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Diabetes Flashcards

(47 cards)

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1
Q

What are the risk factors of Type 1 diabetes?

A

no major risk factors: genetic and environment factors both play a role

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2
Q

What are the signs and symptoms of Type 1 diabetes?

A

Polyuria, polydypsia, polyphagia (increased appetite), fatigue, weakness, rapid weight loss, blurred vision

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3
Q

What is the renal threshold for glucosuria?

A

~180-200 mg/dl

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4
Q

What are the risk factors for Type 2 diabetes?

A

MUST HAVE GENETIC PREDISPOSITION. Additional factors: Age, ethnicity (african american, mexican, asian american, american indian and pacific islands), obesity, sedentary lifestyle, diet high in saturated fat, low in fiber / CHO

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5
Q

What signs and symptoms distinguish Type 2 from Type 1 diabetes?

A

Warning signs typically worsen over a long time. Also: Numbness / tingling associated with neuropathy from prolonged high blood sugar periods, more gradual weight loss, and acanthosis nigricans

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6
Q

What is is acanthosis nigricans? What triggers it?

A

Skin pigmentation disorder characterized by dark, hyperkeratin plaques found in axillae, back of neck, and other flexural areas. Triggered by high insulin levels in the blood

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7
Q

What puts an individual at risk for gestational diabetes GDM?

A

Obese women, advanced maternal age, GDM in previous pregnancy, family history, belongs to an at-risk ethnicity

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8
Q

How does a fasting plasma glucose work? Who is this best for?

A

Patient has 8-12 hour overnight fast. This is preferred for non-pregnant adults and children

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9
Q

How does an A1c work? Who is this best for?

A

Checks the amount of glycated hemoglobin, which is good because no fasting is required. Not good for children (poor data)

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10
Q

What are the threshold values for FPG and A1c for pre-diabetes?

A

100-125 mg/dl = impaired fasting glucose

5.7 to 6.4% = a1c

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11
Q

What are the threshold values for FPG and A1c for diabetes?

A

126 or above mg/dl = diabetes

6.5% or above for A1c

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12
Q

What is the oral glucose tolerance test and what is it best used for?

A

Best used in pregnancy for gestational diabetes, can use a 1 or two step strategy, two step does a non-fasting first. Fasting will ultimately need to be done in both to confirm

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13
Q

How high must blood glucose levels be in a random blood test to diagnosis diabetes?

A

> 200 mg/dl with significant symptoms

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14
Q

What type of sweetener is sucrose and what must be done when patients take it?

A

Nutritive, it is table sugar. can be substituted for another, but need to count consumption and cover with insulin / meds. Limit use

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15
Q

What type of sweetener is fructose? How does it affect blood sugar and what are your recommendations for patients?

A

Nutritive - naturally occurs in fruits and vegetables.

Less effect than sucrose on postprandial blood glucose, but has adverse effects on plasma lipids

Recommendation: avoid added fructose in processed foods

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16
Q

What type of sweetener are sugar alcohols and what must be considered about them?

A

Nutritive - 1/2 calories of sucrose
Sorbitol and mannitol are examples. Consider laxative effects if eaten in high amounts, and they do have calories so they are not “free”

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17
Q

What are general recommendations regarding nonnutritive sweeteners?

A

Acceptable Daily Intake levels (ADI) are established by FDA (1/100 level which produce observable efects). Considered safe

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18
Q

What is Acesulfame-K’s street name?

A

Sweet One

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19
Q

What is Aspartame’s street name?

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A

Equal, NutraSweet

20
Q

What is Saccharin’s street name?

21
Q

What is sucralose’s street name?

22
Q

What is neotame’s street name?

23
Q

What is Advantame?

Study These Flashcards
A

General purpose sweetener

24
Q

What are generally regarded as safe sweeteners?

Study These Flashcards
A

Stevia, Luo Han Guo

25
What is the recommended calories from fat for diabetic patients, and who goes on the low / high end?
25-35% of calories Low: Overweight, those with metabolic syndrome + abnormal lipid profiles High: Well-controlled patients with good lipid profiles and normal weight
26
What are the recommendations for specialty fats in diabetes? I.e. saturated fats, trans fat, cholesterol
<7% of calories saturated fats No trans fat Choose from mono and polyunsaturated sources, especially omega-3 fatty acids, i.e. nuts, seeds, fish, olive oil, canola oil. Limit cholesterol to <200 mg per day
27
How much protein should a diabetic patient be consuming?
Same as normal: 0.8-1g per kg. 10-20% of total calories However, newly diagnosed should be at 1g/kg because they are catabolic
28
How much protein is in 1 oz of meat / poultry? What are some equivalents for vegetarians?
~7g protein. Size of palm = 3 oz. Vegeterians: 1/2 cup of beans is 6-9 g, milk = 8 g / cup.
29
What is the recommended intake of fiber for diabetics?
Although one study showed that it improved glycemic control, recommendations are not for extra consumption. 14g / 1000 kcal is recommended = 20-35 g per day feasibly
30
How do you get patients to aim for 30 grams of fiber per day? What additional recommendation do you give them?
10 g from grains / cereals - i.e. oatmeal, whole grain 10 g from fruits / vegetables - i.e. raspberries / blackberries 10 g from legumes, nuts, and seeds DRINK WATER to avoid constipation
31
What type of vegetables count as carbs? Does diary count?
Starchy vegetables: peas, corn, squash, beans, lentils Milk / yogurt also count
32
How many carbohydrate choices should the average person with 2000 kcal/day have?
55% of diet should be carb calories (45-65 range). 55%*2000 = 1100 kcals from CHO A carbohydrate choice = 15 g of CHO = 60 calories 1100 / 60 = 18 CHO choices
33
How does fiber in food affect CHO choices?
If a food contains >5g of fiber per serving, subtract 1/2 the fiber from the total CHO to find available CHO for carb counting. The grams of fiber are always included in the total CHO
34
What is glycemic response?
The change in an individual's blood glucose / insulin levels after consuming a CHO-containing food at a given time. It varies dramatically, and can be affected by type of CHO, other foods eaten, ripeness, cooking, etc
35
What is glycemic index?
Rise in blood glucose following ingestion of a food, as compared to a reference food set at 100 (glucose, or white bread in which case glucose would be 140)
36
What is glycemic load?
A value which takes into account the likely portion size as well as the glycemic index. It is the amount of CHO in a food adjusted for its glycemic potency. For instance, watermelon has a high GI CHO, but low GL due to only a small amount of CHO in a serving of watermelon
37
What is the calculation for glycemic load?
GL = (GI * grams of carbohydrate per serving) / 100
38
What are the ranges of low, medium, and high GL?
Low <10 Medium 10-20 High >20
39
What makes up the total daily dose (TDD) of insulin?
TDD = all basal plus bolus insulin | I.e. 35-40 units
40
What is the Insulin-to-Carbohydrate Ratio calculation and who does it work for?
Works best for T1 diabetics who don't produce their own insulin Rule of 500 for rapid-acting insulin 500/TDD = IC ratio = 500/40 is about 13 IC = 1:13 Rule of 450 for short-acting (Regular)
41
What is the usage of the IC ratio?
It's how many units of insulin a person needs if they ingest a given number of grams of carbs. If IC is 13, and they ingested 60 gram of carbs 60/13 = 4.5 units of insulin needed
42
What is the insulin correction / sensitivity factor?
The drop in blood glucose, measured in mg/dl, caused by 1 unit of insulin
43
How do you determine the insulin correction factor?
1700 rule with rapid-acting 1700/ TDD = drop in blood glucose per unit 1500 rule with regular insulin
44
How do you determine the correction bolus?
The correction factor as determined by the 1700 rule, i.e. 49 mg/dl Correction bolus = (Current - Target BG) / correction factor Use this whenever your post-meal BG is higher than your target BG
45
What is hypoglycemic / insulin shock and what are the common causes?
BG < 70 mg/dl Common causes: Missing a meal, excessive insulin / meds, prolonged duration or increased exercise intensity (makes you suck up more glucose), alcohol intake without food, vomiting / diarrhea
46
What are the symptoms of hypoglycemic shock?
Sweating, impatience, diplopia, hunger, pallor, trembling, palpitations, headache, faintness, mental confusion + unconsciousness
47
What is the treatment scheme for hypoglycemic shock?
15/15 rule Take 15 g of CHO (one CHO choice), check BG after 15 minutes. Repeat as needed. Often is a 4 oz fruit juice, 3-4 tsp of sugar, several pieces of hard candy or glucose tablets

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