Diabetes in kids Flashcards
(25 cards)
What is diabetes?
Common metabolic disease that is a disorder of carbs, protein, and fat metabolism because of impaired or decreased insulin production . There’s two types common in kids
T or F: most kids/teens have DT1 but DT2 is becoming more common d/t rise in childhood obesity
True
How to dx diabetes in kids/teens?
If the have a plasma glucose level of 11.1 mmol/L of higher with symptoms or diabetes, or fasting plasma glucose >7 mmol/L or oral glucose tolerance test >11 mmol/L. We don’t use A1C value to dx kids
What is diabetes type 1?
Autoimmune destruction of insulin producing cells of the pancreas which causes complete insulin deficiency. Main therapy is insulin injections. Peak incidence is early childhood (4-6yrs) and 10-14 yrs. First degree relatives of pt with T1D carry higher risk factor to develop it. T1D is equal between genders
What is type 2 diabetes? and risk factors
Inability to effectively utilize the body’s insulin/unable to generate sufficient amounts of it. Type 2 is increasing in teens/kids worldwide and it affects 90% of kids/youth with first or second degree relatives who has T2D. Risk factor for T2 is obesity.
Type 2 diabetes among different ethnicities and FN?
DE- aboriginal has highest rates of T2, followed by caucasian, then asian, African,
T2 is higher in FN living on reserves vs off of reserves
Diabetes in kids?
Treatment is different than adults, they develop more serious complications because they are exposed to metabolic consequences over longer period of time (b/c they get diabetes so young), its more severe/aggressive than adults with diabetes
T2 diabetes in Saskatchewan ?
Incidence is increasing, it disproportionally affects indigenous people (FN women higher than FN men, they have higher rates than non indg women/men)
Colonization impacts on diabetes?
Treaties cause them to not get some services, there’s SDOH inequities, racism scares them away from hospital treatment, and inter generational trauma has a lasting impact on
What is food insecurity?
Someone is unable to access/afford enough nutritious food. May be the result of consuming less nutritions/affordable packaged foods. Fresh food in scarce in some communities like reserves/rural areas, so they have to drive to supermarkets. Food insecurity is major risk factor for T2D. Most problems with food insecurity are r/t SDOH
Socioeconomic determinants for T2D?
Usually less private insurance, lower household income, and lower education levels
Demographic data for pre diabetes, overweight, HTN for different ethnicities?
PD- filipino has highest rates, followed by FN then European
O- Highest rate is Indg, then filipino, and then european
HTN- highest is european, followed by filipino and the Indg
Urban vs rural rates for BP, blood glucose, and BMI?
Urban has higher rates of HTN than rural, urban is greater risk for diabetes then rural, and more obese people live in rural setting than urban
Complications of type 2?
Can occur more quickly in teens than adults. Loss of B cell function is accelerated in young T2D which leads to development of complications with adverse effective on quality of life. T2D associated with increased risk for HTN, neuropathy, kidney disease, retinopathy, and dyslipidemia.
What is hemoglobin A1C?
Form of hemoglobin used to identified average plasma glucose concentration over prolonged periods of time (3 months).
What is diabetic ketoacidosis? DKA
Complex metabolic state of hyperglycemia, ketosis, and acidosis. DKA is the leading cause of morbidity and morality in kids. Occurs in 40% of kids with a new onset of diabetes.
What is hypoglycemia? S+S
Low glucose levels. It’s a major obstacle for kids with T1D because sometimes they can’t recognize when their glucose levels are low. Some S+S are sweating, pallor, hunger, fatigue, irritability, lack of concentration, tremor, behaviour changes, LOC, and rapid HR
Signs of hyperglycemia?
Mental status change, fatigue, weakness, dry skin, blurry vision, vomiting, fruity breath, abdominal cramps, dehydration, increased WOB, weight loss, increased hunger/thirst, increased UO
Recommended ranges for kids/teens with T1D for A1C, fasting glucose, and 2 hrs post glucose test?
A1C- <7.5%
Fasting glucose 4-8 mmol/L
2 hrs post glucose test 5-10 mmol/L
What is insulin?
Anabolic hormone made in beta cells of the pancreas. Allows cells of body to store carbs. It alters the permeability of cell membranes allowing the entrance of glucose.
Insulin pumps? disadvantage
Allow for continuous subcutaneous insulin infusion, helps maintain blood glucose control, decreases A1C, reduced injection numbers, allows kids to eat without adherence to a schedule, and it more closely stimulates normal pancreatic functions. Pumps are now free for kids/adults.
Disadvantage- sometimes it doesn’t work accurately if phone gets too hot/cold to track properly
Treatment for DKA vs hypoglycemia?
DKA- ABCs, IV fluids, electrolyte replacement, insulin therapy using a pump should be stopped
Hypo- ABCs, short term treatment with IV bolus of dextrose, after bolus give IV infusion
Nursing interventions for diabetes?
Optimize normal growth/devlopement, promote optimal glucose regulation, assess for S+S of hypo/hyperglycemia, prevent long term complications, and document hx of events (onset, triggers, exercise, stress, dietary intake)
Nursing interventions regarding teaching?
Teach insulin action/administration, BG and ketone testing, nutrition therapy, exercise, prevention/detection/treatment of hypo., managment and prevention of DKA
