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chapter 15 - diabetes Flashcards

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1
Q

what is diabetes melitus

A

group of serious and chronic disorders affecting metabolism of carb

absence or misuse of insulin = hyperglycemia

precursor is prediabetes (impaired glucose tolerance) - blood glucose levels higher than normal but not high enough to diagnose diabetes + growing insulin resistance

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2
Q

metabolic syndrome (dysmetabolic syndrome)

A
  • constellation of conditions that pose signficiant risk of developing heart disease, stroke, and diabetes
  • abn cholesterol
  • excess body fat around waist
  • increased bp and blood sugar
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3
Q

diabetes insipidus

A

large amt of urine but not sweet (insipid)

caused by damaged pituitary land

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4
Q

___ millino have diabetes in US (___% percent of US pop) with ____ diagnosed and ___ undignosed

A

29.1 millin

9.3%

diagnosed: 18.8 mil
diagnomsed: 8.1 mil

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5
Q

what is t2d major cause for

A

blindness
heart and kidney disease
amputation of toes, feet, and legs
infection
ieath

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6
Q

meaning behind t2d naeme

A

dibates - flow through (large amt of urine)
mellitus - honey (glucose in urine)

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7
Q

what secretes insulin

A

beta cells of sislets of Langerhans in pancreas

inadequate production of insulin or body is unable to use insulin it produces

glocuse cant enter cells and accumulate in blood, = hyperglycemia

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8
Q

glucagon role

A

secreted by alpha cells of islets of langerhans

helps release energy when needed to convert glycogen to glocuse

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9
Q

somatostatin

A

hormone produced by delta cells of islets of langerhans and hypothalamus

inhibits release of insulin and glocagons

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10
Q

glycosuria

A

glocuse excreted in urine when hyperglcemia exceeds renal threshold

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11
Q

what causes polyphagia in diabetes

A

inability to metabolize glucose causes body to break down its own tissue for protein and fat

causes polyphagia and loss of weight, weakness, and fatigue

use of protein from its own tissue causes body to excrete nitrogen

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12
Q

ketones in diabetes

A

excess fat is broken down, thus liver produces ketones from fatty acids

causes ketonemia and ketonuria

ketoacidos : lead to loss of consciousness and possibly death if not treated w fluids and insulin

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13
Q

neuropathy occurs in ____ of clients w diabetes

A

60-70%

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14
Q

what is number one cause of need for kidney dialysis

A

nephropathy

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15
Q

symptoms of diabetes

A

urinating often
feelign v thirsty
feelnig v hungry even though you have been eating
extreme fatigue
blurry vision
cuts or bruises that are slow to heal
weight loss (even though eating more - T1D)
tingling pain or numbness in hands or feet (T2D)

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16
Q

classification of diabetes (types)

A

prediabetes
Type 1 diabetes
type 2 diabetes
gestational diabetes
type of diabetes due to toerh causes like drug or chemical induced diabetes

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17
Q

1 in ___ adults ahve prediabetes

A

3

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18
Q

results indiciate pre-diabetes

A

fasting glucose of 100 and 125 mg/dL
A1C of 5.7-6.4
OGTT 2hr blood glucose of 140-199 mg/dL

start testing at 45 yo w 3 y intervals

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19
Q

risk facotrs for prediabetes

A

physical inactivity
first-degree relative w diabetes
members of high risk race or ethnicity (AA, Latino, native or Asian AMerican, Pacific Islanter)
women who delivered babies ? 9lb or had gestatoin diabetes
hypertension
dyslipidemia
PCOS
elevated labs
clinical conditions associated w insulin resistance (severe obesity, acanthosis, nigricans)
history of CVD

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20
Q

type 1 diabetes

A

juvenile diabetes
body immune system destroys pancraitc beta cells
5% of all diabetes cases
diagnose using blood glucose (over 126 mg/dL)

risk factors include genetics, autoimmune status, environmental factor

treat w exogenous insulin

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21
Q

type 2 diabetes

A

usually occur after 40 yo

diagnose w fasting glucose of 126 mg/dL, 2 our glcusoe of 200 mg/dL during OGTT, A1C of > 6.5

control w diet and exercise and oral diabetes medication

metformin is original medication

goal of nutrition therapy is maintain healthy glucose, blood pressure, and lipid levels

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22
Q

rapid acting insulin

A

Lispro (Humalog)
Aspart (Novolog)
Glulisine (Apidra)

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23
Q

short acting insulin

A

Regular (Humulin R, Novolin R)

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24
Q

intermediate acting insulin

A

NPH (Humulin N, Novolin N)

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25
long actign insulin
detemir (Levemir) Glargine (lantus, Basaglar, Toujeo)
26
inhaled insulin
afrezza
27
premixed insulin
Humulin or Novolin 70/30 Novolog 70/30 Humalog 75/25 Humulin 50/50
28
criteria for testing T2D in asymptomaitc children
overweight (BMI > 85th percentile) + amily history of T2D in first or second degree relative; race/ ethnicity at risk; signs of insulin restiance or condition associated w insulin resistance (including small-for-gestational age birth wight) age of iniaitiion (age 10 year or puberty at younger age)
29
meglitinide
repaglinide
30
d-phenylalanines
Nateglinide
31
Thiazolidinedione
Pioglitazone rosiglitzaone
32
Nonsulfonylurea
Metformin Metformin and time-released cpntrolling polymer
33
Alpha-glucosidase inhibitor
Miglitol
34
Second gen suflonylureas
Glyburides Glipizide Glimepride
35
Class-bile acid sequestrants (primariyl used to decrease cholesterol)
Colesevelam
36
DPP-4 inhibitor
Sitagliptin Saxagliptin Linagliptin AlogliptinS
37
SGLTZ inhibitor
Canagliflozin Dapagliflozin Empagliflozin
38
opamine receptor agonist
Bromocriptine Mesylate
39
Combinatio ndrugs
Glcuovance, Avandamet, Metaglip ACTOplus Met, Avandaryl, Duetact, Janumet, Kmobigylze XR, Kazano, Oseni, Juvisync, Jentadueto, Invokamet, Xigduo XT, Glyxambi
40
incretin mimetics
injected same as insulin but not insulin used in conjunction w oral med to lower A1C to less than 7% (American diabetes association prefer outcomes less than 7% for clients w diabetes, American college of endocrinology preers less than 6.5%)
41
Pramlintide
used in clients w t1d lowers blood sugars by assisting insulin injected at meals to lower postmeal blood sugar levels suppress potmeal glucagon release, slows gastric emptying, and decreasing appetite act on beta cells in pancreas to increase glucose-dependent insulin secretion
42
gestational diabetes
occurs during pregnancy btwn weeks 16 and 28 diagnosed w OGTT if not responsive to diet, exercise, or oral medication, insulin injection therapy w be used avoid concentrated sugars usually disappear after infant is born women who have had gestational diabetes have 35-60% chance of developing T2D
43
secondary diabetes
infrequent caused by certain drugs or by disease of pancreas like steroid meds can increase blood sugars and client can develop steroid induced diabetes
44
treatments for diabetes
lose 7% of body weight increase mod intensity physical activity to at least 150 min a week control blood glucose levels provide optimal nourishment for client prevent symptoms and thus delay complications diet alone or diet w insulin or oral guclose lowered medication plus regulated exercise and regular monitoring of clients blood glucose levels
45
dietitan for type 2 diabetes
ned to know client diets history, food likes and dislikes, and lifestyle client cal needs depend on age, activities, lean muscle mass, size, and resting energy expendtirute
46
carb intake for diabetes
whole grains veg fruits legumes dairy products w emphasis on foods higher in fiber and lower in glycemic load should be advised over other sources esp those contain sugars
47
how much should sodium be limited
<2300 mg a day
48
treatment for T1D
nurtition plan that balances cal and nutrient needs w insulin therapy and exercise meals and snacks be composed of similar nutrients and cal and eaten at reg time small meals pus 2 to 3 snacks may be more helpful in maintaining steady blood glucose levels than 3 large meals
49
carb counting for pt w t2d
starch and bread category, milk and fruit placed under heading of carb 4 carb breakfast protein for lunch and dinner only 1 or 2 fat per meal 2 carb and 1 oz protein for evenignsnacks given in terms of exchanges rather than as particular foods
50
high fiber
25-35 g of dietary fiber daily increased fiber requires increased water intake for clients dosing insulin based on g of carb, priotn of fiber may be subtracted (fi fiber content is greater than 5g half the grams of fiber may be subtracted from total carb for which client is doing)
51
sucralose
splenda made from sugar molecule altered so body can t absorb 600x sweter than sugar linked int to increased leukemia in mice in utero
52
Aspartame
equal nutrasweet 2 amino acids: phenylalanine, aspartic acid 200x sweeter than sugar least desirable sweenter to use bc linked to cancer in rats and mice
53
Saccharin
350x sweeter than sugars linked to bladder cancer in rodents
54
acesulfmae-potassium
equal original or equal spoonful 200x sweetre than sugar (used w sucralose or aspartame to cut bitterness ) two studies showed risk for cancer in rats
55
Advantame
20,000x sweeter than sugar safe bc v small amount used in food
56
Neotame
8000x sweeter than sugar no safet concerns by rarely used
57
Stevia Lead Extract
high purified viewed as safe whole-lead stevia or crude stevia not allowed in foods
58
alchohol and diabetes
if cnonsumed on empty stomach, may experiecne hypoglycemia
59
exericse and T2D
helps body use glucose by increasing insulin receptor sites and stimulating creation of glucagon lowers cholesterol and bp and reduces stress and body fat as it toens muscles helps improve wt control, glucose levels, and CV system
60
exercise and T1d
exercise can complicate glucose control lowers glucose level = hypoglycemia
61
exogenous insulin
protein must be injected bc if swallowed would be digetested human insulin is most common; synthesized in lab similar to how pancreas makes it - animal insulin are rarely used bc contain antibodies for t1d 2 or more injections daily w more than one type of insulin (rapid vs long acting (for gen use regardless of meal))
62
insulin pump therapy
deliver insulin in 2 ways: basal rate and premeal bolus basal; very rapid acting insulin delivered continuously throughout day (keep gucose in check btwn meals and during night) premeal bolus; cover food eaten during meal
63

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