Lecture 7 Flashcards
(23 cards)
What constitutes DM?
Hgb A1c >6.5%
Fasting plasma glucose >126mg/dL
2-hour OGTT >200mg/dL
Random plasma glucose >200mg/dL (if in hyperglycemic crisis)
What percentage of DM is type 1? type 2?
10%
90%
What differentiates type 1 and type 2 DM?
Type 1 can’t make insulin due to destruction of B-cells
Type 2 is insulin resistant
What is type 3 DM?
Not a true DM
Development of insulin resistance and insufficiency from the development of Alzheimer’s
What lab values reflect pre diabetes?
Fasting glucose 100-125
OGTT 140-199 (impaired glucose tolerance)
HbA1c 5.7-6.4%
What is gestational DM?
Diabetes during pregnancy that resolves after birth, because pregnant women get insulin resistance
What are the goals of managing DM or preDM?
Maintain normal glcuose
Prevent/reverse lipid abnormalities
Prevent/delay complications of prolonged hyperglycemia
What are the goals of managing DM or preDM?
Maintain normal glcuose
Prevent/reverse lipid abnormalities
Prevent/delay complications of prolonged hyperglycemia
What are types of management of glycemic control in DM pts?
Type 1: must receive insulin, but benefits from lifestyle modificaitons
Type 2: lifestyle modifications and can be treated solely off of it
What are types of management of glycemic control in DM pts?
Type 1: must receive insulin, but benefits from lifestyle modificaitons
Type 2: lifestyle modifications and can be treated solely off of it
What are general interventions for DM management?
Healthy eating
Exercise
Sleep
No tobacco
Weight loss(especially if truncoabdominal)
What macro diet composition should a DM pt eat?
Carbs/high fiber: about 30g/day, minimal processed, plant-based
Fats: mono/polyunsaturated fats
Protein: 0.8g/kg/day
What macro diet composition should a DM pt eat?
Carbs/high fiber: about 30g/day, minimal processed, plant-based
Fats: mono/polyunsaturated fats
Protein: 0.8g/kg/day
Whats the best diet for DM pts?
Keto diet, however the best one is the one the pt can adhere to
What should you consider for each pts diet?
Comorbidites and weight status
Dietary preferences
Access to food
Ability to prepare meals at home
Generally, should DM pts do diet wise?
Eat healthy foods
What resources can pts use to develop a meal plan?
Plate method
Diabetic recipes
Diet exchange lists(helpful for counting carbs)
What are the benefits on consuming nuts?
Reduced CVD risk
Preventing DM
Filling, low in carbs
Rich in fiber, MUFAs, PUFAs
What are some not-benefits on consuming nuts?
Does NOT improve glycemic control with those already DM
Could increase overall caloric intake
Why is ETOH bad for DM?
Interferes with hepatic gluconeogenesis
Risk of hypoglycemia when consumed w/o food
Elevated TG and worse glucose control
What has the highest risk of hepatic gluconeogensis?
Drinking ETOH while taking insulin or drugs that stimulate insulin release
How does caffeine affect DM?
Higher plasma glucose
Higher insulin lvls
Decreased insulin sensitivity in T2DM
What are benefits to caffeine?
Long-term abstinence from caffeine lowers HbA1c
Lowers risk of DM(however also shown in decaf coffee drinkers and tea drinkers)
