Chp 14 Diabetes Flashcards
(25 cards)
As of 2015 - percent of the US with DM
9.4%
2012 - US DM costs total
Direct
Indirect
$245 billion
$176 B direct
$69 B indirect
5 counter regulatory hormones to insulin
1) glucagon
2) epinephrine
3) norepinephrine
4) growth hormone
5) cortisol
Elevated depressive sx and/or depression affect how many pts?
1 in 4
Diabetes distress
emotional issues related to worries and burdens living with chronic disease – in the ABSENCE of depression
Hyperglycemia sx
Increased thirst, excessive urination, unusual fatigue, unexplained hunger, rapid weight loss, slow healing cuts and infections
What % of people have T1DM
5-10%
What % loss of body weight can reverse insulin resistance?
5-7%
Insulin resistance, 3 factors
1) overweight/obesity
2) physical inactivity
3) poor diet
WHR increased = 2.5x risk
Pre-diabetes defn
Where does it occur primarily, i.e. tissue
What percent Americans with it?
A state of relative insulin resistance
Muscle - limited capacity to store CHO
38%
DX criteria for DM - A1c, fasting glucose, oral GTT
Pre-diabetes A1c criteria
6.5% or higher
>126 mg/dL
2 hour value >/equal to 200
Pre-DM: 5.7-6.4%
Fasting glucose normal
Pre-DM levels
70-99 mg/dL
Pre-DM: 100-125 mg/dL
GTT pre-DM values, 2 hour post prandial
140-199 mg/dL
US Preventive Services Task Force recs for screening glucose (age related)
As part of a CV risk assessment, ages 50-70, AND overweight/obese
What tissues do DM meds target?
pancreas - increase insulin release
liver - decrease glucose output
muscles - more responsive to insulin
gut - slow down absorption of CHO and glucose
kidneys - releasing excess glucose in urine
Basal insulin meets what need in context to food?
covers NON food related insulin needs – covers background need through the day
Health and wellness goals for DM and preDM revolve around 4 points
Self mgt to —> lower insulin —> manage BG levels —> result in wt loss —> assist in keeping weight off
Other factors affecting BG
stress, hydration, hormones, and illness
Exercise - safety recs:
BG levels
Threshold (elevated) and warning signs
Range of 80-180
Above 250 okay IF no ketones are present
Stipulations for >300 mg/dL while exercising…..
no ketones present
CAN use caution at mild to moderate intensity until BG decreases
How to decrease risk for DM
1) weight control
2) physical activity @ least 150 minutes per week
3) medical nutrition therapy
4) f/u counseling
Losing ____ pounds improves insulin action, lowers systemic inflammation, reduces A1c, enhances HDL and lowers LDL, reduces risk of T2DM
What % of starting weight applies here?
10 pounds
5-7%
Rec activity levels
Duration: 150 minutes at least per week/ 75 minutes more intense (aerobic) —– 8-10 exercises, 1-3 sets, 10-15 reps (resistance)
Frequency: 3-7 days/week (aerobic) —– 2-3 days (strength)
When to refer
Evaluation and diagnosis info
Annual assessment
New cx factors
Transition of care
