Diabetes Flashcards

1
Q

Type I Diabetes

A
  • deficiency of insulin production from destruction of beta cells in pancreas
  • typically insulin dependent

-5-10% of all diabetes

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2
Q

Absolute Insulin Deficiency

A

body can’t make insulin

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3
Q

Relative Insulin Deficiency

A

body can’t use insulin

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4
Q

3 Types of Diabetes

A
  • Type 1
  • Type 2
  • Gestational
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5
Q

Diabetic Ketoacidosis

A
  • lack of insulin causes build up of glucose in blood, so body uses fat for ATP
  • ketones are a byproduct of using fats & they make blood acidic

-causes fruity (alcoholic) breath

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6
Q

Type 2 Diabetes

A
  • hyperglycemia due to incr insulin resistance in cells
  • decrease insulin uptake
  • pancreas keeps making insulin but Mm can’t use it

90-95% of all diabetes

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7
Q

Patients with Type I Diabetes are prone to:

A

-diabetic ketoacidosis

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8
Q

Ketones

A
  • byproduct of fat metabolism
  • make blood more acidic
  • drink lots of water to flush out
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9
Q

Gestational Diabetes

A
  • due to contra-insulin effects of pregnancy
  • diagnosed with oral test in 2nd trimester
  • usually resolves post partum, but 50% develop type 2 diabetes
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10
Q

Normal Glucose Levels

A

70-105 mg/dL

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11
Q

Insulin

A

-allows glucose to enter cells of insulin sensitive tissue

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12
Q

Retinopathy

A
  • damage to small vessels in retina
  • 90% of people with diabetes for ?25 years have some changes
  • can be treated and prevented
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13
Q

Type 2 Diabetes and GLUT 4

A

-insulin can’t make GLUT 4 transport to cell membrane

EXERCISE can stimulate GLUT 4 to go to membrane

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14
Q

When to do Ex’s Testing

A
  • Type 1 & >30 years old
  • Type 1 for >15 years
  • Type 2 & >35 years old
  • Type 2 for >10 years
  • any risk factor for CAD
  • Suspected/Known CAD
  • Microvascular/neurological diabetic complications
  • PVD peripheral vascular disease
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15
Q

How Insulin Controls Glucose Levels

A
  • pancreatic beta cells release insulin in blood in response to glucose
  • insulin binds to protein & cause GLUT 4 to move cell to edge
  • GLUT 4 helps diffusion of glucose into cell
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16
Q

Exercise & GLUT 4

A

exercise causes GLUT 4 to transfer to cell membrane so glucose can enter cell from blood

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17
Q

Exercise Recommendation for Type 2

A
  • no exercise if blood sugar is >400mg/dL
  • burn 1000 kcal/week minimum
  • burn >2000 kcal/week if goal is weight loss
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18
Q

Type 1 Diabetes:

  • if exercise is planned
  • if exercise is unplanned
A
  • planned: decrease insulin prior

- unplanned: eat additional (15g) CHO prior

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19
Q

Benefits of Exercise with Type 2 Diabetes

A

-increase insulin sensitivity, may not lead to incr glycemic control

20
Q

Overall Exercise Benefits

A
  • decr cardiovascular risk factors
  • incr cardiovascular benefits
  • decr body fat
  • decr stress
  • prevent type 2 diabetes
21
Q

For each hour of exercise:

A

additional 15g of CHO needed before or after exercise

22
Q

If exercising >60 min

A

-may need to test blood sugar during ex’s

23
Q

complete Exercise ____prior to bedtime to _____

A
  • 2 hours

- prevent nocturnal hypoglycemia

24
Q

Hypoglycemia S/Sx

A
  • drowsiness
  • confusion
  • irritability
  • unable to concentrate
  • loss consciousness
  • convulsions
  • poor coordination
  • blurred/double vision
  • slurred speech
  • tremors
  • nervousness
  • sweating
  • excessive hunger
  • fatigue
25
Q

Kussmaul respiration

A
  • fast and deep

- to compensate for ketoacidosis (breathing off excess CO2)

26
Q

Complications of Diabetes

A
  • atherosclerosis
  • retinopathy
  • neuropathy
27
Q

S/Sx Diabetes

A
  • polyuria
  • polydipsia
  • polyphagia
  • weight loss
  • fatigue
  • M cramps
  • irritability
  • blurry vision
  • headache
  • nausea
28
Q

Type 2 Risk Factors

A
  • > 40 years old
  • minorities
  • family Hx
  • decreased SES
  • inactivity
  • obesity (abdominal)
29
Q

Glucose Tests

A
  • 2 hour glucose tolerance test

- glycosylated hemoglobin

30
Q

HbA1C

A

-glycosylated hemoglobin

31
Q

Glycosylated Hemoglobin

A
  • HbA1C
  • average blood glucose over 3 months
  • measure how much Hb is bound to glucose

-Normal: <6%

32
Q

Medications

A
  • Insulin

- oral hypoglycemic agents

33
Q

Diabetic Ketoacidosis Occurs at:

A
  • glucose levels of 300-700 mg/dL

- because too little insulin in conjunction with too much glucagon, catecholamines, cortisol or growth hormone

34
Q

1% Change in HbA1C=

A

-30mg glucose

  • 6%=135mg/dL
  • 9%=240mg/dL
35
Q

Hypoglycemic Shock

A
  • glucose level s

- -Treatment: ingest glucose

36
Q

2 Stages of Retinopathy

A
  • nonproliferative

- praliferative

37
Q

Nonproliferative Retinopathy

A
  • (early stages)
  • clucose damage to vessels cause fluid to leak & cause retina to swell
  • blurred vision
  • treated with laser surgery
38
Q

Proliferative Retinopathy

A

(more severe)

  • abnormal blood vessels grow over retina surface & rupture & bleed into vitreous humor
  • scar tissue form & cause detachment of retina from back of eye
  • result in loss of vision
  • surgery can help
39
Q

Benefits of Exercise with Type 1 Diabetes

A
  • incr insulin sensitivity
  • little/no effect on HbA1C
  • doesnt decr number of hypoglycemic events
40
Q

Do NOT ex’s if:

A

-glucose >250mgdL & ketones are present

41
Q

symptoms of nocturnal hypoglycemia

A

-headache next morning
-bad dreams
-perspiring
restless sleep

42
Q

Hyperglycemia S/Sx

A
  • weakness
  • incr thirst
  • dry mouth
  • frequent bud decr volume of urine
  • abdominal tenderness
  • acetone breath
  • kussmaul respirations
43
Q

Contradincidations for Exercise

A
  • glucose >250
  • glucose <100mg/dL
  • illness/infection
  • active retinal hemorrage or Tx for retinopathy
44
Q

Exercise & Type I diabetes

A
  • check glucose before and after to determine how much used

- end e’s glucose should be >110mg/dL

45
Q

Ex’s Type I

a. frequency
b. intensity
c. time
d. type

A

a. 7 days/week
b. 45-80% MHR, 10-16 RPE
c. 20-30 min
d. large muscle groups

46
Q

Ex’s Type 2

a. frequency
b. intensity
c. time
d. type

A

a. 5 days/week
b. 45-70% MHR, 10-14 RPE
c. 40-60 min
d. large Mm groups