class 8 diabetes Flashcards
what is diabetes mellitus
a metabolic disorder characterized by the presence of hyperglycemia due to:
1. the impairment of insulin secretion, defective insulin production, action, or both
2. inefficient utilization of insulin in the body (insulin resistance
0
what happens if there is beta cell destruction in DM
absolute insulin deficiency
classic symptoms of DM
polyuria, polydipsia, polyphagia (3 p’s), unexplained weight loss
controllable risk factors for DM
sedentary lifestyle
obesity
uncontrollable risk factors for DM
-family hx
-race
-autoimmune
-metabolic conditons
-HTN
tx for type 1
insulin
tx for type 2
lifestyle
po hypoglycemic
insulin as a last line
tx for prediabetes
education & lifestyle
3 things to minimize complications
-early screening
-intervention
-optimization of glycemic control
what is prediabetes
a condition where blood sugar levels are higher than normal, but are not yet high enough to be diagnosed as type 2 diabetes
-they may not go on to develop diabetes
how does DKA develop
when there is no insulin to use blood glucose for energy the body breaks down fat stores to get energy when creates ketones
age of onset for DM1
any age
peak incidence is age 10-15
age of onset DM2
over 30/any age
increasing rates in children
symptoms of DM1
abrupt
-3 p’s: polyuria, polydipsia, polyphagia
-fatigue
-weight loss
symptoms of DM2
frequently none, gradual & vague
-s/s of glucose intolerance
-fatigue
-recurrent infections (^B/G=immune dysfunction)
ketosis in DM1
can occur often
DKA
ketosis in DM2
very rare
can experience HHNS
management of DM1
insulin
management of DM2
lifestyle mod
may need oral hypoglycemics
insulin if necessary (last resort)
normal fasting b/g in adults
4-7
normal fasting b/g in kids
4-8
hypoglycemia=
<4
critical hypoglycemia
<2.8
lab results for diagnosis of DM
-fasting plasma glucose (pg) >=7
-2h pg in a 75g OGTT >=11.1
-random pg >11.1
-HbgA1C: over 7 adults, 7.5 kids
HbgA1C: prediabetes
6.0-6.4
what is HbgA1C
measures the % of RBC’s that are coated in glucose over a 120 day period
HbgA1c; # predict the development of retinopathy
6.5 or greater
how often should HbgA1C be taken if blood glucose targets are not being met/making changes to management
every 3 months
factors that can alter HbgA1c:
anything that affects RBC’s
-age
-chronic conditions that affect RBC production
-dec EPO
-iron def anemia
nonpharm management of type 1 and 2
diet
exercise
maintaining a healthy weight
regular screening for complications