Blood Glucose Regulation Flashcards
(34 cards)
diabetes mellitus
a disorder of carbohydrate metabolism and results in high levels of blood glucose
carbohydrate metabolism
- insulin supported process of facilitated diffusion moves glucose from blood into cells
- after eating: synchronous rise and fall of glucose and insulin
glucose
energy, stored as glycogen, or component or of lipid molecules
insulin
- produced by beta cells
- facilitated diffusion moves glucose from blood into cells
glycogenesis
glycogen formation in the liver
glycogenolysis
- glycogen breakdown into glucose
- occurs when blood glucose falls and body needs energy
hypoglycemia
- BG less than 70 mg/dL
- compensatory response by the liver and hypothalamus to raise BG
- epinephrine, glucagon, activation of SNS
- need to administer fast acting carbs
- avoid fats bc they delay glucose absorption
- IV glucose can be provided
- glucagon by subq injection
- hypoglycemia is a MEDICAL EMERGENCY
hyperglycemia
blood glucose greater than 100 mg/dL
Diabetic Ketoacidosis
occurs when there isnt enough insulin in the body
- think strenuous exercise
- fatigue
- weakness
Somogyi effect
- nighttime BG normal —> hypoglycemia —> BG doubles by morning
- epinephrine, cortisol, and hormones are released and BG levels double
s/s type 1 diabetes
- polydipsia
- polyuria
- polyphagia
- fatigue
- possible infection
patho type 1 diabetes
- T cell mediated attack of beta cells
- blood sugar goes up while insulin goes down (0)
- genetic influence
- autoimmune
- insulin deficient/ not enough to do its job
presenting sign of type 1 diabetes
DKA- because the early signs are not recognized
- will develop in people with no insulin reserves and the liver starts to mobilize fats
tx for type 1 diabetes
insulin replacement
s/s type 2 diabetes
- polydipsia
- polyphagia
- polyuria
- blurred vision
- electrolyte imbalance- hyperkalemia
- glycogenolysis
- gluconeogenesis
diagnostic testing type 2 diabetes
- blood and urine tests
- fasting BG greater than 126 on 2 separate occasions
- random BG greater than 200 more than 1 time
- OGTT(oral glucose tolerance test) greater than 200
- A1c above 6.5%
- glucosuria (sugar in urine, dipstick test)
- ketonuria (ketones in urine, dipstick test)
what foods are appropriate for the glycemic index diet
- foods low in carbohydrates!
- dried beans
- legumes
- whole grains
- some fruits- watermelon, apple, nectarines
- avocado
- dates
tx type 2 diabetes
- exercise, maintain ideal body weight, reduce insulin before physical activity (exercise before administering insulin)
- diet changes: 40-50% carbs, 25-30% fats, low fat/low salt diet
- self monitor glucose levels
examples of fast acting carbs in the event of hypoglycemia
- 4 glucose tablets
- glucose gel
- 4 oz fruit juice
- 4 oz regular soda
- 8 oz milk
- 5-6 pieces hard candy
- 1-2 tsp honey or sugar
- 2 tbsp raisins
causes of hypoglycemia
- too much insulin use
- excessive physical activity
- surgery
- antibiotics
risk factors for diabetes
- obesity
- sedentary lifestyle
- polygenic disorder (T1)
- environmental triggers: diet, infection
role of insulin
- facilitates glucose uptake by cells
- facilitates glucose storage in the liver (glucose cannot get into the liver without insulin)
- promotes glycogen formation
- decreases utilization of fat
- anabolic hormone- muscle building function
patho of type 2 diabetes
- insulin resistance
- increased insulin levels
- metabolic syndrome
- blood sugar up, insulin up
- can go undiagnosed for years
diabetic foot complications
- most common cause of nontraumatic lower extremity amputation
- peripheral neuropathy, poor circulation, suppressed immune response
- increase infection susceptibility
- can lead to gangrene and amputation
- osteomyelitis can occur
- postprandial hyperglycemia puts pts at risk for these issues
