Lecture Flashcards by Sasha Bonney

4 things to remember with diabetes

Diabetes care team: members and roles
Diabetes basics
Components of diabetes care plan
Helping patients cope with diabetes

How well did you know this?

Not at all

Perfectly

A good diabetes care takes a team…

Patient
Physician : Primary Care Physician , Endocrinologist
Nurse (RN, NP, LPN)
Physician assistant
Medical assistant
Other office staff members
Family and friends
Certified diabetes educator
Registered dietitian
Ophthalmologist
Foot doctor
Pharmacist

How well did you know this?

Not at all

Perfectly

beta cells of pancreas produce no insulin

Type 1:

How well did you know this?

Not at all

Perfectly

beta cells produce insufficient insulin and body does not use insulin effectively

Type 2:

How well did you know this?

Not at all

Perfectly

diabetes diagnosed during pregnancy

Gestational

How well did you know this?

Not at all

Perfectly

general category that includes diabetic related to other causes (eg. genetic disorder or pancreatic disease)

other forms of diabetes

How well did you know this?

Not at all

Perfectly

Carbohydrates are metabolized into glucose during digestion

Glucose enters bloodstream

Rising blood glucose level causes beta cells in the pancreas to release insulin

Insulin moves glucose from blood into the cells, where it is used for engery

Carbohydrates increase blood glucose levels; insulin decreases blood glucose levels

How Food Turns into Energy:

How well did you know this?

Not at all

Perfectly

________ makes little or no insulin or the body cannot use the insulin that is in the body

Pancreas

How well did you know this?

Not at all

Perfectly

____ can’t get in the cell so it stays in the blood causing hypoglycemia

glucose

How well did you know this?

Not at all

Perfectly

Glucose can’t get into cells, so it stays in the

_______

blood

How well did you know this?

Not at all

Perfectly

Blood glucose levels increase, resulting in_________

hyperglycemia

How well did you know this?

Not at all

Perfectly

Family history of diabetes
High-risk ethnic population
Excessive body weight
High blood pressure
Physical inactivity

Risk Factors.. Type 2 Diabetes

How well did you know this?

Not at all

Perfectly

A1C 6.5% or higher: A1C: over a 3 month span

Fasting blood sugar 126 mg/dL or higher

2-hour blood glucose 200mg.dL or higher during oral glucose tolerance test

Classic: symptoms of high blood sugar or hyperglycemia crisis and blood sugar over 200 or higher on a random blood glucose test

Criteria for Diagnosis of Diabetes…

How well did you know this?

Not at all

Perfectly

A1C 5.1

prediabetes

How well did you know this?

Not at all

Perfectly

Urinating often 
Being thirsty or hungry more often than usual
Unusual weight loss
Tired more often than usual
Numb or tingling hands or feet
Cuts or bruises slow to heal
Blurry vision
Irritability

Signs and Symptoms:

of diabetes

How well did you know this?

Not at all

Perfectly

Patients need to understand:
The basics of diabetes

How to incorporate a meal plan into their lifestyle

How to incorporate physical activity into their lifestyle

How to take medicines

How to check their blood sugar

How to prevent, detect and manage diabetes-related problems

What strategies they can use to make health-related changes

How to deal with psychosocial issues (depression can cause diabetes or diabetes can cause depression

Developing a Diabetes Care Plan:

How well did you know this?

Not at all

Perfectly

Help patients to understand that they need to …

want a variety of healthy foods

eat meals and snacks at regular times

check food labels for calories, CHO, fat, sodium, cholesterol, protein, and fiber

watch portion sizes, especially of CHO foods.

The Basics of a Meal Plan…

How well did you know this?

Not at all

Perfectly

Motivate patient by informing them about the benefits

-> Improved blood glucose control
->Reduced risk of CV disease
-> Weight loss
-> Improved well being

Provide a physical activity prescription

-> At least 150 minutes (2.5 hours) per week of moderate-intensity aerobic activity
-> In absence of contraindications, 2 session per week of resistance exercise

The basics of physical activity plan…

How well did you know this?

Not at all

Perfectly

Check blood sugar before and at regular intervals during activity
Wear or carry medical ID
Carry food or meals
Check you feet
A1C
Home monitoring of blood sugar
Checking both A1C and blood sugar helps assess diabetes control
Higher the A1C more related to fasting
Over 9% is more post meal

Checkinging Both A1C and Blood Sugar is Important…

How well did you know this?

Not at all

Perfectly

Reflects average blood sugar for the past few months

If at goal they would check it 2 a year

AIC

How well did you know this?

Not at all

Perfectly

Provides instant feedback or current blood sugar level

home glucose monitoring

How well did you know this?

Not at all

Perfectly

when do we check blood sugars

Study These Flashcards

At bedtime and after
waking up

Before meals

1 to 2 hours after meals

In the middle of the night

Advise patient to track readings in a blood sugar diary

What Are the Goals for Blood Sugar and A1C?

Study These Flashcards

Blood glucose parameters

->A1C
->Preprandial glucose

What Are the ABC’s?

Study These Flashcards

A: A1C
B: Blood glucose
C:Cholesterol

A Sample Diabetes Care Schedule Every 3 months:

Regular office visit A1 C test ( if blood sugar is not stable) Check: Blood pressure, Weight, Feet

A Sample Diabetes Care Schedule Every 6 months:

A1C blood sugar is stable Dental exam

A Sample Diabetes Care Schedule Every year:

Physical Exam Comprehensive foot exam Check: Lipid profile, Kidneys, Eyes Flu shot/ pneumonia shots

Teaching Patient to Recognize Signs and Symptoms of High Blood Sugar (3)

1. Thirst or hunger 2. Passing more urine than usual 3. Feeling tired

Check blood sugar

Following meal, physical activity and medicine plans Call doctor or nurse if blood sugar is high and they don't know why Note high blood sugar readings in diary along with factors that may have contributed so that the can discuss missed the rest of this slide

causes of Hypoglycemia

Too little food or CHO Skipping or delaying meals Being more active than usual Taking too much insulin

signs and symptoms of hypoglycemia

``` Hunger Anger/irritable Nausea Lightheadedness Shakiness Tiredness Clammy/sweaty pale skin ```

Rule of 15

Eat or drink something with 15 grams of carbohydrates, such as: - -> 0.5 cup of regular juice (4 ounces) - -> 0.5 cup of regular soda - -> Candy like pack of skittles: 5 to 6 hard candies - -> 3 or 4 glucose tabs Check blood sugar again 15 min If blood sugar is still low, eat or drink another 15 grams of CHO

tell you patient when they should be checking their

blood sugars and urine ketones

Advice patient to stay motivated they do not need to be perfect help them to identify obstacles that may be preventing them from taking the best possible care of themselves Advise them to make sure that they have support Encourage them to stay in close touch with the diabetes care team.

Helping Patients Cope with Diabetes Burnout

Hoffman said: Know what lab values and test values for diabetes: go with ADA recommendation

so i will add this once i find it

Why meals matter in diabetes

``` Be a part of diabetes care plan Blood sugar is affected by What we eat How much we eat When we eat ```

Your meal plan should consider

Culture Lifestyle Food likes and dislikes Budget

80/20 rule

eat healthy 80% of the time; other 20% they can eat what they want

Carbohydrate counting

more flexible meal plan

It's important to… Eat at regular times Match amount eaten with activity level Count carbohydrates (carbs)

Planning Healthy Meals

``` Lots of vegetables and fruits Whole-grain foods Fish 2 to 3 times a week Lean cuts of beef and pork Non fat dairy products More liquid fats than solid fats (Limit grantinitie) ```

healthy food choices

One of the main components of meals The main kind of food that raises blood sugar levels Simple (sugar) or complex (starchy foods)

Carbohydrates

The 3 Main Types of Carbohydrates

Starches (or complex carbs): fructose, fruit, lactose, milk Sugars (simple carbohydrates) : honey, agave nectar, Fiber *****All 3 types raise blood sugar, but they do so at different rates

Foods that contain the most carbs

``` Starches (for example, bread) Starchy vegetables Fruits and fruit juices Milk and yogurt Sweets and other sugary foods ```

Foods that don’t contain cards

Meats and eggs | Fats and oils

Lack enzymes to break down fiber → should eat 25 to 30 a day Adding fiber to the diet should be gradual

sugars

Check serving size, information on the label is based on the serving size See how many grams of carb are in each serving Decide whether the food fits in the plan. Don’t forget to count the carbs in your dinks

find something that works for you reading the label

Calorie counting: what are you looking at on the label (6)

``` Harmful fats: Saturated fat Trans fat Healthier fats Monosaccharides Polyunsaturated fat ```

Eating out: Tips that can help

Split dinner in half | If you don’t know what's in a dish, ask…..

The 10 diabetes superfoods some reason only have 5 written.. so five me 5

``` Beans Dark green leafy veges Citrus fruits Sweet potatoes Berries ```

Cornerstones 4 care:

Patient support program

60-65g per day of carbs

Males

45-60g per day of carbs

Women

Lecture Flashcards

(53 cards)