it _____ BP.

A

Sudafed

increases

39
Q

What health promotion can you do for diabetics, regarding illness?

A

recommend flu vaccine and pneumococcal vaccine (q5yrs)

40
Q

What is hypoglycemia?

A

BG

41
Q

What are common causes of hypoglycemia?

A
  • too much insulin
  • omitting meals
  • over exertion without CHO
  • fluid imbalance
42
Q

What are the symptoms of hypoglycemia?

A
  • headache
  • irritability
  • tachycardia
  • poor coordination
  • diaphoretic
  • trembling
  • seating
  • anxiety
  • weakness
    (may appear drunk, confused, disoriented, pallor, visual disturbances, numbness or tingling in the tongue or lips, difficulty speaking)
43
Q

How do you manage hypoglycemia?

A
  • check BG immediately
  • take 15g fast acting CHO
  • recheck BG in 15 min; if still, 4.0 mol/L, then treat again
  • If meals is > 1h. away or will be active, eat a snack with CHO and protein
44
Q

How do you prevent hypoglycemia?

A

frequent SBGM, balancing exercise with intake of insulin

45
Q

What does your BG need to be to be able to drive?

A

BG equal to are greater than 5.0 mol/L; recheck every 4 hours with continuous driving

46
Q

20

A

20

Chronic Health Challenges (5 decks)

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