diabetes
a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both
diabetic ketoacidosis (DKA)
a metabolic derangement in type 1 diabetes that results from a deficiency of insulin; highly acidic ketone bodies are formed, resulting in acidosis
fasting plasma glucose (FPG)
blood glucose determination obtained in the laboratory after fasting for at least 8 hours
gestational diabetes
any degree of glucose intolerance with its onset during pregnancy due to placental hormones
glycated hemoglobin (glycosylated hemoglobin, HgbA1C, or A1C)
a measure of glucose control that is a result of glucose molecule attaching to hemoglobin for the life of the red blood cell (120 days)
glycemic index
the amount a given food increases the blood glucose level compared with an equivalent amount of glucose
hyperglycemia
elevated blood glucose level
hyperglycemic hyperosmolar syndrome (HHS)
a metabolic disorder of type 2 diabetes resulting from a relative insulin deficiency initiated by an illness that raises the demand for insulin
hypoglycemia
low blood glucose level
impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)
a metabolic stage intermediate between normal glucose homeostasis and diabetes; referred to as prediabetes
insulin
a hormone secreted by the beta cells of the islets of Langerhans of the pancreas that is necessary for the metabolism of carbohydrates, proteins, and fats; a deficiency of insulin results in diabetes
insulin pump
a continuous subcutaneous insulin infusion device that delivers insulin on a 24-hour basis
ketone
a highly acidic substance formed when the liver breaks down free fatty acids in the absence of insulin
latent autoimmune diabetes of adults (LADA)
A subtype of diabetes
medical nutrition therapy (MNT)
nutritional therapy prescribed for management of diabetes that usually is given by a registered dietician
nephropathy
a long-term complication of diabetes in which the kidney cells are damaged; characterized by microalbuminuria in early stages and progressing to end-stage kidney disease
neuropathy
a long-term complication of diabetes resulting from damage to the nerve cell
prediabetes
impaired glucose metabolism in which blood glucose concentrations fall between normal levels and those considered diagnostic for diabetes; includes impaired fasting glucose and impaired glucose tolerance, not clinical entities in their own right but risk factors for future diabetes and cardiovascular disease
retinopathy
a complication of diabetes in which the small blood vessels that nourish the retina in the eye are damaged
self-monitoring of blood glucose (SMBG)
a method of capillary blood glucose testing
type 1 diabetes
a metabolic disorder characterized by an absence of insulin production and secretion from autoimmune destruction of the beta cells of the islets of Langerhans in the pancreas; formerly called insulin-dependent diabetes, or juvenile diabetes
type 2 diabetes
a metabolic disorder characterized by the relative deficiency of insulin production and a decreased insulin action and increased insulin resistance; formerly called non–insulin-dependent diabetes, or adult-onset diabetes
What hormone inhibits glycogenolisys?
insulin
What are the “three P’s”?
Polyuria, polydipsia, polyphagia
What percentage of the daily diet should be whole grain carbohydrates (for diabetic patients)?
50-60%
What percentage of the daily diet should be fats (for diabetic patients)?
30%
What percentage of protein foods are converted to glucose?
50%
How many grams are in one serving of carbohydrates?
15 grams
What is a good range for blood sugar control?
80-140
What are few things that can decreased blood sugar?
exercise and diet
What are a few things that can increase blood sugar.
Carbohydrates, stress, illness or infection
With what type of insulin do you need to eat 5-15 minutes after injection?
Rapid-acting. lispro, aspart, and glulisine.
What type of insulin can be given once a day due to its 24 hour absorption?
Very long acting, “peakless” or basal.
glargine or detemir.
What is the dawn effect regarding blood glucose levels?
Relatively normal blood glucose until approx. 3 am and then blood glucose levels begin to rise. This effect Type I patients more.
What is the Somogyi effect?
Nocturnal hypoglycemia followed by rebound hyperglycemia.
What are the emergency measures for hypoglycemia for a patient that is unconscious or cannot swallow?
Subcutaneous or IM glucagon (1mg)
25-50 mL of 50% dextrose solution IV push
What are some clinical manifestations in the hyperglycemic aspects of DKA?
3-Ps, fatigue, blurred vision, weakness, and headache. Drop in systolic BP to 20 mmHg (orthostatic), weak rapid pulse, and FVD.
What are some clinical manifestations in the ketosis and acidosis aspects of DKA?
GI symptoms: anorexia, nausea, vomiting, abdominal pain. Acetone breath & elevated ketone levels. Hyperventilation: deep but not labored. Mental status varies: alert, lethargic or comatose.
High A1C in diabetes does what to hemoglobin?
excess glucose in the blood causes damage and attaches to the hemoglobin
Hydration of a patient with DKA is important however these patients are usually on ECG monitoring due to what electrolyte change?
Potassium loss.
What is the most common complication that leads to hospitalization in diabetic patients?
Foot injury!